Phil Castell
Castell Insurance
426 E. Washington St., Sequim, WA 98382
Phone: 360-683-9284 • Fax: 360-683-9026
Phil@CastellInsurance.com
www.CastellInsurance.com  

 

Not since Medicare standardized the design of Medicare supplements in 1990 have the programs undergone such a transformation as the one that currently is under way.

To differentiate be-tween the plans, they have been called either "standardized" or "modernized," and in this column I have used "old" or "new."

Standardized plans of the 1990 design are grandfathered in.



Highlights

_ At-home recovery and preventive care benefits will not be available on new plans. (Reason: Medicare in 2011 will do a much better job on preventive care and no one really used the very limited HHC benefits offered under the supplement plans.)

_ Plans E, H, I and J are withdrawn. Due to the above changes, those benefit packages now mirror other plans and no longer are necessary.

_ All "modernized" plans will include a hospice benefit as well as coverage for preventive care Part B co-insurance.

_ Plans M and N are introduced and some carriers now are offering plans K and L.



Plan by plan

These descriptions will show the differences:

Plan F - basically covers 100 percent of all co-pays and deductibles not covered by Medicare.

Plan G - Benefits are the same as F except it does not cover the Part B deductible and now covers Part B excess at 100 percent.

Plan K - Does not cover the Part B deductible or excess and only 50 percent of the remaining charges, i.e. 50 percent of the 20 percent - leaving the client with the balance.

Plan L - same as Plan K except it covers the charges left at 75 percent, not 50 percent.

Plan M - same as F except only 50 percent of Part A deductible and no Part B or excess charges covered.

Plan N - Same as F except no Part B deductibles and excess charges covered, as well as up to $20 co-pay for doctor visits and $50 for emergency room visits.



Big savings

The Office of the Insurance Commissioner has allowed carriers to treat the new plans as totally new and re-price their offerings. This has led to far lower premiums for new clients.

The most extreme is Premera Blue Cross Plan F. The old Plan F premium cost $197 per month and the new Plan F is $134, savings of more than $60 a month for basically the same coverage.

All carriers I have

spoken to (except one) will not allow replacement from the old plans to new plan on a guaranteed issue basis.

A number of insurance carriers are offering Medicare supplement plans in Washington for the first time.

These include Colonial Penn, Gerber Life, Government Personnel Mutual and Sentinel Insurance. Carriers that are primarily Medicare Advantage players are expanding into the Medicare supplement market, including Humana and Sterling.



Opinions, insights

Those are the facts. Following are my opinions and insights into the options available as I am aware of them today.

Mutual of Omaha is the only carrier that will offer Plan N for everyone on a guaranteed issue basis, regardless of health or whether they have had a Medicare supplement plan in the past.

With Mutual Plan N open to anyone, this is an opportunity to get people coverage. Once a person has Plan N, Washington rules say he or she can change to any new "modernized" plan on a guaranteed issue basis.

Premera Blue Cross will be very popular for those people who can figure out a way to obtain coverage.

Hmmm. Please refer to item two items above this.

As always, if you have Medicare-related questions, contact the folks at SHIBA who are at the Sequim Senior Activity Center from 10 a.m.-noon Tuesdays or an insurance agent.



Phil Castell is an independent insurance agent in Sequim. He can be reached at 683-9284 or PhilCastell@msn.com.