The 2013 Medicare Advantage Guidelines

The 2013 Medicare Advantage Guidelines

The Obama administration recently sent the 2013 policy and payment guidelines to US health insurers who wish to participate in the Medicare Advantage program. According to management, the proposed changes to the guidelines would result in lower premiums and stable or improved benefits. Because the guidelines had no inclusion of any official estimate of the average net percentage difference in reimbursements, many financial markets and insurers ignored the possible impact of the Medicare Advantage guidelines of 2013 in the industry. Click here to find out more.

Low fees and stable rewards are likely to continue

Medicare private health plans, popularly referred to as Medicare Advantage policies and prescription medication policies (Part D of Medicare), have very low premium rates and stable rewards. Federal officials are of the opinion this trend is likely to continue in 2013.

Employees reported a percentage growth in Medicare per capita expenses and stated that this will be used to determine and set rates for Medicare Advantage plans in 2013. According to the Centers for Medicare and Medicaid Services (CMS), the agency that manages the Federal health care program for the elderly, the 2013 guidelines project an annual growth rate of 2.47% and a per capita growth rate of 2.3% next year. In a statement issued by the agency, “this positive rise in trend will help guarantee that beneficiaries maintain a selection of policies without a huge increase in cost or decreases in benefits.” CMS officials added that the total and final 2013 net rate announcements will be published and published on April 2, 2012.

CMS said it is accepting public comments about the 2013 policy and payment guidelines for Medicare Advantage plans and prescription drugs. In accordance with the Early Warning and Call Letter for 2013, CMS will exercise its authority under the Affordable Health Care Act to deny offers from plan insurers that propose a “very significant” increase in beneficiary cost sharing or a decrease in the benefits.

What are Medicare Advantage plans?

About 25% or 48 million Medicare beneficiaries participate in Medicare Advantage plans (MA plans). Unlike traditional Medicare, MA plans are offered by private health insurance companies. Its goal is to replace Medicare, unlike Medicare supplement insurance plans, which only complement Medicare Parts A and B.MA plans are very popular among beneficiaries since they have no medical subscription. All Medicare beneficiaries are guaranteed acceptance, except ESRD. These plans are also called Medicare Plan C because they combine the benefits provided by Medicare Parts A, B and part of the Part D coverage.

A Basic Guide to Medicare Advantage Plans (Part C)

A Basic Guide to Medicare Advantage Plans (Part C)

Medicare Part A and B coverage, as well as other benefits, are included in Medicare Advantage policies. Most of these policies also include Medicare Part D or coverage for prescription drug. If you wish to enroll in one of the Advantage plans available from private companies, you may do so as long as you already have or may qualify for regular Medicare coverage. You will not need these three or any Medigap coverage if you enroll in Plan C.

The Differences Between Original Medicare and Medicare Advantage Plans can found at where you can learn more about Medicare plans.

While everything Medicare generally covers is covered by a Medicare Advantage plan, there are some differences between them to consider. Most of the time, the difference is in the amount you pay for your pocket health care. Some of these differences include:

  • insurances or pay a different percentage of your medical bills
  • copies
  • franchises

Network of providers available.

  • In-network versus out-of-network

In addition, urgent and urgent medical care is included in best Medicare Advantage (Part C) plans. In some cases, dental, vision and / or routine programs may also be covered by some plans. Most will include Part D coverage. However, Part C coverage does not include hospice care, even with a Medicare Advantage plan, as it is still covered by Medicare.

Different Types of Medicare Advantage Part C Plans:

To determine which type of Part C plan will make your needs easier, review the different types of plans currently available. There are several different plans that include the following:

  • HMO – Health Maintenance Organization Plan
  • MSA – Medical Savings Account Plan
  • PFFS – Private Service Payment Plan
  • POS – Point of Service Plan
  • PPO – Preferred Supplier Organization Plan
  • SNP – Special Needs Plans

Information on these six different types of plans is available online simply by using the abbreviation or what they mean as keywords for your Google search.

Part C Registration

Finally, the application process for Medicare Advantage plans (Part C) will differ depending on the private insurance company you select. However, the registration periods are identical regardless. Enrollment is allowed when you are eligible for Medicare, but there is a 7 month waiting period that starts 90 days before your 65th birthday and continues for 120 days after. Finally, if you are under 65 and receiving SSDI (Social Security Disability Insurance), you will qualify after receiving SSDI for 2 years and 1 month.

Medicare Supplement Plan F 2020

Medicare Supplement Plan F 2020

There are some major changes happening for Medicare Supplement Plan F. This was once the most popular of all the Supplement plans, but it has become considerably less popular due to the savings of other plans such as Plan G over the years. This, along with it being removed from the plan lineup, is part of the reason why Medicare Supplement Plan F in 2020 might not be the best option that most seniors should bother with in the coming year.

What’s Happening to Medicare Supplement Plan F in 2020?

Medicare Supplement Plan F in 2020 is not going away entirely, but it is being limited. Starting on January 1st of 2020, if you don’t already have Plan F, then you will not be able to enroll in one. It’s now part of a closed risk pool that limits who is able to sign up for it. Those who decide to remain in Plan F may or may not see an increase in the prices. This also includes the removal of two other Medigap Plans, both Medicare Supplement Plan C and the high-deductible version of Plan F. Plan C was identical to Plan F except it does not cover Part B excess charges.

The high-deductible Plan F will be replaced with a High Deductible Medicare Plan G.

First Dollar Coverage – No More

The main reason for the removal of Plan F and C is due to it providing what is called “first dollar coverage”. This means that policy holders of Plan F were not required to pay any deductibles, coinsurance, or co-payments before the coverage began paying. This resulted in massively high claims which of course, drove up health care costs. Therefore new legislation was enacted to minimize the disadvantages of Plan F.

Now Plan F can only be renewed, and it is not something that you can sign up for in 2020, if you were not subscribed to it in 2019. It joins the list of several past plans that have succumbed to the same fate. This includes what was the most popular plan years ago, Medicare Supplement Plan J.

What Medigap Plan F Covers

Plan F’s coverage is higher than that of any other Supplement plan. It is the full coverage Medicare Supplement you can get quotes for by clicking and that simply means that it covers all the medical expenses that fall under the supplementary category. Let’s take a look at what they are:

  • Medicare Part A copayment- What you pay alongside Medicare for Part A services
  • Medicare Part B copayment, the same as Part A’s copayment, but related to outpatient services
  • Medicare part B excess charges- What you pay when you receive Part B services from a medical facility where Medicare is not fully honored or accepted
  • Medicare Part A coinsurance- This covers hospice care expenses on top of what is covered by the basic Medicare plan
  • Medicare Part A deductible- You have to pay this for Part A services before Medicare pays anything
  • Medicare Part B deductible- You’ll need to pay this before receiving any Medicare coverage for Part B services
  • Nursing care coinsurance- You pay this alongside what Medicare covers for nursing services
  • Blood use- You have to pay for the first three pints of blood each year, if you have Medicare, and Plan F will cover those three pints for you
  • Foreign travel exchange- With this coverage item, you get taken care of for up to 80% of the cost of emergency medical transport outside US borders and as much as $50,000 over your lifetime

Changes to Medicare

Medicare Supplement Plan F is not the only plan affected by the changes happening to Medicare Supplements. In fact, changes are occurring across the board to Medicare and Medicare-branded plans. This is all part of the MACRA 2020 shakeup. MACRA is the Medicare Access and Chip Re-Authorization act of 2015, and it is still in effect for 2020. The changes are mostly affecting the kinds of cards that are issued, which will not contain Social Security numbers. Instead they will have an all-new number that is unique to each Medicare member and card. New cards are being issued, but not all current Medicare subscribers have received new cards yet. Until then, their current cards will still be valid.

New cards began to be issued in 2018, but they will still be issued through much of 2019. The plan is to have all seniors fully transitioned over to the new cards by April 2019.

With any change to Medicare this major, there are bound to be changes that affect the Supplement plans, and this time is no exception. Plan F is not the only Supplement plan going into the closed risk pool and being taken off the market for new subscribers. Medicare Supplement Plan C is joining it, and the same restrictions apply to it as to Medicare Supplement Plan F 2020. Anyone who wanted to sign up for either of those plans for the 2020 year will need to find a different plan to pick. Anyone who is still signed up to either of those plans can choose to renew their coverage, change it or cancel their coverage outright.

If you are confused about the changes to Medicare, you just want some help or you want to have some questions answered, then please feel free to get in touch with us. Our Medicare professionals can assist you and help you understand the changes that have occurred to Medicare and the Medicare Supplements. They can tell you how those changes are going to affect you and what new choices you may have to make for the future.

Should You Keep Medicare Supplement Plan F after 2020?

If you have Medigap Plan F right now, should you renew your coverage for the 2020 year? It’s a question that every senior should be asking who is signed up for this plan. It’s time to question Plan F and what it does for you.

Simply put, no one knows where the rates will go for regular Medicare Plan F after 2020. The plan will be considered a “closed” block of business or risk pool. This means that no new premiums or people will be joining, many of them people turning age 65 who likely would be relatively healthy. This is especially important because future rate increases are based on the amount of premiums coming into the group, versus claims being paid out. After that is calculated any new rate increases are established. Often people think insurance carriers can simply make up rates as they go on. This is not the case. In fact, by law a certain percentage of every dollar collected by the insurance company must go to pay health claims.

If there are no new premiums coming in to offset claims, historically the only way for rates to go were up. When Medicare supplement Plan J exited the market this happened with almost every carrier in almost every state. Again, it is not a guarantee that rates will raise rapidly once Plan F goes away.

That being said…

Should you really be on Plan F to begin with?

Quite honestly, in many cases Plan F actually costs you extra money to be on in most markets across the country. Because the only difference between Plan F and G is who pays the annual Part B deductible, and the much higher cost to have Plan F anyway, most often Medicare Supplement Plan G is a better option anyway. Now, and beyond 2020.

The next best plan as far as high coverage goes is going to be Medicare Supplement Plan G. This one will cover you nearly as well as Plan F did, but it costs less, so it’s a great deal in most instances. Of course, the rates vary from one insurance company to the next, and you can use our website to compare them and see who has the best rates on Plan G. What you will find, though, is that Plan G is priced affordably most of the time and is well worth the money, so long as you can use the coverage that it offers you.

Plan G will cover you for Medicare Part A’s deductible, Part B’s excess charges, Part A’s copayment for in-hospital stays and Part B’s coinsurance of 20% on all Medicare approved expenses. It covers the coinsurance payment for hospice care from Part A as well, along with nursing care coinsurance and the first three pints of blood that you use up each year. It will even cover you for the cost of being transported to a medical facility in a foreign country in an emergency.

You can sign up for Plan G at any time during the year, especially during the 2020 Open Enrollment period. This runs from October 15th of 2019 until December 7th of the same year. If you have a Medicare Advantage plan and you’re wanting to return to Original Medicare and a supplement, you will have to sign up during that period if you want to be covered by Plan G for 2020. If you had Plan F previously or were thinking about signing up for Plan F due to how well it might fit you, then definitely consider Plan G now and don’t wait until the enrollment period!

 It’s the highest coverage plan available to new subscribers, and there are plenty of insurers selling it at reasonable prices. You should not have to overpay to get the coverage it offers, so long as you use resources like our website to get rates and compare them to one another.

As the most comprehensive Supplement plan starting January 1st, 2020, Plan G is worth considering for every senior and not just those who want or had Plan F. It offers so much coverage that it could provide peace of mind to people who want to be covered for the unexpected. It may not be affordable for everyone, though, so be sure to use our website to compare rates on this plan and others to see what you can afford.

Signing Up for Medicare Supplement Plans in 2020

Medicare Supplements are available to anyone who is 65 or older, as well as those who qualify earlier for these plans due to a medical condition. If you are not sure if you are eligible for Medicare or Medicare Supplements, then you can always talk to us or to a Medicare insurance agent to get an answer.

With any Supplement plan, you also need to have basic Medicare insurance. This needs to be a valid, active plan for your Supplement plan to function properly. You won’t receive any coverage from the Supplement plan until the basic Medicare plan is active.

All Medicare supplement plans are offered by private insurance carriers and not Medicare directly. This means that numerous insurance companies can offer them to seniors, and they can even set their own rates for these plans. That is why it is so important to use our site to compare the rates and source your quotes. There is no faster way to compare prices and get multiple quotes.


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Once you have signed up for Plan F or any Supplement plan you choose, you will be locked into that plan for the next full year. The coverage will begin on January 1st and end on December 31st. While your coverage is active, you will pay exactly the same rate each month and will receive the same coverage as well for likely a full year, as it’s not typical that rates increase within the first 12 months of your policy.

If your insurance company wants to change prices mid-year, then that won’t affect you until it is time to renew your plan on its anniversary in most cases. You can choose to renew and get the same coverage plan at the new price, or you can switch to another plan within the same company or cancel your plan completely.

An important factor to note when you are applying for a Supplement plan is the guaranteed coverage from company to company. You can have the same coverage being sold at all sorts of different prices. The coverage plan you choose (be it Plan F or something else) is not going to have more or less coverage than advertised simply because you got a different price on it. If you pay a lot for Plan F, you still get covered just as much as if you paid a much cheaper price for it. This means that it it to your benefit to find the cheapest price you can on the plan you want. There are some good deals on Supplement plans that you will miss out on if you do not source multiple quotes and compare the prices as much as possible.

Medicare Supplement Plan F in 2020

Plan F is not for everyone, and even though it was a very popular plan in the past, it simply isn’t going to be available to most seniors for the 2020 year. Only people who are already subscribed to Plan F in the previous year can have that same plan moving forward. It is simply not available for anyone else. There is no eligibility process to go through to determine if you can sign up for Plan F. You either renew that plan or you don’t get it.

Thankfully, Medicare Supplement Plan F 2020 is not the only option for seniors wanting a high coverage Supplement plan. There are several other great choices that bear consideration. If you are not sure what plan to sign up for or what you should do if you are Plan F subscriber, then you can call us and let us answer your questions. We will help you make the right choice and ensure you are informed about your options and what the best move is for you to be well covered for 2020.