To make a decision between the original Medicare path or the Medicare Advantage (MA) path, it is important to make a choice between MA with out-of-pocket protection and one of the Medicare Supplemental Plans (Medigap) that pay the 20% not covered by original Medicare.
KNOWING MEDIGAP PRICES BY PLAN IS CRITICAL!
The NRLN had urged the Centers for Medicare and Medicaid (CMS) to post prices by zip code for Medigap plans. Now that CMS has made Medigap pricing data available by zip code and plan type we want to make it easy to navigate the CMS website. Jacqueline Lawson, NRLN webmaster, has created a step-by-step video on the NRLN homepage at www.nrln.org to guide individuals through the process of accessing the various Medigap plans and the prices available in the zip code area where they live.
How to Choose Medigap Plans
An example of the importance of being able to determine the best price for Medigap plans is the experience the NRLN had beginning in 2018 with our Tennessee Valley Retirree Chapter (TVARC). The Tennessee Valley Authority discontinued a company sponsored Medicare supplemental healthcare plan in 2017 and it hired a Private Medicare Exchange (PME) company to manage a Special Enrollment Period (SEP). The PME offered 14,000 beneficiaries what it and the TVA characterized as quality plans at low market-based prices. An SEP is to ensure an unbiased open enrollment period for retirees whose companies terminated supplemental healthcare benefits.
The TVARC/NRLN team investigated and found that the PME only offered plans they sold on behalf of selected insurers, resulting in retirees paying 35 – 52% more for the same plan sold by other insurers in the same zip code. In fact, they sold the same plans under commission that could have been purchased direct from the insurer at far lower premiums.
This experience caused the NRLN to pursue the matter with the Tennessee Insurance Commission and CMS officials. The NRLN also asked Tennessee Senator Marsha Blackburn’s staff to pursue this matter of price disclosure and deceptive marketing with CMS.
We then pursued the case with U.S. House and Senate committees. After years of debate, prices are now available online at www.Medicare.gov for you to see. Watch the video and shop for better prices!
We are seeking a new SEP for 14,000 TVA retirees where pre-existing conditions would be waived.
Bill Kadereit, President
National Retiree Legislative Network