Category Archives: Medicare Supplement Insurance

How To Select A Medigap Plan

Calendly Topic:  “How To Select a Medigap Plan”

What does Medicare cover?  Learn how to make a smart decision when it comes time to sign up for Medicare Supplement Insurance i.e. the best practices of How To Select A Medigap Plan.  We are an independent agency , authorized to offer AARP branded United Healthcare, Blue Shield of California, Anthem Blue Cross, HealthNet and more.

Learn the nuances between these programs before you make this important decision. Our free consultation explains the very basics, in a non-salesy manner, and there is no obligation to buy.

For intelligent answers to your questions, call (408) 252-7300 or schedule it here!

“Disclosure: these plans will compensate us but this adds no extra cost to your policy. And the best news is, you won’t have to pay us for our services.”

How To Select A Medigap

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Medigap Supplemental Plan G FAQs: Your Top Questions Answered

Medigap Supplement Plan G FAQs

Navigating the world of Medigap plans can be overwhelming, especially with 25 Medigap Plan G

Medigap Supplemental Plan G FAQs: Your Top Questions Answered choices in the San Jose – Mountain View region alone. Plus a recent, major Plan Closure.  How does one determine which is the best choice for your situation? To help, we’ve compiled the top 5 questions from residents in Sunnyvale to Hollister.  First, make sure you are enrolled in Medicare Part A and Part B.  (If you are returning to traditional Medicare from Medicare Advantage, read this first.)

Are All Plan G Medicare Medigap Plans the Same?

At first glance, all Medigap Plan G policies might appear identical since they are standardized by the federal government. This means the core benefits remain the same regardless of the insurance company you choose. However, there are differences worth noting, particularly in how these plans are priced and the level of customer service provided.

Do Some Medigap Plan G Policies Cover More Doctors Than Others?

Medigap Plan G policies do not typically vary in terms of the doctors they cover. Most Plan G policies are accepted by any doctor or hospital that accepts Medicare. However, it’s always wise to confirm with your preferred healthcare providers that they accept the specific insurance company’s Medigap policy.

Do Some Medigap Plan G Policies Cover More Services Than Others?

In terms of covered services, Medigap Plan G policies are uniform across all providers. They cover the same services, including Medicare Part A coinsurance and hospital costs, Part B coinsurance or copayments, the first three pints of blood for medical procedures, and more. Nevertheless, the difference lies in additional perks or services that some insurance companies might offer, such as fitness programs or discounts on vision care, which can vary.

Understanding Pricing: Community Pricing vs. Attained Age Pricing

According to Medicare.gov, only one of the 25 Medigap Plan G policies in the Santa Clara Valley has adopted Community Pricing, while most others use Attained Age Pricing. Here’s what these terms mean:

  • Community Pricing: The same monthly premium is charged to everyone, regardless of age.
  • Attained Age Pricing: Premiums are based on your current age and will increase as you get older.

Why Do Monthly Premium Costs Range So Widely?

Even though Plan G benefits are standardized for Part A and Part B medical services, the monthly premiums can vary significantly—from $100 to $188 in Santa Clara County. This difference is due to factors like the pricing method, the insurance company’s administrative costs, and additional benefits they may offer. [Read our sister article, The Buzz About Plan G and Plan G Extra, for more insights. or How To Select A Medigap Plan]

Our Expertise in the Bay Area

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We specialize in guiding Bay Area residents who prefer Original Medicare along with a Medigap  Plan G. Particularly those who wish to retain their specialists at Sutter PAMF and Stanford Medicine. Our advisement service involves no additional premium or fees. For those who prefer an online enrollment without direct consultation, visit CaliforniaEnrollment.com.

Why Local Knowledge Matters

“We help you see what matters most between the Plan Gs, and discern what is ‘marketing fluff.’ An independent agent really makes a difference in explaining the nuances of these plans. Local is better.“

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if you’re facing deadlines and need answers now, don’t hesitate to schedule a consultation with us. Do not overpay or miss an important deadline.

Schedule a Consult: (408) 252-7300 or schedule a phone meeting via our calendly app.

“We help you see “what matters” most between different Plan Gs, and discern what is ‘marketing fluff.’  An independent agent really makes a difference in explaining the nuances of these plans.  A local agent is better!.”

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How To Select A Medigap Plan

The Changes to Blue Shield Plan G Inspire What You Need to Know

Blue Shield of California has announced its intention to withdraw Plan G Inspire from its Medicare Supplement Insurance offerings, potentially as soon as January 1, 2025, pending regulatory approval. This move follows their decision to stop accepting new Plan G Inspire applications back in April.

An Unforeseen Change to Plan G Inspire

As an agent, these developments caught me by surprise. Only last December, Blue Shield was actively promoting Plan G Inspire in select counties across the Bay Area and Northern California.  As a side note, Plan G Extra continues to be offered statewide.  The dynamic nature of the Medicare market underscores the importance of staying connected with a knowledgeable local agent.

Why You Need a Medicare-Focused Agent

The Medicare landscape is constantly evolving, and these changes highlight the necessity of having an agent who specializes in Medicare. Working with an independent agent can provide Plan G Inspire Optionsyou with a broader view of your options.  We help you make informed decisions about your healthcare coverage.   As well as keeping abreast of important provider network changes.

The Value of Blue Shield

Blue Shield has been a significant player in providing innovative features for California seniors. However, if you’re now required to transition to a new plan e.g. Plan G Extra, it may be the

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perfect opportunity to reassess your options. Consulting with an independent agent can give you a wider perspective on today’s Medicare choices.

We’re Here to Help You transition from Plan G Inspire

Our local, independent insurance agency has assisted many customers with Blue Shield, United Healthcare, Anthem, and HealthNet. We offer intelligent answers to your questions and can help guide you through this transition…even to gain a better understanding Plan G Extra.  Scheduling a short consultation with us is free and can provide you with the clarity you need during this time of change.

Why Contact Us?

Perhaps you’re a Blue Shield of California policyholder and your current agent hasn’t reached out to discuss these developments.  It might be time to connect with a local agent. Using an independent agent doesn’t add any extra cost to your insurance premiums, but it does offer peace of mind and expert guidance.  You can also use the United Healthcare Local Agent Finder tool:  UHC “vets” these agents and a relatively small number actually qualify for their directory.

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Changes in Medicare Supplement Insurance can be overwhelming, but you don’t have to

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navigate them alone. Reach out to us for personalized assistance and make sure your healthcare coverage meets your needs:  Phone (408) 252-7300

Rewritten to provide clarity on the changing Medicare Supplement Insurance landscape, this article aims to educate Blue Shield of California Medigap members and seniors about the upcoming withdrawal of Plan G Inspire and the importance of consulting with a knowledgeable agent.  Schedule your Phone Meeting with us.  

Is Blue Shield and Blue Cross the Same Company in California? Local Focus on Medigap

Is Blue Shield and Blue Cross the Same?

Blue Shield of California is not the same as Anthem Blue Cross. In fact, their Medicare Supplement (aka “medigap”) products compete directly against one another.

Is Blue Shield and Blue Cross the same?

By most estimates, Blue Shield of California is the market share leader for the number of medigap (medicare supplement) insurance policies issued in California.  Approximately two years ago, Blue Shield dethroned United Healthcare as #1, although United Healthcare continues to dominate across all 50 states.   An impressive accomplishment, given Blue Shield’s not-for-profit ownership status.

Further down the marketshare list is Anthem Blue Cross, who recently rebranded as Elevance Health.  Not-for-Profit Blue Shield of California has many things going for it, including…

  • Blue Shield’s unique 2% Pledge, which limits their net income to 2% of revenue. Any earnings beyond this limit are returned to customers or invested in the community.
  • Northern California location (Oakland, CA).
  • Blue Shield of California offers both regular Plan G medigap and Plan G Extra (Innovative
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    class) medigap product choices for consumers.

Blue Shield of California’s rates are competitive, see both insurance company’s pricing and compare for yourself:

Blue Shield of California’s Leadership

While Blue Shield may enjoy a Number 1 ranking of medigap policies issued in California, no discussion is complete with mentioning a close rival, United Healthcare.  Where Blue Shield boasts not-for-profit ownership status, United Healthcare boasts a branding relationship with the largest senior advocacy organization in the United States.

Further, United Healthcare’s medigap products include the Community Rating method, in contrast to Blue Shield’s Attained Age method. As far as we can tell, no other individual medigap insurer in California prices their supplemental medigap policies based on a community rate.

How does community rating work?  This is a great question and another good question is “do some medigap insurance policies cover more doctors than others” e.g. Stanford, Sutter, Palo Alto Medical Foundation?  These issues are best discussed with a local independent agent who is contracted with Blue Shield of California, Anthem (Elevance), and United Healthcare.  Book a short consult with a licensed sales agent and save a lot of research time:  There is no obligation to buy.

Free 15-Minute Telephone Consult

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You should never overpay for medigap insurance, instead, get expert advice before you enroll.  Learn the latest on Medicare access to Stanford, Sutter-PAMF etc.  In California, there’s no extra cost when you use a local, independent agent  and, the best news is the agent is compensated by the insurance company (not you)!   First, Learn About Us

Blue Shield of California Talking Points

  • In Blue Shield of California’s words, “We’re driven by our mission — not by meeting shareholder expectations. That’s why we cap our net income at 2% of revenue and return anything above that to our customers and the communities we serve.”
  • Headquartered in Bay Area 

Additional Resources:

Book an obligation-free Telephone Consult or phone (408) 252-7300 Located in west San Jose.

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Is Blue Shield and Blue Cross the same?

The Buzz About Plan G and Plan G Extra

Choosing The Best Medigap Plan G

What’s all the Buzz about Plan G and its “medigap cousin,” Plan G Extra?  For persons turning 65 on or after January 1, 2020, Plan G replaces the hugely popular Plan F.  Early feedback is Plan G is just as popular as before, and now, in 2024 there are additional plans to consider,  the appropriately named “Plan G Extra” (or Plan G Plus or Plan G Inspire, which is being withdrawn from Blue Shield’s portfolio) the name varies according to the medicare supplement insurer who issues it).

“Breaking News:  The popular Blue Shield of California Plan G Inspire will be withdrawn from the market for new enrollments, effective 4/1/2024.”  Please use our Calendly app if you wish to schedule a discussion about this plan with one of our licensed agents.

Plan G Extra Benefits

Plan G Extra is a separate plan, distinct from the regular Plan G:  Think of it as constructed on a

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Plan G chassis or base plan, with some added benefits.  So what’s the Buzz About the Plan G “Extra” benefits?  First, the premium difference is minor.  Second, the additional benefits are for services not covered by Medicare, so these are truly “bonus” coverages e.g. Vision, Hearing
Aide, Gym services etc.  Request a Q&A phone session with one of our licensed sales agents, using Calendly.

We are a bay area family-owned insurance agency representing United Healthcare and Blue Shield of California medigap plans for 2024 and 2025.  There is no extra cost to using a local agent.  But if you want to enroll quickly without talking to an agent, go to CaliforniaEnrollment.com.

 

View Blue Shield Comparison of Plan G and Plan G Extra or Inspire

Blue Shield is one of the insurers who offer both Plan G and Plan G Extra (not every insurer Free Telephone Consultoffers both plans).  For FAQs on Plan G, including summary of benefits, pricing and required disclosures, phone us at 408-252-7300.  There’s no obligation to buy from this Not-For-Profit, Northern California-based insurer.  Read more about Blue Shield’s Not-For-Profit status and other Blue Shield savings below.

Blue Shield Savings

With Blue Shield, there are several opportunities to save on your monthly plan dues. One example, is the savings due to increased efficiencies from administering Medicare Supplement plans are passed on to the subscriber, not Wall Street.  Blue Shield’s Not-For-Profit status means savings for you!  Continue below to checkout the Buzz about Plan G and Plan G Extra:

Blue Shield Plan G and Plan G Extra plans

Finally, an interesting aspect of the Plan G “extra” plans is the “additional benefits” vary from

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insurer to insurer. In fact, many insurers do not even offer the “extra” version of Plan G. Research Tip: It costs nothing (“extra”) to hire an independent agent to explain the differences. The premium is the same with or without the agent. Moreover, the insurer compensates the agent for enrolling you.  So chat with an agent today or just self-enroll at CaliforniaEnrollment.com.  You could also use the United Healthcare Local Agent Finder tool to find someone near you.

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“We do not offer every plan available in your area.  Any information we provide is limited to those plans we do offer in your area.  Please contact Medicare.gov or 1-800-MEDICARE to get information on all your options.”

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My Medicare Supplement Is Getting More Expensive

I finally understand why my Medicare Supplement is getting more expensive.  In the beginning (age 65), most California plans are under $150 per month.  Yet, if you do not take action, it will continue to increase and your smiles will turn to frowns as you get older.

A Common Example

My 85 year-old mother switched Medicare Supplement (medigap) insurance companies and saved $75 per month for the same plan!  So, why is my Medicare Supplement getting more expensive?  In my opinion, the three biggest culprits are below:

3 Biggest Reasons Your  Medicare Supplement is getting more expensive

  1. You purchased a medigap plan that is based on an “Attained Age” pricing methodology, rather than a community rated model.  Therefore, rates go up as you get older.
  2. Medicare (CMS) annually increases Medicare Part A and Part B deductibles, coinsurance, and copayments.  The annual increased copayment responsibility is passed through to your Medicare Supplement (medigap) plan, which of course adjusts rates to offset the higher costs.
  3. General medical inflation.

Excerpt from Medicare’s (CMS) “Guide To Choosing A Medigap Policy”

Medigap Basics- Medigap Pricing Methodology- p 18

Are Medicare Supplements Really All The Same?

Many Medicare Supplement (medigap) plans are excellent, but they are not all the same.  So if

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your Medicare Supplement is getting more expensive, research if your policy was filed with the State of California as Attained Age or Community Rated, as depicted above.  Rather than do all the research yourself, find a trusted local independent agent who represents many plans.  Let the agent do the work, because it costs you nothing.

 

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In California, premiums are the same whether you buy directly from a company or with an agent’s help.  And, thanks to the California birthday rule, it is easy to change Medicare Supplement (medigap) insurance companies during your birthday month, each year.  Note: This is a California rule, and is not available in all states.

Don’t Pay too much, request your free insurance agent consultation below, or Phone (408) 252-7300:

Do You Really Need Medigap Insurance?

Do you really need Medigap (Medicare Supplement) Insurance?  What is the worst-case financial exposure for those who rely solely on Medicare Part A and Part B?  Many Californians are surprised to learn traditional or original Medicare does not have out of pocket limits.  Yet, this type of protection is common with employer-sponsored insurance.  

“Do Californians really need Medigap (Medicare Supplement) Insurance?” 

Before looking closer at your potential financial out of pocket, let’s be clear on the terms we are using:  Medigap (Medicare Supplement Insurance) is not Original Medicare; rather it is private insurance that supplements Original Medicare benefits, such as Part A and Part B. OK, let’s continue…

Assuming an average copayment of 20% for Part B expenses, you could face large financial liability, should you experience surgical work for Cancer, Cardiac, Hip, Knee etc. i.e. services that are not uncommon for individuals over 65. 

“The short answer is yes, you do need Medigap (Medicare Supplement) insurance. “

Yet, your financial exposure could be far worse:  The preceding paragraph made no mention of your copayment responsibility under Medicare Part A, should you experience hospitalization or skilled nursing services.

For example, Medicare grants each beneficiary a specified number of Hospital Days per lifetime.

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Hospital Days also have significant copayments (see example here), paid by you.  A Medicare Supplement (Medigap) policy can add 365 additional days to the 60 day lifetime limit.  In summary, Medigap is offered by private insurance companies to supplement the Original Medicare program.  If you purchase it when turning 65, the cost is relatively inexpensive, sometimes costing less than what the government charges for Part B. 

Never pay more than you have to for Medigap.  It is wise to use an independent agent to research several plans at once, saving you time.  Good to know:  You pay the same monthly premium using an independent agent, as you would purchasing directly from the insurer.  So why take a chance of paying more?

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