Category Archives: Innovative Plan G

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

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?