Medicare Supplement Plan G vs Plan N?

[regfman]

My wife and I have had a Plan G supplemental since starting Medicare 9 (my wife 8 years) ago. I really like the Plan G. We don't have any serious medical conditions but we see general doctors twice a year and specialists like dermatology 3 times a year for me to have skin cancers biopsies, a urologist last year for a prostate procedure that required a non overnight procedure and followup care, and few other needs. Wife is similar with aches and pains. But no ongoing serious stuff. I'd estimate we are each seeing one doctor or another about once a month.

We recently moved from part time Californians to full time Floridians and changed our address and found out that our Plan G is going up quite a lot, 22% for me, and 33% for my wife. When calling the insurance broker to learn this reason he suggested I could save a lot of money with a Plan N policy where there would be $20 co-pays with each doctor visit. Plus trips to the emergency room are charged $50 with Plan N but free on Plan G. We haven't needed emergency rooms in quite a long time.

It's a simple calculation: The monthly difference of the premium for me to go to a Plan N would save me about $60 a month, and my wife about $80. If we average maybe one doctor visit a month that's $40 cheaper ($60-$20) for me and $60 cheaper ($80-$20) for my wife. If you throw in the possibility of needing to see doctors or emergency rooms more often as we get into our mid 70s I can imagine the differential begins to lessen. I'm wondering if it's worth switching plans from G to N.

How do others approach this decision?

[Vinny_in_NJ]

My wife and I are on Plan N but were originally thinking Plan G. It was a purely financial decision for us because basically G & N are the same except as you noted. One thing to know though is on Plan N you may encounter excess charges, but you can find it out before going to the Doc by looking the Doc up on the Medicare.gov website. Also, the $50 copay for ER goes away if you are admitted to the hospital and not all Dr visits have that $20 copay but a lot do.

As long as you are OK with the "paperwork" of keeping tabs of the copays and such then the money saved is well worth it IMO. I saved $50 and my wife save $30 a month by being on Plan N. Some of the Medicare insurance videos I've seen have said that Plan G will also go up more the N as time goes on.

I've seen about 4 Docs so far and all has been OK. 1 Doc charged me a copay that shouldn't have and refunded my $20 - no problems ... that's the paperwork I'm speaking about.

[mhalley]

I switched from g to n recently due to price increases but I’m healthy for now. Remember er visits skip the copay if you are admitted. Plus there is no copay for urgent care visits. This YouTube video has a comparison of costs between the 2.
https://m.youtube.com/watch?v=oXoQOtewE ... YgcG9ja2V0

[tj]

Before you mess with changing plan letters, go to Medicare.gov and search for premiums for your zip code for G. Perhaps there's a better plan that you're broker does not sell.

[Retired1809]

I agree that Plan N would probably save you some money as long as the number of doctor visits doesn't increase enough. I have just signed up for Plan N for myself. I'm willing to pay up to $20 for each doctor visit, %50 for emergency room visits and face the possibility of having to pay those rare excess charges.

Just keep in mind that switching from one plan to another (even within the same insurance company) will mean going through another "medically underwritten" process answering questions about your respective medical histories.

[vested1]

We've been on Plan N since signing up for Medicare, 7.5 years ago. I've found that most doctors and specialists don't add the extra charge, which if memory serves is 15% of the charge that neither Part B nor Plan N will cover. That usually doesn't add up to much, but it could on a surgery. My wife had both knees replaced within a year and a half at 50k each for outpatient surgery. Our extra charges were not billed. That doesn't mean the couldn't have been charged.

If I had to do it again I would switch to Plan G though, because the peace of mind of guaranteed zero extra charge bills would stop me from wondering if the next time would be different with Plan N. Ages 71 and 72, premiums in 2025 $172 and $185 respectively, and goes up every year.

[regfman]

I switched from g to n recently due to price increases but I’m healthy for now. Remember er visits skip the copay if you are admitted. Plus there is no copay for urgent care visits. This YouTube video has a comparison of costs between the 2.
https://m.youtube.com/watch?v=oXoQOtewE ... YgcG9ja2V0

The guy in the video says (at about 5 mins in) that he has not seen anybody get the excess charges that are possible with the Plan N. So that theoretical disadvantage with the N doesn't sound like much to worry about.

[cheese_breath]

I've been on Medigap 18 years, and I''ve never incurred any excess charges. Ditto for DW, although it was only 9 years for her.

[ModifiedDuration]

If you are going to save $140 a month, then switch to Plan N.

All the two of you would need to do is average less than 80 doctor office visits a year going forward to come out ahead.

[Vinny_in_NJ]

I've been on Medigap 18 years, and I''ve never incurred any excess charges. Ditto for DW, although it was only 9 years for her.

My sister is on Plan N for 10 years and she just got excess charges from a Doc, it was $65 a visit or something like that. The Doc was part of a team where apparently all the other Docs accepted Medicare assignment so she didn't think to ask. I'm sure the money she saved was more than what she paid out. They're out there but very unusual not the norm.

[mhalley]

I seem to recall that the majority of excess charges are for mental health services. https://medigapseminars.org/what-are-me ... 20industry.

Medicare Part B excess charges are rare. Only 2% of doctors contracted with Medicare are allowed to charge an excess charge and more than 40% of those are in the mental health industry.

[regfman]

Between my wife and I we don't see doctors at anywhere near 80 times a year. So yes the Plan N would save money with the only immediate downside that we'll be pulling out our credit cards when we visit a doctor's office, or get a bill online or in the mail for that copay. If those copay bills come later they are a little bit of hassle to go online and make the payments but after I've paid a small number I will have accounts and passwords set up at the different doctor's billing companies and the payments should go smoothly. All just the energy of carefully tapping the computer keyboard and keeping track to not miss any payments. I can see that.

But I wonder will the differential between the plans always remain the way it is? I've seen predictions that Plan G will go up at a faster rate than Plan N. But what is that based on? Could it go the other way? Right now it is not a problem for us to make the switch from G to N because we are healthy enough to not have any disqualifying conditions and can pass the underwriter qualifying test. But as we get older that can easily change and the option will be gone.

Can we imagine a situation where the Plan G becomes more attractive because the N is going up faster? Maybe the differential between premiums doesn't change but the co-payments go up, or something else that makes G better for people even if they don't use the plan that much?

[Retired1809]

Code: Select all

[code][quote][/quote I've seen predictions that Plan G will go up at a faster rate than Plan N. But what is that based on? Could it go the other way? Right now it is not a problem for us to make the switch from G to N because we are healthy enough to not have any disqualifying conditions and can pass the underwriter qualifying test. But as we get older that can easily change and the option will be gone.

[/code]

Here's why Plan G future annual premiums can be expected to rise faster than Plan N:
1. Anyone whose Medicare Advantage plan is no longer available will qualify for entering Plan G without medical underwriting. The same is not true for Plan N where qualifying medically would be required. Hence, you most likely have a healthier group of folks in Plan N than in Plan N, which would most likely result in lower annual premium increases for Plan N folks.
2. Self-selection. I would posit that folks in less need to visit doctors for treatment or evaluation tend to be healthier than folks requiring more frequent doctor visits, as a general rule, these are the folks who would find Plan N attractive.
3. Possible overuse of doctors' visits by Plan G insureds: "Hey, it's free (to me) to visit the doctor. Let's go!" Meanwhile, Medicare gets billed for possible unnecessary doctors' visits.

In the end, choosing between Plan G and Plan N may be another "behavioral economics" problem. Medical insurance is an area that my wife assigns to me. So I chose Plan N for myself but Plan G for her since, for her, I would rather err on the side of being over-insured rather than under-insured although the rational decision would probably be Plan N for both of us.

You buys your ticket and you take your chances. (But you won't go too far wrong either way.)

[gips]

Have you looked at plan g hi? In our county, it’s guaranteed to cost less than plan g and provides an opportunity to save tens of thousands of dollars if you don’t use doctors often. I signed up for it 3 years ago and have saved $4000 over the cost of plan g.

[Harry Livermore]

I've been on Medigap 18 years, and I''ve never incurred any excess charges. Ditto for DW, although it was only 9 years for her.

I believe some states prohibit excess charges, based on the many hours of youtube watching, book reading, and online research I did a month ago in helping my mom with her enrollment. OP could maybe verify their state as being one of them. Or, I could be wrong lol.
Cheers

[tm3]

Have you looked at plan g hi? In our county, it’s guaranteed to cost less than plan g and provides an opportunity to save tens of thousands of dollars if you don’t use doctors often. I signed up for it 3 years ago and have saved $4000 over the cost of plan g.

When I ran the numbers, high deductible was a clear choice. But it depends on individual circumstance.

In general, I stayed away from helpful information offered by "agents" and "brokers."

[ModifiedDuration]

Have you looked at plan g hi? In our county, it’s guaranteed to cost less than plan g and provides an opportunity to save tens of thousands of dollars if you don’t use doctors often. I signed up for it 3 years ago and have saved $4000 over the cost of plan g.

My results have been similar. I have been saving about $1,500 a year with Plan G-HD vs Plan G.

Even though I knew Medicare-approved rates were low, I didn’t know how low they actually are (for example, an anesthesiologist billed $850, the Medicare-approved amount was $70, 20% of that $14) and that Medicare would 100% cover my bloodwork, colonoscopies, and vaccinations (with Part D).

Before going on Medicare, the spreadsheets I did assuming various levels of Medicare expenses way overestimated what my expenses have actually been.