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  

 

As I write this on Feb.25, I have been watching with some amusement the president's health care bipartisan summit - all six hours of it.

I say some amusement because politicians use far more words and say far less in front of a camera. Sometimes, I think, things best are sorted out behind closed doors where people can speak freely without having every utterance be a potential landmine at election time.

And yes, this year is an election year. So regardless of whatever happens with President Obama's health care initiative, we already have changes being implemented.

In last month's column I promised to update on the revised Medicare Supplement (Medigap) policies that will be available soon. These are the biggest changes in individual Medicare Supplements since they were standardized in 1990.

I want to assure everyone that their current plans will continue if they choose. Only policies sold with start dates of June 2010 or later will be affected.

In talking to the Office of the Insurance Commissioner in Olympia, I find they already have approved a few plans, with more anticipated in the near future.



The changes

The main differences among Plans A-L are:

_ "At home recovery" and "preventive care" no longer will be included in any new plan because few people used the "at home recovery" benefit. I personally know of only one claim that was paid under that benefit. "Preventive care" also has been removed because Medicare does a better job of screenings than it did in 1990.

_ One major new benefit to all plans is hospice. While hospice often was included under original Medicare, it had not been defined clearly under the supplements. That now has been addressed with new language in all new policies.

_ Eliminating home care and preventive provisions streamlined the number of plans. As of June 1, plans E, H, I and J no longer will be offered. However, remember you are grandfathered if you have such a plan and may keep it as long as you wish.



Stay with Plan J

In our office, we have hundreds of clients who are covered by Mutual of Omaha Plan J, which has benefits that no longer will be available on other plans. We recommend clients hold on to those benefits as long as possible, unless plans' prices dictate otherwise.

_ Plan G has been modified slightly so that it now pays 100 percent of Medicare Part B excess charges, not the prior 80 percent. This is minor, as I am aware of only two doctors in Sequim who charge the excess fees.

But this minor change has made plans F and G identical, except for the Part B annual deductible ($155 in 2010). Plan F covers it; Plan G does not. If you can find Plan G priced $13 less than Plan F, Plan G is a better value.



What's new

Phew! Now I'll describe about the new plans:

_ Plans M and N will be available, but how many companies will offer them isn't known. They will have co-pays and deductibles.

Plan M's co-pays and deductibles are based upon a percentage, while Plan N's are based upon a fixed amount. For example, a $20 co-pay for a doctor's office visit, or $50 for an ER visit.

I think Plan N's known payments will be more appealing than unknown expenses based upon a percentage of the bill.

It seems the more things change the more they stay the same. When people work until they retire, they are used to having a co-pay when they visit the doctor. When people are on the Medicare Advantage Plans, they have co-pays. Now when they are on a traditional supplement, they also will have co-pays.

The lines are blurring between all the options, and benefits are appearing more uniform.

We will have a few months to get used to all these changes before they hit at the end of the year.

I thought life was going

to get easier and slow down for a while. Was I wrong!



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