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Old 02-18-2020, 11:55 AM
 
3,563 posts, read 2,997,946 times
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Shopping for a plan for my brother. He is 65 years old, has signed-up for Parts A, B and D and now we need to find him a supplemental plan. He has Parkinson's, still in the fairly early stages. Right now, he is doing OK and is still active and working part-time, but I know that down the line, the Parkinson's will worsen.

We're in NJ. United Healthcare (which I *think* is community-rated, but I can't find on their website where they say that) is the plan we're looking at:

Plan G: $155.68/mo
Plan N: $127.04/mo

The big difference I can see between the two plans is (a) no coverage for Excess Charges with Plan N, and (b) an office visit co-pay with Plan N.

Given his health history and likely future need of more medical services, which plan would you go with? My husband has Medicare for years and we have never encountered Excess Charges anywhere. But if you have had experience getting billed for those charges, I would like to hear about it. We can handle an office visit co-pay without a problem.



Thank you to anyone who responds!
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Old 02-18-2020, 01:01 PM
 
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This has been discussed. The most important difference is does the doctor or hospital accept assignment?
https://www.city-data.com/forum/heal...missing-2.html
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Old 02-19-2020, 08:26 AM
 
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all i can advise is that i picked g last year and right after had 3 heart issues 3 days in the hospital and 2 procedures and 3 er trips and have not paid a cent with UHC G

you never know what and when something happens - fortunately we can afford G

My wife just signed up for G this month

i like the fact i can pick the hospital pick a doctor pick a specialist anytime anywhere in the US
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Old 02-19-2020, 08:44 AM
 
209 posts, read 118,785 times
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This is mostly a personal comfort thing, I think. Before I had Medicare I could only afford (even with income-based tax credits) a very high deductible insurance plan. I didn't have any medical needs so did not in fact ever use my insurance at all. It was expensive, I paid and paid and paid those premiums and only got a few "annual" wellness visits (like very 5 years of so) out of the policy. First, I know I am VERY fortunate to not have needed that insurance, but I also from time to time thought, 'I should go see a doc about this' or 'maybe I should have a doctor check this out' and I never went because I knew with that high deductible that financially I'd be stuck for all the costs. It meant I never went to the doctor at all. That turned out to be just fine, but it was a frustrating reality that I was paying for something but didn't feel free to see a doctor if I was worried about something.

When I had to choose between Plan G and Plan N in a Medigap plan (I also have UHC) the difference in monthly premium was not enough to make me go back to a high deductible plan. I wanted to just be able to go to a doctor without feeling pressured by a multi-thousand dollar deductible. I wanted to feel like I was getting something for those monthly premiums other than coverage for catastrophic (or at least 'very serious') issues.

All that said, 3 months after I got my Plan G policy I was out hiking and I tripped and broke my leg. Everything after the very small Medicare deductible was totally covered including physical therapy. I was very glad to have it. Could we have managed with having to pay for it all (the medical care and PT didn't all total come up to the Plan N deductible)? Sure we could have, but I was really relieved to finally after all those years of high-deductible coverage to be able to just get it treated without that psychological pressure of the deductible.

Given my general good health I probably, being totally practical should have gotten a Plan N but I'm going to keep my G even though I'm sure I could get underwritten to drop down to N if I wanted to. The deductible for N isn't that bad, so it's a great option if the deductible isn't the kind of mental or financial barrier for you and your brother as it was for me.
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Old 02-19-2020, 11:04 AM
 
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Quote:
Originally Posted by Jessie Mitchell View Post
This is mostly a personal comfort thing, I think. Before I had Medicare I could only afford (even with income-based tax credits) a very high deductible insurance plan. I didn't have any medical needs so did not in fact ever use my insurance at all. It was expensive, I paid and paid and paid those premiums and only got a few "annual" wellness visits (like very 5 years of so) out of the policy. First, I know I am VERY fortunate to not have needed that insurance, but I also from time to time thought, 'I should go see a doc about this' or 'maybe I should have a doctor check this out' and I never went because I knew with that high deductible that financially I'd be stuck for all the costs. It meant I never went to the doctor at all. That turned out to be just fine, but it was a frustrating reality that I was paying for something but didn't feel free to see a doctor if I was worried about something.

When I had to choose between Plan G and Plan N in a Medigap plan (I also have UHC) the difference in monthly premium was not enough to make me go back to a high deductible plan. I wanted to just be able to go to a doctor without feeling pressured by a multi-thousand dollar deductible. I wanted to feel like I was getting something for those monthly premiums other than coverage for catastrophic (or at least 'very serious') issues.

All that said, 3 months after I got my Plan G policy I was out hiking and I tripped and broke my leg. Everything after the very small Medicare deductible was totally covered including physical therapy. I was very glad to have it. Could we have managed with having to pay for it all (the medical care and PT didn't all total come up to the Plan N deductible)? Sure we could have, but I was really relieved to finally after all those years of high-deductible coverage to be able to just get it treated without that psychological pressure of the deductible.

Given my general good health I probably, being totally practical should have gotten a Plan N but I'm going to keep my G even though I'm sure I could get underwritten to drop down to N if I wanted to. The deductible for N isn't that bad, so it's a great option if the deductible isn't the kind of mental or financial barrier for you and your brother as it was for me.
You don’t pay a copay for physical therapy under Plan N. And plan N is not a high deductible plan either. There isn’t a big difference between plan N and Plan G. Like I said, only if your doctor or hospital doesn’t accept assignment. You sound confused by the plan N deductible, it’s the same deductible as plan G.
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Old 02-19-2020, 01:15 PM
 
Location: Wisconsin
23,573 posts, read 50,242,219 times
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Quote:
Originally Posted by Jessie Mitchell View Post
When I had to choose between Plan G and Plan N in a Medigap plan (I also have UHC) the difference in monthly premium was not enough to make me go back to a high deductible plan.

Given my general good health I probably, being totally practical should have gotten a Plan N but I'm going to keep my G even though I'm sure I could get underwritten to drop down to N if I wanted to. The deductible for N isn't that bad,
UHC will downgrade you to an N without underwriting, if you wish.

Know that there is no significant deductible for Plan N. Both N and G require payment of $198 Part B deductible before Medicare will pay for Part B services.

The lack of coverage for excess charges seems to be the major reason why many choose Plan G over Plan N. Other than that, there is no significant difference in coverage.

The only difference between Plan G and Plan N is N doesn't cover excess charges for the rare nonparticipating Medicare provider and requires no more than a $20 copay for Dr. office visit (not a dealbreaker) and $50 for ER visit if one is not admitted as an inpatient.

Those here who have N and have encountered very serious issues such as ongoing cancer treatment find Plan N more than meets their needs with negligible out-of-pocket charges - i.e., $20 copay for office visits and $198 Part B deductible.

Fyi - there are high-deductible Medigaps but, those, too, are unlike insurance you've had the past. Under the high-deductible Medigaps, Medicare continues to pay its 80%, you pay the remaining 20% (usually very tiny amounts) until the $2,340 deductible is met. After that, the high-deductible Medigap pays 100%. So, even had you chosen a high-deductible Medigap, your out-of-pockets for that broken leg probably wouldn't have amounted to much. Example - incur $4,000 in Medicare charges, you pay $800. Premiums for the high-deductible Medigaps are about one-third to one-half the cost of a full Medigap - usually in the $40-$75/mo. range depending on where you live.

Last edited by Ariadne22; 02-19-2020 at 01:32 PM..
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Old 02-19-2020, 02:38 PM
 
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Thank you to all who have responded! Rep points all around.
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Old 02-19-2020, 04:15 PM
 
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Lori,
Look up your doctors and hospitals that you will be using on the Medicare website. There it will tell you if the doctor or facility accepts assignment. If they do, than plan N is no different than Plan G, except for the small copay.
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Old 02-20-2020, 12:02 PM
 
Location: Las Cruces, NM
47 posts, read 82,820 times
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Another thing to consider that I have not seen mentioned in this thread is that Plan G is now going to be one of the three guaranteed issue plans.


So people moving into Medicare from an ex-employer's insurance or from an Advantage Plan that is being discontinued will be guaranteed acceptance into Plan G regardless of their health while Plan N still needs underwriting.


That means Plan G will very likely have a less healthy pool of people insured going forward which translates to more aggressive yearly rate hikes for Plan G.


And as mentioned by others, Jessie Mitchell's post above is absolutely incorrect and false regarding Plan N.
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Old 02-20-2020, 03:42 PM
 
1,616 posts, read 1,438,005 times
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If you read my linked post “What am I Missing” there is a video talking about Plan G being a guaranteed issue plan.
I did a lot of research before deciding on Plan N.
https://m.youtube.com/watch?v=odzQ7y36dKI

Last edited by organic_donna; 02-20-2020 at 03:52 PM..
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