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Have Medicare High Deductible Plan F and have had since I became 65. Never used it. The initial deductible is $2180 and then this plan pays 100% of the excess charges. AS a healthy older person, made no sense to pay a higher premium for non-use. My monthly premium is $55.00. Medicare will discontinue this plan for new enrollees, but grandfather those of us who remain. I found this to work for both my situation and my husband's. Forces us to not run to the doctor with every ache and pain and also to make sure we have the deductibles safely tucked away for the time when we need to be hospitalized. Wouldn't work for everyone, I realize. Have learned a great deal from all of you. Thank you.
Good synopsis of the advantage of a high-deductible plan. For new Medicare enrollees, high-deductible F will be replaced with high-deductible G. Part B deductible will be factored into the current $2,300 deductible, for total exposure of $2,485. As yet, we don't know the 2020 deductibles for Part B or the high-deductible plan.
Ariadne22,
I can’t thank you enough for your valuable help. I would not have understood much of anything regarding medigap plans, and because of you, I was able to make an informed decision. I would not have considered a plan N before reading your posts, and now I understand issued age, attained age and community ratings.
Thank you so much,
Donna
Thank you. We all learn from each other around here. Your research identified Transamerica as an option for those first enrolling in Medicare considering issue-age policies. In your area, TA's policies are very competitively priced. Transamerica has not filed with the OIC in WI. Generally, in my state, issue-age policies are too expensive - starting at $202/mo. for Plan G/N v. $128 for UHC. So, if one wants to control premium increases, in WI UHC community-rated is the next best long-term choice.
Last edited by Ariadne22; 10-07-2019 at 04:13 PM..
One more thing....if I went to Mayo Clinic for surgery, the only excess fees would be for my doctors appointments and any outpatient procedures. So the surgery and hospital stay would be paid for on Plan N. My mother went to Mayo to have a pituitary tumor removed. Before the surgery they did a lot of tests to try and find a primary tumor that might have metastasized. They did a mammogram, lung scan, etc., would those tests be covered under Plan N?
Also, I read if the hospital accepts assignment, all of their doctors have to accept assignment too.
I have 6 months to change my mind, so still questioning some things.
One more thing....if I went to Mayo Clinic for surgery, the only excess fees would be for my doctors appointments and any outpatient procedures. So the surgery and hospital stay would be paid for on Plan N. My mother went to Mayo to have a pituitary tumor removed. Before the surgery they did a lot of tests to try and find a primary tumor that might have metastasized. They did a mammogram, lung scan, etc., would those tests be covered under Plan N?
Also, I read if the hospital accepts assignment, all of their doctors have to accept assignment too.
Plan N is never a decider on what services it will or won't pay. Plan N will only pay its share of a Medicare-approved charge. If doctors consider a Medicare-allowed service medically necessary, Medicare will pay. If Medicare pays, so will Plan N pay its share.
Mayo in FL and AZ remain nonparticipating providers and are no longer accepting new Medicare patients. Both FL and AZ clinics have waiting lists for Medicare patients. Even its Medallion concierge program ($6k/person, $10k/couple) is closed - and has a waiting list as well. I don't know if a Medicare patient traveling to either of these Mayos under referral from another doctor would be an exception.
Mayo in Rochester, if I am understanding its website correctly, is a now a participating provider for all Medicare patients whether in or out-of-state. This is a recent change. So, you should be OK there with Plan N - assuming Mayo in Rochester is still seeing new Medicare patients. You might call and ask. If so, as a participating provider, your Plan N will cover all Medicare-approved services.
MDAnderson in TX, another well-known cancer treatment center, remains a nonparticipating provider and can charge excess fees. Afaik, it is still seeing Medicare patients.
Last edited by Ariadne22; 10-07-2019 at 09:20 PM..
Let me rephrase my question.
Let’s say I am diagnosed with a serious illness and go to a hospital that accepts Medicare patients but does not accept assignment. I understand that my excessive charges only apply to part B, which are doctors visits and outpatient surgery. So do I assume the surgery and all surgeons fees are covered as well as my hospital stay. Would I only be paying for follow up visits on Plan N? How would Plan G differ?
I am starting to second guess Plan N, even though my research concluded it was the best plan from a cost standpoint.
Last edited by organic_donna; 10-08-2019 at 10:11 AM..
Let’s say I am diagnosed with a serious illness and go to a hospital that accepts Medicare patients but does not accept assignment. I understand that my excessive charges only apply to part B, which are doctors visits and outpatient surgery. So do I assume the surgery and all surgeons fees are covered as well as my hospital stay. Would I only be paying for follow up visits on Plan N? How would Plan G differ?
Mayo hospitals in FL and AZ are nonparticipating providers and, afaik, allowed to charge the excess/limiting fee for its hospital as well as physician charges.
Quote:
Mayo Clinic has chosen to be a nonparticipating facilityin Arizona and Florida, and thus does not accept assignment from Medicare Part B for out-of-state residents at its campuses in Arizona or Florida. Nonparticipating means that Mayo Clinic does not accept the Medicare approved amount as payment in full.
If you have found information that states hospitals are excluded from the nonparticipating provider designation and are not allowed to charge excess/limiting fees, please post.
Further, again afaik, and depending on the state, it is quite possible to have a hospital as a participating provider and one or more of its staff docs/surgeons/specialists nonparticipating. State and/or hospital rules prevail as to how that doc can bill. Again, if you've found more definitive information on this issue, please post.
An easier way around all of this is to purchase a high-deductible plan which will cover excess fees once the deductible is met. Lower premium for years - catastrophic coverage for all Medicare-allowed charges when you need it.
Last edited by Ariadne22; 10-08-2019 at 12:35 PM..
How interesting that Plan G would go up so high when all the talk has been focused how Plan F rates would go up due it no longer being available in 2020 and that the rates for Plan F will go up for those who still have it!?
Not sure what you mean by so high. Per other posters with community-rated UHC, their rates have been going up 10% a year for years - age-based and inflation. Once past age 77, expect 5%/year. Furthermore, F is not yet closed. We won't know for a year or two what impact closure of F has on the G rates, although, for sure, the rush to downgrade from F to G has put pressure on the G rate and insurance companies no doubt are raising G rates now in anticipation of the GI issue risk effective 1/2020.
I would be interested to hear from FL policyholders on their rate increases. FL mandates that all Medigaps sold be issue-age. Therefore, the increases should be less than 10%.
Last edited by Ariadne22; 10-08-2019 at 02:40 PM..
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How interesting that Plan G would go up so high when all the talk has been focused how Plan F rates would go up due it no longer being available in 2020 and that the rates for Plan F will go up for those who still have it!?
