Unraveling the Most Preferred Medicare Plan and Why
If you are grappling with the variety of Medicare plans and still unsure which one is right for you, this blog post is tailored for you. We cover an analysis of the choice made by the last 10,000 people who sought our services as independent Medicare brokers in the United States.
Multiple Medicare Plans, Yet One Clear Winner
Interestingly, a significant proportion – 78% – of these people chose the same plan type, though from different insurance companies. Curious about which plan emerges top and why? Let’s unravel this together!
Deciphering the Six Types of Medicare Plans
From our recent analysis of 10,000 applications, several plans were unveiled. But the least preferred was the Plan F, a Medigap policy. Here’s a brief explanation of how various Medicare plans work, particularly with Medigap policies:
There are two parts to Original Medicare:
- A (Inpatient side of Medicare)
- B (Outpatient side and all doctor-related services)
Whenever Original Medicare is utilized, there is often a balance bill, referred to as your liability or gaps in coverage. Hence, the need for a Medigap policy to cover these gaps.
Here’s a quick review of the gaps involved in using Medicare (Medicare A and Medicare B):
- In the case of
Medicare A, this liability accumulates when you are in a hospital. This could include deductibles, copays, or skilled nursing, depending on the length of your hospital stay. - As for
Medicare B, this covers mostly outpatient services and doctor-related bills. Concerns could include excess charges (whenever you see a doctor who sees Medicare patients but does not accept the full Medicare reimbursement amount).
Remember these details as we discuss the Medigap policies. Overall, there are six gaps in Original Medicare.
Medigap Plan F – The Least Preferred Option
Medigap Plan F covers all six of the gaps in Original Medicare — in essence, providing full coverage. However, it comes with certain restrictions which make it less popular, such as:
- Only those born before January 1, 1955, can purchase it.
- Since it’s gradually being phased out, few people can buy it today.
These restrictions, coupled with the fact that it lacks good value, account for its unpopularity among our clients.
Medigap Plan N – The Fourth In Line
Compared to Plan F, Plan N is slightly more popular. It covers four of the six gaps in Original Medicare. Note that you’d still be responsible for the Part B deductible and an excess charge (if any). Its affordability, despite a few copays and the risk of excess, endears it to about 4% of our clients.
On the downside, Plan N subjects users to a $20 copay for every doctor visit and a $50 copay for emergency room visits.
The Medicare Advantage (MA) Only Plan – The Uncommon Choice
The fifth in line is the Medicare Advantage (MA) only plan. Differing from the previous plans, the MA Plan covers inpatient and outpatient services only — no prescription drug coverage is included. Therefore, it only appeals to certain groups of people, such as:
- Eligible Veterans Affair (VA) benefit holders
- Retired military personnel with TRICARE for Life
- Retired civil service workers with the Federal Employee Health Benefits (FEHB) scheme
All of these groups can get their prescriptions through those systems, as they’re considered credible coverage plans.
Medigap Plan G – The Most Preferred
Finally, the most preferred of all plans is the Medigap Plan G. Not surprising given its extensive coverage of five of the six gaps in Original Medicare, after meeting a small Medicare Part B deductible. So why do so many people prefer Plan G?
- It doesn’t require pre-authorizations for any treatments, meaning your healthcare provider doesn’t need to seek prior approval from the insurance company for them to cover a service.
- The policy is permanent, giving users longevity and portability benefits.
- It allows users to choose any provider that accepts Medicare, voiding any network limitations.
Not only that, this plan is well-loved because it enables users to pick their drug plans. This flexibility can be handy when there are changes in medication need.
While every client’s situation is unique, the choices they make say a lot about the suitability and value of these plans. Unless the plan is inapplicable due to a person’s circumstances (birth date restrictions, for example), the goal is to ensure the best fit – one that provides the right cover and gives clients the confidence that they’ve made the best choice. However, there is no one-size-fits-all approach; everyone must strike a balance between their health considerations and budgetary constraints.
“There really is no bad Medicare plan; But what there is, is a bad fit”.
Therefore, it is essential to work with professional brokers who take the time to explain all these differences, ensuring that when you enroll in a plan, it’s the best choice for your situation.
