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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.  

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Sutter PAMF Medicare Options in 2025

This Sutter PAMF Medicare Article has been updated on October 9, 2024 for 2025 plans

Big news for Medicare beneficiaries who are counting on having Sutter Palo Alto Medical Foundation Medicare options:  We are closing out a tough year in the bay area medicare market, and we all wonder, will 2025 be better or worse?

  • In 2024, we lost AARP® Medicare Advantage SecureHorizons® (HMO-POS)
  • We also lost the Essence Healthcare, which included Sutter/PAMF, and other respected provider organizations in the bay area, such as Stanford Medicine and Stanford Hospital.

2025 Sutter PAMF Breaking News

  • On October 1, 2024 we learned United Healthcare is closing its Medicare Advantage PPO products throughout northern California, effective January 1, 2025.  We have received reports that the loss has extended to retirees of CalPERS and HP.

“United Healthcare’s withdrawal of its medicare advantage PPO products from Northern California is reportedly impacting retirees of CalPERS and HP.”

Announcing Sutter PAMF Medicare Advantage Options in 2025

Existing Sutter patients on Medicare are grandfathered for the time being, but new patients seeking access to Sutter/PAMF in Santa Clara County have only two options:

  • Alignment
  • Wellcare
  • However, in San Mateo County there are 3 Options and in Santa Cruz County, 2 Options!
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“In San Mateo County there are 3 Sutter/PAMF options and 2 options in Santa Cruz County for 2025!”

An independent agent can explain the merits of each plan and help you make an informed decision.  We have already filled 75% of our calendar this fall, schedule a free consult before we run out of space.

Everyone should have a local independent agent:  Medicare is ever-changing and local agents will be a life-long partner and resource for your family.  Call for a free consult, today or schedule a phone call from our calendar.

If you are losing Sutter PAMF providers and need answers now, phone (408) 252-7300 or schedule a future phone meeting on our calendar:

Sutter PAMF Medicare Options in 2025

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If you are leaving a Medicare Advantage plan and returning to traditional Medicare, read this first.

If you are losing Sutter PAMF providers and need answers now, phone (408) 252-7300 or schedule a future phone meeting on our calendar:

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Sutter PAMF Advantage Plans of Santa Clara Valley and San Mateo Counties

(408) 252-7300 CALL TODAY to talk to a local, California licensed sales agent

 A licensed, local, independent insurance agent will respond within 24 hours

Remember, local is Better!  Check out our reviews on YELP and NextDoor.

“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.”

How To Select A Medigap Plan

Calendly Topic:  “How To Select a Medigap Plan”

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 consult sessions book up quickly so call (408) 252-7300 or schedule today!

“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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If our calendar is full, phone us at (408) 252-7300 and request special handling.

Accessing Stanford or Sutter with Medicare

Navigating Medicare with Stanford or Sutter/PAMF

Accessing Stanford or Sutter/Palo Alto Medical Foundation (PAMF) with your Medicare has become progressively more challenging in recent years.  However, it’s not impossible.

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Gone are the days of purchasing a Medicare policy and keeping it forever. The dynamic Medicare market in the Bay Area is fluid and constantly changing e.g. a new major Plan Closure. Utilize the experience and knowledge of a local, independent agent to make informed decisions about your Medicare options. There is no added cost to your policy for this service. Given the ever-changing nature of Medicare, you may need someone in your corner to help you navigate these complexities in the future.

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Choosing Between Medigap and Medicare Advantage

Depending on your objectives, you might find that traditional Medicare combined with a solid Medigap supplemental policy suits your needs best. In other situations, accessing your physicians through a contracted Medicare Advantage plan may be your best option. An independent agent can act as a time-saving advisor to help you understand the pros and cons of either choice.

“Leverage your time and research with the experience and knowledge of a local, independent agent.”

Our specialty is assisting Bay Area residents who prefer original Medicare plus some type of Medigap Supplemental Plan G and wish to retain their specialists at Sutter PAMF and/or Stanford Medicine. Our advice is free of charge—there are no added premiums or fees. If you’d prefer not to speak with an agent, you can also self-enroll at CaliforniaEnrollment.com.

If you’re facing deadlines and need immediate answers, please complete the Contact Request Form at the bottom of this page. A licensed, San Jose-based independent agent will respond within 24 hours to discuss your options under traditional Medicare.

Act Now to Secure Your Medicare Coverage

Understanding and selecting the right Medicare plan can be daunting. Whether you choose to work with an independent agent or self-enroll, taking action now can ensure you have the coverage you need, tailored to your specific medical requirements at top-tier institutions like Stanford and Sutter/PAMF. Schedule your free 15-minute telephone consultation today and take the first step towards seamless Medicare coverage.

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Related article:  2025 Sutter PAMF Medicare Options

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.

Need Immediate Assistance?

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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 Learn More About Us

Is Blue Shield and Blue Cross the same?

AARP-branded United Healthcare Medigap Plans

Returning To Original Medicare and Medigap Plan G

People are leaving Medicare Advantage

We are expecting large numbers leaving Medicare Advantage and returning to original Medicare this (AEP) season. Frankly, people are just “done with it,” after last season’s plan closures.  Popular providers, such as Stanford and PAMF / Sutter dropped out of plans in 2024, and it appears more volatility is on the way in 2025.  Even Barron’s magazine suggests this could be a silver lining.  But watch out:

Medicare provides multiple avenues to depart from Medicare Advantage and return to original Medicare Part A and Part B.  Should you do it?  This is a complex issue; Even if the answer is yes,Medicare Medigap Plan G disaster could await you when returning to traditional Medicare, should you find that an insurance company denied your application for supplemental medigap insurance [learn how in this 3-minute video].

Returning to Traditional Medicare

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The difficulty rises when medical underwriting approval is required for your supplemental medigap application. Please don’t learn this news after you have returned to Traditional Medicare.  Fortunately, in certain instances underwriting may not be required.  An independent agent can help you evaluate your situation and provide technical assistance in preparing your application.

 “You may only get one shot at this, get advice before you act” 

Schedule your Free 15-minute Telephone Consult

This is where the DIY (do it yourself) crowd gets burned:   It’s a complex subject matter.  Fortunately, there are safe pathways back from Medicare Advantage to Traditional Medicare, but these “free gifts” are hard to find.

The Top 3 Issues When Returning to Original Medicare

Here are the Top 3 Issues when Leaving Medicare Advantage and returning to Original Medicare:

  1. The Number One issue is do you qualify for guaranteed acceptance underwriting for Medigap Plan G or the more expensive Plan F? A number of factors will determine which plan you may purchase.
  2. The Number 2 issue concerns your qualifying scenario i.e. Did you actually lose your Leaving Medicare Advantage for Original MedicareMedicare Advantage Plan or just your Physician?
  3. The Number 3 issue is properly filling out the application for a supplemental medigap insurance plan.  In other words, how to avoid disaster when completing the application
    Click to Schedule(because you provided the wrong response). An experienced, local agent can provide free technical assistance here.

You reduce the risk of a critical mistake when using a local insurance agent, experienced in this area.  Not a regular insurance agent, but one who specializes in only Medicare.  Just as you would use a neurosurgeon specialist in lieu of your primary care physician for surgery on your brain.

Consider yourself lucky to find an agent who is local, still accepting new clients, and writes with lots of insurance companies, that’s a bonus.

We are a bay area, family-owned insurance agency of 65 years and can assist with enrollment applications for multiple medigap insurance companies.  Please know there is no extra cost to your premium and the insurance company compensates the agent.  Using an experienced, local agent is always better when it comes to avoiding an enrollment mistake.  Always check YELP and NextDoor ratings.

If you are facing “Returning to original Medicare” deadlines and need answers now, phone

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(408) 252-7300 or schedule your own telephone consult using our CALENDER link.

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Resources

How To Select A Medigap Plan

 

Retiring and Making the Switch to Medicare- A Checklist

Retiring and Making the Switch To Medicare

Are you preparing to retire and leave your employer-sponsored health insurance and make the switch to Medicare? This transition can be daunting, but understanding the steps involved can Retiring and switching to Medicaremake the process smoother. Here’s a comprehensive checklist to guide you through retiring and enrolling in Medicare.  (Read this article If you are already enrolled in a Medicare Advantage plan, but wish to return to traditional Medicare.)

1. Don’t Rush into Medicare Part B

If you are still working and receiving employer-sponsored health insurance, it’s usually not necessary to sign up for Medicare Part B just because you turned 65, especially if you work for a large employer with 20 or more employees. There are exceptions, so it’s crucial to understand your specific situation. For more detailed information, refer to our related article, “Understand What You Are Getting Into.”

2. Keep Employer Plan Disclosures before Retiring

Documents like CMS-L564 and Annual Notice of Creditable Coverage for prescriptions are essential if you’re 65 or older. Discarding these could lead to extra costs after retiring and switching to Medicare. We recommend starting a Medicare Preparedness File where you can keep this article and other crucial documents as part of your checklist. Schedule a free Calendly Meeting if you would like more information.

3. Keep Your “Friends Close but your Doctors Closer” before Switching to Medicare

You may have experienced difficulty finding a primary care physician in the Bay Area. Have a conversation with your PCP to confirm if they accept new (or existing) patients on traditional Medicare. It’s also prudent to ask if they plan to retire soon. Knowing this early can give you ample time to find a new primary care physician if necessary. This is critical:  If you schedule a free consult, we will send you some great resources.

4. Seek Guidance from an Independent Medicare Agent

Find an independent agent who specializes in Medicare health plans and offers a broad range of options. Their unbiased advice is invaluable as Medicare plans can change over time. An agent can help you develop your transition plan for retiring and making the switch to Medicare Part A and/or Part B, including a bridge plan for a spouse or partner.  Additionally, they can provide independent feedback on Medigap plans and help you navigate through various Plan G options. For more insights, check out our article, “The Buzz About Plan G and Plan G Extra.”

By following these steps can help you achieve a seamless transition from your employer health insurance to Medicare, and avoid unnecessary hassles or anxiety.

Related Links

Sutter PAMF Medicare Options in 2025

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Applying For Medicare Part A and Part B

Under normal circumstances, you may Apply for Medicare Part A and even Part B (only) at a local Social Applying for Medicare Part A and Part B Security Administration office.  Since appointments are limited, consider applying online:

  • You can apply for Part A and Part B at ssa.gov/benefits/medicare and until recently, via telephone appointment:  In some situations, it may still be possible to schedule a telephone appointment:  Phone Social Security at (800) 772-1213‬.
  • Use this link if you already have Part A and intend to Apply for Part B only
  • If you are returning to original Medicare from Medicare Advantage, read this.
  • Link to Social Security’s Video on applying for Medicare through the Social Security website.
  • When should you begin the process of applying to Medicare? Read about important timelines and deadlines in a recent article on this site or phone our office and request a consultation: 408-252-7300.  The ideal age to start understanding and preparing is age 62.
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Did you know, Local, Independent Agents are a free resource and can help you avoid delays and save time applying Medicare Medicare Part A and Part B.  And there is no added cost to your policy!  This saves you valuable time and helps avoid unexpected delays that could cause a missed deadline. Get a free initial consultation today and sign up for our Newsletter to receive periodic “good ideas” on Medicare.

Best Practices: Applying for Medicare Part A and Part B

  • If you are age 61, 62, 63 or 64, here is another must-read article.  It is also helpful for persons working past 65.
  • Find your doctors well before applying for Medicare- See related article.
  • Find a local, experienced Independent Agent, representing lots of insurance companies.

Schedule a Consult:  (408) 252-7300

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Leaving Employer Insurance For Medicare

Get Prepared for Part B

It is time to think about leaving your employer insurance for Medicare and to Apply for Medicare Part B.  The purpose of this article is to help you prepare for Medicare, in advance, Losing Sutter Medicare: Returning from Medicare Advantage to Traditional Medicareand to avoid missing important deadlines, which could lead to missed opportunities or even extra costs.  Bookmark this story or share it with a friend.

CHECKLIST: Leaving Employer Insurance and Transitioning to Medicare From Employer Health Insurance

  1. First, if you are currently working and receiving employer-sponsored health insurance, do not sign up for Medicare Part B solely because you turned 65.  Read our related article to Understand what you are getting into.  While there are some exceptions, if you work for a large employer (20 or more employees), you don’t need to do this yet.
  2. Second, those employer plan disclosures e.g. Annual Notice of Creditable Coverage for prescriptions? Don’t throw them away if you are Age 65 or older.  This could cost you extra money.  My advice is to start a Medicare Preparedness File, and save this article as part of your checklist.
  3. Third, have a discussion with your primary care physician:  Ask if they currently accept new patients, especially those on traditional Medicare.  Be bold, and ask if they plan to retire in the near future.  It’s better to find out sooner than later if you need to research a new primary care physician.
  4. Fourth, find an independent agent who focuses on Medicare health plans…and I mean lots
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    of plans e.g FAQs on various Plan Gs.  You are going to need their ongoing, independent advice, as plans (and Medicare) do change over time.  Plus, you need help initially, to discuss a transition plan for leaving employer insurance for Medicare Part A and/or Part B and possibly coordinating temporary COBRA coverage for you and/or a spouse .  Finally, get independent feedback on all the medigap plans and different “flavors of G.”  We put together a good introduction to this topic.  Read:  The Buzz About Plan G and Plan G Extra.

“Our insurance agency is local, and fiercely independent, and contracted with 37 different insurance companies.”

It Is Foolish Not To Use A Local, Independent Agent

Californians do not receive a premium discount when you bypass an agent to go directly to

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the insurer; you only lose your “independence.”  Once you understand this, it is in your best interest to find an experienced, independent agent  to help your transition from employer-sponsored plans to the Medicare world (It’s better than waiting on hold for two hours with Social Security).

A more detailed article on these issues and important timelines and deadlines can be found on our website, derendingerins.com.

Related Links

Watch this video on YouTube.
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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.”