Published by Carolyn Portanova

If you're not discussing Plan N with your clients, it's time to start. Why? It has very similar coverage to Plan G, which is clearly one of the most popular Med Supp plans out there, next to the Plan F. If your clients are unable to purchase a Plan F due to MACRA, then you may tend to encourage them to purchase a Plan G. And that's always been a smart move. However, the differences between Plan G and Plan N are as follows:

• Plan N requires policy holders to pay the Part B deductible ($240 in 2024)
• Plan N requires policy holders to cover the cost of any copays (up to $20 for some office visits and up to $50 for ER visits)
• Plan N requires policy holders to pay any Part B excess charges (15% more than what Medicare covers).

Here's where it gets really interesting though. The vast majority of Plan N policy holders never end up paying the Part B excess charges because nearly every doctor in the U.S. (96%) who accepts Medicare, only charges the amount Medicare has approved for their services. So what does that mean? It means that your Plan N clients will likely only pay the cost-share copays and the Part B deductible.

Let's dig a little more into the Plan G vs. Plan N discussion. 
If your clients purchase a Plan N:

• they will have nearly identical coverage to Plan G
• their premiums will definitely be lower
• they will likely not experience rate increases as quickly as those with Plan G
• their out-of-pocket costs will be the Part B deductible and any copays they may incur​

*Plan N pays 100% of the Part B coinsurance, except for a copayment of up to $20 for some office visits and up to a $50 copayment for emergency room visits that don’t result in admission.

Consider offering Plan N to your clients and carefully explain to them the cost differences, and how in the end, Plan N might be their better option, especially if they don't visit the doctor frequently. In the end, they could wind up saving more money over a Plan G and have the best coverage for their needs.​

Published by Carolyn Portanova

Part B giveback is another term for a Part B premium reduction or rebate. This is when a Medicare Advantage plan reduces the amount your client pays towards their Part B monthly premium. These rebates are offered by some Medicare Advantage plans and are designed to make plans more affordable. The amount of these Part B rebates can range depending upon the Medicare Advantage plan. They can be as low as $20 for some plans and yet, some plans offer more than $100 in giveback rebates. ​

​How it Works:
If a Medicare beneficiary is on Social Security, the Part B premium comes out of their monthly benefit before the funds are deposited to their bank account OR it's reflected in their monthly check. The Part B giveback reduces their Part B premium, which means more money ends up in the individual’s bank account. 

If your client pays their Part B premium directly (not by automatic Social Security check deduction), their Part B premium statement will be updated with the giveback amount credited to what they owe. The standard Part B premium for 2024 is $174.70. This amount changes yearly and is based on income. 

An Example:
​If a beneficiary's monthly Social Security check is normally $1,600 and their giveback is $100, their Social Security benefit will now be $1,700. If they pay the standard Part B premium ($174.70) the amount they will owe after receiving the giveback will be $74.70.

Part B givebacks can offer Medicare beneficiaries a way to save money by choosing a Medicare Advantage plan. ​​To be eligible for this program your client must be responsible for paying their own Part B premium, which means they are NOT eligible to receive Medicaid or participate in a Medicare Savings Plan. 

​As always, it's important to make sure a Medicare Advantage plan fits your client's needs and budget. It's also crucial to make sure it includes access to the doctors and hospitals they need, as well as making sure their prescription drugs are on the plan’s formulary.​