New High Deductible Plan G will Replace High Deductible Plan F in 2020

| September 17, 2019 | 0 Comments | Email This Post Email This Post


Medicare policies are facing big changes as early as next year. The new High-Deductible Plan G (HDG) will replace High-Deductible Plan F (HDF) in 2020. The federally funded national health care policy is constantly changing. The new year is no exception, changes may impact all current and potential future Medicare beneficiaries.

Members should constantly educate themselves to stay in the loop about when Medicare makes any policy changes. The new program updates may encourage beneficiaries to adjust their current plans before the shift in coverage takes place.

The Medicare Access and CHIP Reauthorization Act (otherwise known as MACRA) is changing the way the nation calculates health care professionals and how they get paid for services. Additionally, MACRA strictly prohibits carriers from offering any Supplement plan that includes coverage for the Part B deductible.

First-Dollar Coverage plans F, C and High-Deductible F will no longer be available to those eligible for Medicare after January 1, 2020. However, any person eligible for coverage before the new year may enroll, even after the plans retire. Any state that fails to comply with the new requirements may give up their rights to regulate Medigap coverage all together.

Newly eligible individuals will see the biggest impact. Although, some current members may see a small impact too. Some plans are going away, coverage gap is coming to an end and new options for coverage are available. Seniors with Medicare should anticipate a big year for benefit and coverage updates.

New High-Deductible Plan G will Replace High-Deductible Plan F in 2020

The new, much anticipated, High-Deductible Plan G is making its’ big debut come the new year. Future beneficiaries, or those newly eligible may use the HDG policy in place of retiring plan HDF.

Individuals eligible for Medicare health insurance coverage AFTER January 1, 2020 may not enroll in the popular High-Deductible Plan F. However, HDG offers a high deductible option to both current and newly eligible beneficiaries.

The Part B deductible for 2019 is $185. While this amount isn’t part of the HDG policy, it may apply towards the deductible amount. Aside from the differences in deductible costs, HDG mirrors the popular High-Deductible Plan F.

The HDG’s benefit summary isn’t yet available. According to past events, beneficiaries can expect the deductible requirements to be met before coverage can start.

Any beneficiary eligible for Medicare health insurance before 2020 may still enroll in the retiring plan. Current High-Deductible Plan F members are grand-fathered in; meaning, coverage may continue for these plans. Although, it’s likely premium amounts may increase as less people enroll in the plan.

First-dollar Coverage Plans are Going Away

The introduction of MACRA began in 2015. Currently, some Medigap policies cover the Medicare Part B deductible cost. MACRA requires the elimination of any plans including the Part B deductible. But why? If it wasn’t a problem in the past, why is it an issue now?

Well, Congress believes Medicare beneficiaries should be responsible for the first-dollar of care. Otherwise, beneficiaries should pay a deductible amount before coverage starts.

First-dollar coverage plans start covering costs immediately. This means, no deductible is necessary for benefits to begin. Congress states that the over-use of healthcare services is a result of the zero-dollar out-out-pocket costs for coverage.

Ultimately, the goal is to require ALL beneficiaries to meet a Part B deductible cost before benefits can begin. In turn, Medicare claim expenses are expected to decrease. Holding individuals responsible for SOME of their healthcare costs, may reduce the number of unnecessary office visits.

Medigap Plan F and HDF

In 2019, the most comprehensive Medigap policy available is Plan F. Often known as Medicare Supplement Plan F, coverage includes both deductible and copays/coinsurance costs. Beneficiaries with Plan F don’t need to worry about any unexpected out-of-pocket expenses.

Premium Medicare Plan F policies account for more than half of all Medigap plans in place. Adding Supplement Plan F to Original Medicare, provides the most comprehensive coverage. Medicare defines Medigap Plan F as the most beneficial supplement policy available to those eligible before January 2020.

Covering all benefit gaps that comes with Original Medicare Parts A and B, Plan F is often the most sought after. Including deductible amounts for both hospital (Part A) and outpatient (Part B) services.

Additionally, it even covers the 20% that otherwise is the beneficiary’s responsibility. Medicare first pays its portion of claims then, Medigap Plan F covers the rest. Hence the $0 out-of-pocket costs.

Policies include any Part B excess charges. Plan F members are never be responsible to pay the standard 15% excess charges allowable for Part B services. Benefits such as the freedom to choose any doctor from more than 880,000 providers across the country.

Plan F members don’t need a referral to visit with a specialist. Beneficiary’s with Plan F have guaranteed renewable policies. Meaning, their coverage can never be revoked due to any health condition or how many claims they file.

High-Deductible Plan F offers all the same benefits. Although, members pay a lower premium rate because their deductible amount is higher before coverage starts.

In 2019, HDF plans have a maximum out-of-pocket cost of $2,300. Therefore, Medicare pays 80% of costs while the beneficiary is responsible for paying their portion until the deductible is met. After, this policy works just like Plan F; covering the entire costs of all Part A and B services.

Best Alternative Plans to Replace Plan F

Replacing Plan F may sound like a hassle, but Medicare offers the best alternative plans to replace Plan F. Plan G is the closest to Plan F as possible. As previously stated, the only difference is Plan G requires a $185 Part B deductible cost to be met before coverage starts.

Otherwise, the benefits are the same. Carriers may receive a $25,000 fine and/or imprisonment for up to 5 years if caught selling plans that include the Part B deductible.

However, the best policy depends on many factors. Things like location, eligibility, age and health conditions may determine what Plan is the best for an individual.

The second most popular supplement alternative is Plan N.

The New HDG Plan Replaces the Old HDF Plan

The prediction of first-dollar coverage plans such as High-Deductible Plan F is that as less become eligible for enrollment – other Supplement plans will become more popular.

Officially, the Medicare Supplement High-Deductible Plan G should be ready for purchase on the Medicare market come January. During this time, the number of HDG enrollees is likely to rise.

The new HDG plan is the best option for those seeking the benefits plan HDF offers. The two plans likely share the same deductible amounts. Supplement Plan HDF has a deductible amount of $2,300. Although, the Part B deductible is only $185 annually, the HDF deductible includes this amount.

While HDG plans may not include the Part B deductible, it’s likely the cost applies towards the total deductible cost.


Author Bio:

Jagger Esch is the President & CEO of Elite Insurance Partners, a senior healthcare learning resource center. As a young entrepreneur and seasoned insurance expert, he has a passion for helping people. Since the inception of his first company in 2012, he has been dedicated to helping those eligible for Medicare by providing them with resources to educate them on all their Medicare options.



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Category: Medicare