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November 11, 2009 at 07:00 PM
During the 2009 and 2010 Medicare marketing and sales years, there will be more and more changes to the health care coverage that is available to Medicare beneficiaries. Medicare Advantage plans will continue to be available, but because of changes in funding by Congress, more emphasis will be placed on Medicare Advantage networks such as HMOs and PPOs. For many seniors in certain parts of the country, choosing an HMO or PPO plan could be advantageous to their health care needs. For other seniors, traditional Medicare supplement plans may once again be their best option, especially in allowing them to see the doctor or facility of their choice. The following is a review of Medicare supplement plans, including when and why they are often the best plans for your clients.
Understanding the basic principles of Med supp will help you jump-start your sales, better prepare you for CMS and carrier testing, and allow you to become a value-added partner to your clients.
The first thing to know is that Medicare supplement plans provide coverage for the gaps in original Medicare parts A and B. There are 12 standardized Med supp policies — plans A through L. Each plan offers various levels of coverage to choose from. However, the benefits of each plan are regulated by CMS, so the coverage of each plan is the same across all carriers (although the plan costs may be different).
Two of the most popular policies are Plan D and Plan F. Plan D is one of the least expensive policies, and covers the hospital deductible, copays, and the 20 percent of doctor charges not covered by original Medicare. Plan F also covers the hospital deductible, copays, and the 20 percent of doctor charges not covered by Medicare, but has the added benefit of covering excess doctor charges up to 115 percent. With few exceptions, Plan F will be a little more expensive than Plan D. As mentioned, Medicare supplement plans allow enrollees to use the doctor or hospital of their choice, and almost all doctors and hospitals across the United States accept Medicare supplement plans. This allows beneficiaries to travel across the country with little worry that they can’t receive needed health care, so for many seniors this fact alone makes Medicare supplements the coverage of choice.
