I'm ENDING The Plan G vs Plan N Debate! 🏆

For many years, the top supplemental plan on the market that most people had was the plan F. But in 2020, Medicare changed all the rules. And now there's actually two top plans, the plan G and the plan N. And there's a lot of discussion and debate about which one of those is the best. So in this video, I'm going to discuss this topic and hopefully end that debate for good. All right, we're going to dive into the differences between the G and the N plan. But just before I do that, I'm going to talk first of all about what do these two plans have in common. Again, they are supplemental plans. So they are going to share some common characteristics. Number one, these plans have no provider networks, no provider networks whatsoever. In fact, whenever you have a supplemental plan, really any letter any company that you go with, you never have to worry about a physician or hospital taking them as long as that physician or hospital takes Medicare. In fact, we tell our clients, you only have to ask someone if they take XYZ plan N or ABC plan G, they don't have to ask because if that provider takes original Medicare A and B, they have to take your supplemental plan of choice, whatever letter, whatever company that you selected. So that's one of the beauties of all supplemental plans. We have no provider networks whatsoever. We call that an open access system go anywhere as long as that provider takes Medicare. Now, if we compare that to Medicare Advantage plans, they always have a network, either an HMO or PPO. So that's one of the beauties of all supplemental plans, including the G plan and the N plan. The second thing that they have is they have no pre authorizations, no pre authorizations. A pre authorization would be a health care service that your doctor said that you need. But you cannot get that service unless the insurance company agrees. Again, as I compare Medicare Advantage plans to these plans, Medicare Advantage plans about 70 to 72 percent of services will require pre authorization. That means doctor says, I recommend that we have this scan, this surgery, this knee replacement, hip replacement. And they make the recommendation. But that recommendation is given to the insurance company who makes a final determination. And that's a pre authorization. So the insurance company has to agree, has to approve of that before you get that service, or at least if you're going to get it and they're going to pay for some of it. OK, so that's a pre authorization. And again, when we have a supplemental plan, whether it's a G plan or N plan or any of the letters, you will not have to undergo pre authorizations by the insurance company. Because if Medicare says they'll cover something and doctor says that you need that end of story, no pre authorizations whatsoever with either one of those plans. Thirdly, all supplemental plans are permanent policies. They're permanent, which means it can never be canceled by the insurance company unless it's not payment of premium. So the point is, as long as you pay your premium, that supplemental plan is written for life, regardless of how old you become, regardless of how unhealthy you may become, and you have a lot of claims, that policy is yours, pay the premium. And frankly, whenever you go to a provider, and you pull out that A and B card and that supplemental card, the coverage is the same anywhere in the country, you never have to worry about that. And then also a feature of these plans are they're portable, portable, which means what? They're tied to you. Medicare Advantage plans are tied to a service area to a geographical location. Supplemental plans are tied to you. So if you live in Denver, Colorado, and you move to Miami, Florida, take that MedSupp plan with you. It's yours for life. Insurance company cannot cancel because you relocated. Alright, they're portable policies. And then another nice feature when we get a supplemental plan would be this, you get to choose your own drug plan, your own drug plan, we call those Part D plans. Why is that? Well, because you do have professionally administered medications covered by A and B in your supplemental plan. But for the meds that you take on your own blood pressure, cholesterol, insulin, those kinds of things, you get to choose your own plan. And so in most markets, there's anywhere from 15 to 25 different plans. So you get to pick the plan out based upon the medications that you take, and the pharmacy you want to go to. Unlike Advantage plans, they actually pick the plan out for you. And they embed that you have to take it whether it's good or bad doesn't matter. Okay, so the whole point is this, I want to make sure you know that all of these features are very, very important features of supplemental plans. And so G and N have all of these in common. Hey, if you found this video helpful, and you want to see more Medicare information just like it, then go below right below the video. And you can give us the thumbs up as well as subscribe to our channel. And every time I put a new video, which is about two every week, you'll be notified of that video. And others just like you who need this vital information will get it as well. Alright, now let's look at the differences. Okay, what are the differences? Well, first off, I want to remind you and educate you if you're not aware of this that anytime someone gets a supplemental plan, what they're doing, they're deciding that they're going to stay enrolled in the original Medicare A and B system, that system that began back in 1965. We call that traditional Medicare. And so supplemental plans supplement traditional Medicare. And so with traditional Medicare, the only health care service that Medicare covers 100% is preventive services. So preventive services could be screenings could be wellness exams, certain immunizations, all those things are covered at no cost to you whatsoever. It's covered 100%. But beyond that, nothing else is covered 100%. There will always be a balance of the bill of those services. And so we call those gaps in coverage. We mean financial gaps. These are things that Medicare covers, but not 100%. There will be a balance and that that balance is called the gap and you're responsible for the gap. I'm not going to educate you on all the gaps. I've got plenty of teaching on that. But I do want to say this about gaps. There are three gaps on the A side of Medicare, which is the hospital inpatient skilled nursing and hospice side of Medicare. And there's three gaps on the B side of Medicare, which is called medical. This is the outpatient side, all doctor services, durable medical equipment, home health care is covered on the B side of Medicare. So we have three financial gaps on the A and we have three financial gaps on the So here's where the G and the N are going to differ. If someone gets a G plan, what happens is five of the six gaps are covered. Everything's covered on the hospital side, skilled nursing side doesn't cost you a penny to go there whatsoever. On the on the B side, the outpatient side of Medicare, you have one gap that G does not cover. And that is the B deductible. This deductible is an annual deductible. It's a calendar year deductible. And so if someone starts their Medicare in January, it's the full year. If you start in July, they don't prorate the 240. It's still a $240 annual deductible. And then that number will reset every January. Sometimes we've seen that number go up. Sometimes we've actually seen it go down. Here's my point. If you have a G plan, all the other gaps are covered, but that one B deductible. So once a year, you're going to get you're going to get in this example here 2024, you're going to get $240 in B bills coming to your mailbox. That could be a couple doctor visits, it could be an MRI 240 MRI or cataract surgery, you have the first 240. But the point is, the first 240 is coming as a bill in your mailbox to some provider or providers. Once you've reached the 240, you're done put the checkbook away, you're done, because now that plan is going to cover everything. So here's my point, as long as Medicare pays first, that G plan fills in all gaps, you should have no out of pocket expenses, other than the B deductible. And that would then be once a year. Okay, that's the G plan. Now, the in plan is going to be different. Again, back to the gaps, we have three gaps in the A and three gaps on the B. And so the in plan, those who purchase those are going to find that that in plan covers for the six gaps like the G, it doesn't cover the B deductible. So you have an in plan, you're responsible for that. But here's where it differs. The G, the G plan covers excess in plan does not. Now, let me clarify, excess charge can only be charged by doctors, specialists, surgeons, people like that. So physicians can charge excess. This means this is a physician who sees Medicare patients, but is not under the contract, where they agree to accept Medicare approved reimbursement rates as payment in full, they're going to add to the bill when they add to the bill, that limit is 15%. And I can assure you when they add to it, they're going to do the full 15%. Now what happens in reality is we do not see excess charges. Often, it's less than 5% of the doctors that do it, it does happen. But it's not a real common occurrence. Okay, there's actually eight states that don't even allow physicians in their state to charge excess now the other 42 do and that will happen from time to time, especially we see this in a lot of cancer type care. But the point is, if you had the implant, and if there was an excess, you would have to pay that out of your pocket. The G plan covered that the end is not in addition to that what happens is the implant does have a couple of copays, you'd be responsible for. And so you're responsible for a $20 up to a $20 copay for anytime you see a physician, a specialist in a healthcare provider, up to a $20 copay would be your responsibility. And if you went to emergency room, unless you're admitted to the hospital, so you go to the ER and they discharge you, you'd be subject to a $50 copay. All right. And so those are the differences. So what's happening is this, we can see the G plan a little bit more comprehensive than the implant. But both of them are again, filling in a lot of the gaps that exist within Medicare. Okay. And so that's the differences between the plans. If you're finding this video to be helpful, and you would like to learn more about Medicare, you'll notice up here on the right hand corner, there's an eye and if you'll click on that eye, it's going to take you to a 20 minute workshop. I see people make mistakes all the time. And we don't want that to happen to you. And that's why we're giving you free access to this workshop. So go ahead, click the link and learn more about Medicare. The last question, final question is this, how to choose? How do you choose this? Well, let me tell you, first of all, the difference between the G plan and the implant right now, as far as monthly premium goes, and I'm just talking about on average, we're a nationwide broker, we write in all 50 states and the District of Columbia. Okay, so I'm just kind of giving you a range here. So the difference between G and N right now is going to be in the neighborhood of about $30 a month. Okay. And again, some places and some companies could be a little lower, could be a little bit higher, I'm just trying to get your mind around this difference financially is about $30 a month. So how to choose? So for some people, they say, hey, that $30 is not going to make me or break me, I would just soon have something that's the most comprehensive plan on the market. And that would then be the G plan. Why? Because we only have one gap and that's the B deductible. And so people that want something that's most comprehensive, where they say that $30 really doesn't matter to me, I can afford that extra $30. And they're comfortable doing that. In other words, it would definitely be the least risk plan today because it just has one gap you're responsible for. Okay, now others would say, you know what, I don't go to doctor often, I don't think I'm gonna see very many copays, I know excess does not occur very often, a very low probability of that I would just soon pocket the $30 and take on a little bit of risk. It's minimal risk for sure, because excess doesn't happen often. And and your copays would be minimal, of course, when you see a doctor go to the emergency room. And so here's my point, how do you choose, you have to decide what's important to you. Again, some will say I went most comprehensive, not worried about the $30. Others say I'll save the $30. That's 360 a year, I'll take that probably not going to encounter some of those other items very often anyways. And so that's what makes them comfortable. And so here's my point, folks. Really, the way I want to end the debate is to say it this way, we are all different, no different than there's Fords, and there's Chevys, and there's Mercedes, and there's Jaguars, there's different products for different people. And so the G and the N plans are still very, very good, regardless of what you would choose, you really cannot make a mistake. Okay, so the point is, let's end the debate, because both are good. And so but what I do want to share with you in closing is this, once you've decided what is most important to you, what is best for your particular situation, really how you are wired, then once you made that decision, I'm saying to you, the most important decision then is to do this. And that is to choose the right carrier. I like G and N, choose the right carrier. I can tell you, and by the way, I'm only 63. I'm a couple years away from Medicare. If I were going to do this, I would take the G plan. I'm just being honest with you. And the reason for that is because the $30 is definitely not going to make me or break me, I would just be willing to spend that just in case I ever encountered an excess charge, I don't have to worry about it. And again, some copays. But the point is, that is not a big issue to me, others that would be not to say they couldn't afford it, they just don't want to afford it. And so again, with that in plan, you have this comprehensive coverage, very good couple couple copays. But again, no pre authorizations. It's a permanent policy, portable policy, and no networks to deal with whatsoever. So those advantages are still in either one of those plans. Okay, so here's my point. Let's make this the big deal. And that is choose the right carrier, make sure you go with the right company. What do I mean by that? There's two things that we look at when we when we talk about a carrier, I'm going to look at the initial premium. And then I'm going to look at the long term stability of the rates. Okay, now listen, sometimes we have a company that offers a very attractive initial premium. And they're also stable in the rate. Sometimes we see a company, they're attractive here, but not so here. And also I'm trying to say to you is look at both items. Yes, I care about the initial premium. What's that going to be? For me, most companies lock that initial premium for a year. But they're all going to go up, everything goes up, folks, because of medical inflation, and really just overall rising healthcare costs. And so we know rates are going to go up. But what we can do stability of rates is we have the ability to look back and look at the history of the rate increases that a carrier has taken in the last 10 years. And so we look at the history of that of all the carriers. And so we're paying attention to this, because normally history repeats itself. If I have a carrier that has proven a very, very stable in the last 10 years, we've seen some price increases for sure, but they've been minimal. And they weren't every year they were just more manageable. And so that's what I mean by a stable carrier. And they'll probably be stable in the future as well. Now, let me just share this last thing with you when it comes to rates. The initial rate could, of course, established by the insurance company, but there's certain rules that states will impose upon insurance companies and tell them how it is that they can establish these initial rates. And without getting too much, you know, too technical, I want to make sure you realize that it's a state insurance commissioner that doesn't direct the amount of the rate, but how the company rates their plans. And so we have community rated plans. And by the way, that means everybody in that community gets the same rate regardless of age, regardless of gender, regardless of health, those typically tend to be higher. But again, there are eight states that require an insurance company to do community rating. The next one down below that, as far as a little less premium is an issue age premium. And that means that you come into the med subgroup that you're coming into, and you're going to pay the premium based upon the age you are when you start that plan. You could be 65, you could be 69, depending upon when you retire. And so the 69 year old pays a higher price than the 65 year old does on the issue age. But once both of you are in that group, your rate is never going to go up because of age, it's going to go up when the whole group goes up, which means what, here's what happens in every med subgroup, you've got a group like this. And what happens is we have premium that goes in, and we have money that comes out. And that is called claims. So money goes in through premium money goes out through claims, eventually claims will exceed premiums when that happens, that group is losing money. And so let's say they're losing 5%. They cannot automatically raise your rate 5%. They have to take that loss. And they have to go over here to the insurance commissioner in the state, usually at the state capitol, and they will ask for a rate increase of 5%. They, our insurance commissioner audits the request, if they approve the request, then everybody in the group goes up 5%. That's a group increase. And so community policies are going to have group increases. Issue age are going to have group increases as well. Okay, community, again, everybody gets the same price, they'll start higher issue age a little bit lower than that, based upon the age you are when the policy is issued, and prices will go up when that occurs as well. Last one's called attained age. This is the lowest initial premiums that we see on the market. By the way, this is the majority of states that do this. And what that means is, it's the lowest, but then every year at the anniversary of your policy, you're going to see an age increase, it's normally about 40 or $50 for the whole year, divide that by 12, you're going to see go up about $4 a month, that's going to happen. And then and then that group also eventually can lose money. So then we can see some group increases. So the attained age policies, their philosophy is will allow the insurance company to go up a little bit every year to offset some of the group increases, we mean we shouldn't see them as frequently or as drastically. And again, there's no right or wrong. Again, you don't have a lot of say so that anyways, the state insurance commissioners pretty much decide what's available. And so what am I looking at? What I care about most of all, is that I have a group that is large. And that is really the most important aspect of this, not whether it's community issue or attained age, it means how many people are in the group. So what we find is that the larger the group, this is why we like national carriers better than local or regional carriers, because the more people that are in that group, the more risk is spread out to those policyholders. And the net result to you is stable rates, silly illustration, but it's so true. Let me compare being in a canoe in an ocean and being in a cruise ship in ocean. If you're going to see waves begin to, you know, get steep, you're going to feel every impact that wave on that little, little boat. But if I'm in a cruise ship, and we see some waves, they're probably not much of an impact. Why? Because it's a big vessel. And we're not going to see and feel those waves near as much. And that's the way it is in a group. If I have a small group, which is typically a regional carrier, maybe a few 1000 people in that group, and there's some health problems in that group, you're not going to feel that you just are, because there's not as many policyholders just spread that risk of those health issues out to if I have a large group, the cruise ship, and now we have, you know, 10s of 1000, 100,000 people in the group, yeah, there's gonna be unhealthy people. But again, the risk is spread out more. So we like to look at is the stability of rates, the market share that that company has in that particular market, because again, they're going to create a much larger group, which in essence, do you would be stable Okay, so here's the point. I like G. And I think ends a wonderful, wonderful option as well. I really, really do. But what's most important is make sure that you go with the right carrier. Yes, initial rates good. But more importantly, is the stability of those long term rates.