Danielle Roberts, founding partner of Boomer Benefits, a Fort Worth–based insurance agency specializing in Medicare-related coverage. She is a Medicare Supplement Accredited Advisor. BoomerBenefits.com
Choosing your Medigap plan isn’t as daunting as it may seem. Only two of the 10 plans offered in 2021—G and N—tend to be worth considering. This supplemental insurance covers many costs that Medicare recipients otherwise would have to pay out of pocket. They are sold by private insurers, but only a limited selection of standardized plans is offered. In most states, those plans are identified by a letter ranging from A to N.
The most popular Medigap plan has long been plan F, which covers all of original Medicare’s copays, coinsurance and deductibles. Plan F was discontinued as of January 1, 2020, but remains open to anyone who was Medicare-eligible prior to that date.
What you need to know about Medigap plans as this year’s October 15 to December 7 open-enrollment window nears…
Plan F was popular for a reason, but now there’s a reason to steer clear. If you have original Medicare and Medigap plan F, you might never again face an unexpected out-of-pocket medical bill. But now that plan F is discontinued, its enrollees are likely to face large premiums. When the government discontinues a Medigap plan, its premiums tend to shoot up sharply over the years that follow. With no new young retirees allowed to join that plan, those insurers must increase premiums to remain profitable with the enrollees who remain…and if those enrollees have significant health problems, it might be difficult for them to switch Medigap plans. Insurers generally must accept anyone who applies for a Medigap plan during his/her initial six-month Medigap openenrollment period, but in most states, insurers can reject people who apply after that period. Rejection is likely if the applicant has an expensive medical condition. So it may be wiser to sign up for a Medigap plan that’s nearly as comprehensive as F but not discontinued.
Plan G is the new plan F. The difference is that G doesn’t cover the Medicare Part B deductible—$203/year in 2021. It is better to pay that relatively modest deductible than risk higher plan F premiums. Recent plan G quotes included $108/month in Texas or $250 in Florida.*
Plan N might save you money depending on your doctors. Plan N is a lot like plan G, but with lower premiums and a few modest out-of-pocket costs— up to a $20 copay for some office visits and a $50 copay for some ER visits. The other difference is that N doesn’t cover part B “excess charges”—if a health-care provider bills more than the Medicareapproved amount, plan G will pay the excess, but plan N won’t. $85/month in Texas…or $170/month in Florida.
High-deductible plan G is a good low-cost option. If you’re looking for a Medigap plan that does have low premiums, your best bet may be a “highdeductible” plan G, if it is available in your state. These provide the plan G coverage described above, but with an annual deductible—$2,370 in 2021. $32/month in Texas or $61/month in Florida.