Southern Senior Care Blog

Why do most people go with an F or G plan instead of C, D or E?

I recently got the following question from a visitor to our website. My reply to her is below. I’m writing this pretty late at night, so for you Type A’s out there, if I have missed any of the finer points in my explanation, please let me know.

First of all, Medicare (CMS) creates the Medicare Supplement plans. Medicare Supplement Companies DO NOT create the plans. Whenever you see a copy of the Medicare Plan Table (see below) you will notice they are all the same - same plans, same options, same check marks, same percentages. No matter which Medicare Supplement company sends you the table, they are simply giving you the standardized table that Medicare created for everyone to use. This is a VERY important point to know. 

Click on the table above to see a larger view.

Medicare Supplement companies simply select the plans that they wish to re-sell and they put their price on it. This is another important point. Even though Medicare standardizes the plans, they do not standardize the prices. Companies can charge whatever they want to for the plans they sell. That is why you will see tremendous variations from one company to another for exactly the same plan.  For example, if you are a 65 year old female living in Gwinnett county and do not use tobacco, you can get a Plan F from one company for $119. The same Plan F is currently available from another company for $220. That is a $1,200 a year difference for EXACTLY the same plan. If you get your plan from company B, you are tipping them $1,200 per year.

So, why do most people go with Plans F & G

There are several reasons. First, more companies offer plans F&G. They are newer, and generally provide a better value for your money. Here are a few comparisons.

Plans C&F are very similar except F adds coverage for Part B excess charges. These charges rarely occur, but if they do, they could create a sizable cost to you. For example, let’s say you have a test proceedure, and the healthcare facility charges $1,000. Medicare will approve a lesser amount, let’s say $600. Healthcare facilities are allowed to charge up to %15 more than Medicare approves. This is called an “excess charge.” So 15% of 600 is $90. If you have Plans C, D or E, you would be responsible for that $90. Plan F would cover 100% of that $90, and Plan G would cover 80%. So with a Plan G, you would have to pay a whopping $18.

D,E&G are fairly similar. D&G cover at home recovery up to $1,700, E covers up to $120 of Preventive Care not covered by Medicare. Neither of these two charges occurs very often. Most preventive care is now covered by Medicare, and for one reason or another, most follow-up home visits are also covered by standard medicare and your supplement. We just don’t see the at home recovery charges occurring very often.

So the real choice most people make is between F & G. The big difference between these two is the Annual Part B deductible of $134. Plan F covers this annual charge. Plan G does not. So why would go with a Plan G? There is a good reason. Many Medicare Supplement companies price their Plan G’s at about $200-$250 less than a Plan F. Why pay $200 more in premium for a Plan F, just to save $134?

The other difference between Plan F and G is the excess charges. Plan F pays 100%, Plan G pays 80%. As we discussed earlier, most doctors don’t charge any excess, so this usually doesn’t come into play, and as we showed above for a $1,000 charge, you would probably end up paying about $12 if you had a Plan G.

So, in a nutshell, Southern Senior Care typically recommends Plan G. The only time we recommend a Plan F is when a client lives in a zip code where the prices between Plan F and G are less than $134. Then you might as well go with an Plan F.

I hope this reduces some confusion and does not increase it. As always, if you have any questions at all, please contact us by phone, email, contact form, or chat.