Mind the Gap

Michael Flack

MY WIFE WILL BE eligible for Medicare in March 2022. To better understand the process, we signed up for a webinar given by Matt, a Medigap insurance broker. Matt did a good job explaining the issues we faced, so we made an appointment to talk with him on the phone—even though he gave off a used car salesman vibe when, at the end of his presentation, he exhorted us to make an appointment before they all filled up. “Only 20 left… wait… now only 19 appointments are available,” he said at one point.

Medicare only pays about 80% of medical care. We thought it would be complicated deciding how to cover the other 20%, but we may have been too pessimistic. After viewing Matt’s presentation and doing some research on our own, we quickly came to two conclusions.

First, traditional Medicare plus a Medigap policy was preferable to Medicare Advantage. My wife had grown used to going to any doctor she wanted, without referrals or concerns about which tests were and weren’t covered. We were also concerned that, if she went with Medicare Advantage and her health deteriorated, she might not be able to swap back to traditional Medicare because she wouldn’t be able to obtain Medigap coverage. Quite simply, traditional Medicare plus Medigap coverage offers more complete coverage and more options. The higher cost seems worth it.

Second, while there are numerous Medigap plans, only two seem to make any sense: Plans G and N. They’re almost identical, but G comes with no copays and coverage for Medicare B excess charges. I think we all understand the benefit of no copays, but the whole excess charge coverage is a little confusing.

Our subsequent 30-minute appointment with Matt covered much of the above, including how you need to factor in the insurance company’s potential rate increases when making your selection. Matt then mentioned that Plan G would cost “about $100 a month and Plan N about $70 a month.” At the end, he asked if we wanted to move forward with him and “lock in a rate.”

I responded that, before we move forward, could he provide quotes for Plan G and Plan N? To that, he replied, “I just did, about $70 for N and $100 for G.” I then became confused. My wife very reluctantly said we needed some time to think about it.

When we got off the phone, we had a “heated discussion” about my lack of listening skills and the fact I was dragging my feet. I replied that when insurance agents provide an auto or home insurance quote, they don’t preface it with “about.” Why should Medigap insurance be any different? Thankfully, a little while later, Matt’s assistant called us back to get some more details and then provided the exact quote for Plan G, which was… $147.51 a month.

Apparently, there was a miscommunication about our zip code. While I was a little disappointed with having to pay “about” $50 more a month, I was ecstatic to realize that my listening skills were just fine. The afterglow lasted all day, which at one point had me running up some stairs two at a time à la Rocky, while singing, “We are the champions.”

It looks like the winner is Medicare Plan G purchased from Aetna at $147.51 a month. But we haven’t yet signed up. My wife is holding off until we find out if her former employer, Ernst & Young, provides any health insurance benefits to retirees. In the end, that appears to be the hardest part of the process.

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