Transcript of High Deductible Medicare Plan G Video

Did you know that there is a high deductible Plan G? Some beneficiaries find this as a surprise since most insurance carriers do not advertise it. But how does it compare to the ever-popular Medigap Plan G? Hi, there. I'm Danielle Roberts, co-founder here at Boomer Benefits. And in this video, I will compare Medigap Plan G versus high deductible Plan G, so you can decide if either of these plans is the one for you. I'm also going to give you a special Boomer Benefits pro tip in this video that is specific to high deductible Plan G, and that you probably won't hear elsewhere. Don't forget to hit that subscribe button if you find this video helpful, and want more up-to-date Medicare info.

First, let's discuss how a Medigap plan works. Original Medicare Parts A and B have gaps and do not fully cover all of your medical services. The biggest gap that you'll need coverage for is your Part B co-insurance, except for some preventive care services, which are covered at 100%, most outpatient care services such as doctor visits, outpatient surgeries, even chemotherapy, are covered only 80% by Medicare. You are responsible for the Part B deductible and a co-insurance of 20% after that, that 20% co-insurance can be quite hefty for expensive treatments, and there's no maximum out-of-pocket limit. You'll pay that forever unless you purchase a Medigap policy to cover that 20% for you. Medigap plans work alongside original Medicare, and pay as secondary coverage. If a healthcare provider accepts Medicare, they will accept your Medigap plan no matter which Medigap plan, or which insurance company you choose. Since Medicare does not have network restrictions, neither do Medigap plans. You can visit any doctor in the United States that accepts original Medicare, and your Medigap plan will pay exactly what it's supposed to. There are 10 standardized Medigap plans, and the Supplement Plan G is currently the most popular plan. Let's look at exactly what Medigap plan G covers.

Since Plan F was phased out for anyone new to Medicare as of January 1st, 2020, Plan G has become the most popular plan with the most comprehensive and predictable healthcare costs throughout the year. And here's what I mean by that. Plan G covers your hospital deductible, your Part A co-insurance, your skilled nursing co-insurance, hospice, Part B excess charges, your Part B co-insurance, and more. That means your only out-of-pocket expense for Medicare-approved services for the whole year is the annual Part B deductible. The Part B deductible in 2023 is $226. You'll pay that when Medicare processes your first outpatient claim of the year. Afterward, your approved Part B services are covered fully for the rest of the year. This means zero out-of-pocket for Part B doctor visits and lab work, but also for more expensive things like diagnostic imaging, and ambulance rides, outpatient surgeries, radiation, chemotherapy, dialysis.

We have thousands of clients who enjoy peace of mind from their Medigap Plan G and its comprehensive coverage. They don't have to worry about frequent bills or what they need to pay and what they don't. It's pretty simple with Plan G. Some beneficiaries, however, have the financial means to cover a higher deductible than just the ordinary small Part B deductible. The high deductible Plan G has surfaced as a cost-effective option for people who are okay with covering some out-of-pocket costs, but they wanna stop loss or limit on those expenses at some point. So, how does this plan work exactly?

High deductible Plan G covers the exact same healthcare services as regular Plan G, but you simply must meet a higher deductible. That deductible is $2,700 in 2023. Let me break it down for you. Medicare will cover its share of Part A and B healthcare services just like it does on any other Medigap plan. Then you pay your share up until you have satisfied the $2,700 high deductible requirement. Any amount you pay toward the Part A and B deductibles counts towards satisfying your high deductible. Any co-pays or co-insurance that you spend also count toward the deductible. If you have a year of heavy healthcare spending, and you meet the $2,700 deductible during the year, then the plan will begin to cover all approved services in full for the rest of the year just like it does with regular Medigap Plan G. Medicare increases the deductible a small amount each year as healthcare costs inflate, and Medicare will usually announce the new deductible for the upcoming year in the fall. So, the difference between the two plans is that you have more out-of-pocket costs with the high deductible Plan G compared to regular Plan G. Now, let's talk about why someone would choose the high deductible version over the standard Plan G.

With such a large deductible, I cannot say that this plan is always my first recommendation. But in certain situations, this plan may be more cost-effective of an option than the alternative original Medicare alone. High deductible plans are popular among cost-conscious consumers who either don't have the budget for a regular Plan G, but are also aware of the potential for massive out-of-pocket costs with original Medicare on its own, or with those who don't go to the doctor often and are pretty healthy right now, but also know that they'd have some money set aside to meet a high deductible if they encounter some unexpected medical needs. The best thing you can do here is some simple math. A high deductible Plan G means lower premiums. That's the trade-off. So, would the savings from that lower premium be worth it for you even knowing that you could spend an additional $2,700 out of pocket, or would you rather pay a higher monthly premium, and not have to worry about paying out-of-pocket costs throughout the year?

The choice, of course, is up to you. Here's my special pro tip. Enrolling in a high deductible Plan G also means paying close attention to your claims, and the amount you pay during the year. Medicare beneficiaries routinely get bills for services they don't actually owe when doctors' offices miscode things like orders for lab work. This is the exact reason we employ such a large client service team here at Boomer Benefits. So, people who buy their Medigap plans from us can call us for help whenever they receive a summary notice from Medicare or a bill that they were not expecting. So, if you decide to enroll in high-deductible Plan G, be sure to sign up for a free account at mymedicare.gov. You'll need to use this account to monitor your claims every month as they are processed by Medicare instead of waiting for the Medicare summary notice in the mail that only comes quarterly.

This way you can stay on top of your claims, and immediately spot one that doesn't sound right, or that Medicare flat-out denies, so that you can take quick action to resolve it. Reviewing your claims monthly will also help you stay informed about how much of that high deductible you have satisfied, and how much you have left to go before you get to 100% coverage. If you aren't sure which Medigap Plan G route is the right one for you, you can rest easy knowing the agents here at Boomer Benefits will get to know your situation, and give you their best recommendation for your coverage. With all that said, I also want to mention that Medigap insurance companies get to choose which plans they sell to beneficiaries, and so, not every carrier will offer high deductible Plan G, and premium prices will vary with the ones who do. For quotes in your zip code, give us a call. We can shop and compare the plans in your area so that you can make an informed decision on your future healthcare. And if you want to learn about regular Medigap Plan G, watch this video next.