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Medicare supplement

Why Choose a High Deductible Medicare Supplement Plan?

“Ask the Experts TV” asked about the Medicare Supplement High Deductible Plan G. Click and watch the video from the February 17 livestream interview here:

reason 1: Lower your MAXIMUM annual out-of-pocket

The annual maximum out-of-pocket is the amount you could potentially pay in medical co-pays after which your plan covers 100%.

Most Medicare Advantage plans include an annual maximum out-of-pocket amount for medical co-pays, ranging from $6,000 to $9,250. With a Medicare Supplement High Deductible plan, your maximum out-of-pocket is $2,950.

So, you would be lowering the amount you would pay before your plan covers 100% – reducing your potential exposure by thousands of dollars.

reason 2: Lower YOUR COMBINED annual premium and deductible costs

Let’s do some math:

Traditional Plan G:
$4800 annual premium (avg. $400/month) check your county
+ $283 Part B deductible
$5083

High Deductible G
$900 annual premium (avg $75/month) check your county
+$2950 maximum (Parts A and B deductible and 20% cost share)
$3850

Smart Tip: Set aside $250 saved in monthly premium payment for the $2950 to cover the Parts A and B deductible and 20% share. Depending on your medical claims you should have money left over on December 31.

NY STATE RATES APPLICATION
IS this Like with other deductibles and I pay the first $2,950 in medical bills?

No. After you pay the Parts A and B deductibles, Medicare pays its share of claims (usually 80%) and you pay the 20%. Once your deductible and 20% share reaches $2,950, then your supplement plan pays 100% for the rest of the year. Think of it as a $2,950 cap on your out of pocket costs.

2026
Part A deductible per period $1,736
+ Part B deductible $283
+ Part B co-share 20%
= Maximum Out of Pocket $2,950

Will hospitals and doctors will accept my High Deductible plan?

Yes, if your provider participates in Original Medicare for your primary coverage, they will accept your Medigap supplemental coverage; including plans with deductibles like Plans G, N and High Deductible. This way you have access to the nationwide network of doctors and hospitals participating in Original Medicare.

How does a High Deductible compare to Medicare Advantage plan?
      •  Medicare Advantage plans include a limit on out-of-pocket costs; ranging from $6,000 to $9,250 per year for in-network medical services. (Up to $13,900 for in and out of network)  Compare to a Medicare Supplement High Deductible plan with the annual maximum out-of-pocket cost capped at $2,950
      • Medicare Advantage plans manage your Medicare benefits through contracts with in-network providers and hospitals. As mentioned above, any provider accepting Original Medicare for your primary coverage will accept your supplement coverage – eliminating the “is my doctor in-network with my plan” questions.
      • Most Medicare Advantage plans, including those with a low monthly premium, include Part D prescription drug coverage. With Medicare Supplement, you will need to obtain separate creditable Part D drug coverage. during an Annual Enrollment, Open Enrollment or Special Enrollment  Period. VA drug benefits are considered creditable coverage.
      • Many Medicare Advantage plans include features like dental allowance, fitness membership, eyewear and hearing aid benefits not available with Original Medicare.
Globe Life of New York
 Download 3 separate documents↓↓↓
Globe Life application Form 1 sign page 3 (and 5 for EFT)
Globe Life application Form 2 sign page 1
Globe Life application Form 3 sign page 1
About Globe Life Insurance of NY

Our agents are authorized to represent the Globe Life Insurance Company and Humana Medicare Supplement High Deductible Plans. Please call us at (518) 346-2115 or send any agent a quick note with your questions:

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Categories
Medicare A & B

Switching Medicare Supplement (Medigap) policies

Reasons Why New Yorkers Switch Their Medicare Supplement (Medigap) Policies:

As a reminder, Medicare Supplement, also known as Medigap, are policies designed primarily to supplement (or fill the gap) Medicare benefits. You simply present your red, white and blue Medicare card to the provider or facility along with the Supplement / Medigap card to help with out-of-pocket costs; such as deductible and co-insurance amounts with Original Medicare Part A and Part B.

Currently, there are 10 standardized Medigap plans, each represented by a letter (A, B, C, D, F, G, K, L, M, N; both Plans F and G offer a high-deductible version). These plans are available in most states. While premiums will vary from state to state the standardized benefits of each lettered plan remain the same despite the insurance company or location. For example, Plan F benefits are the same in Florida as they are in New York.

Q: Is there an Annual / Open Enrollment Period?

Most people buy their Medicare Supplement / Medigap policy during the six month period after they first enroll in Medicare. After that, in many states, Medigap insurance companies are generally allowed to use medical underwriting to decide whether to accept your application and how much to charge you for the Medigap policy.

Q: So How Do New York State Residents Have More Protection?

New York State laws and regulations continue this open enrollment period. A person enrolled in Medicare Parts A and B may purchase a Medigap policy at any time. Insurers may not consider an applicant’s health status, claims experience, or age. Laws in New York also prohibit insurers from basing Medigap premiums on age and charging a higher premium as they grow older. Also,

Q: But What About Pre-Existing Conditions; Are They Covered?

Medigap insurers may impose up to a six-month waiting period to be covered for any preexisting conditions a person may have. Federal law and New York State regulation define a preexisting condition as any condition for which medical advice was given or treatment was recommended by or received from a physician within six months before the effective date of coverage.
Under New York State regulation, the waiting period may be either reduced or waived entirely, depending upon whether an individual has had previous health insurance coverage. Medigap insurers are required to reduce the preexisting condition waiting period by the number of days an individual was covered under some form of “creditable” coverage so long as there were no breaks in coverage of more than 63 calendar days. Translation: If you are switching from a “creditable” plan that you have held consecutively for six months, New York regulation requires the new Medicare Supplement / Medigap plan to reduce or waive the six month pre-existing condition waiting period.

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