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Medicare Supplement Plan F vs. Plan J: What Is the Difference?

In June of 2010, the Medicare Modernization Act was passed, and Medicare Supplement Plan J was dropped from all new sales. If you had Plan J, you were allowed to keep it, but the reasons for dropping Plan J from new sales are not understood by many Plan J policyholders.

There are three benefits that Plan J offered policyholders that Medicare didn’t cover: Preventative care ($120 per year), At-Home Recovery ($1600/year), and prescription drug coverage. Over the years, Medicare has changed what they cover, and now Medicare does cover preventative care and at-home recovery, and Part D prescription drug coverage is available. Therefore, the extra benefits provided by Plan J are now duplicated and rendered unnecessary.

Prior to June of 2010, any consumer shopping for “full coverage” for their Medigap plans were told that Plan J was the full coverage option. Now that Plan J is no longer offered seniors that are looking for “full coverage” for their Medigap plan, they are now offered Medicare Supplement Plan F.

Plan F has the same benefits coverage as Plan J, minus the Preventative Care and At-Home Recovery services. Now that Medicare covers those two line items, the plans perform equally, in terms of coverage.

If the Plans Perform Equally, Why Should You Switch to Plan F?

Rate increases.

There are many people out there that still have their Plan J, and many of them are seeing their rates climb steadily. Each plan letter has a collection of policyholders, or a “risk pool.” Since Plan J has not been sold since May of 2010, there are no new clients entering the Plan J “risk pool.” This fact, combined with the fact of life that we have more health conditions as we get older, combine to conspire against our pocketbooks. Since the insurance companies are in the business to make money, they must keep revenue higher than the claims they pay out. Since they can’t sell new policies, the only way for them to offset the increasing number of claims for Plan J policyholders is to increase the monthly premium of those already in the risk pool. The end result is that those in Plan J will continue to see their monthly rates rise.

Nothing on this website should ever be used as a substitute for professional medical advice. You should always consult with your medical provider regarding diagnosis or treatment for a health condition, including decisions about the correct medication for your condition, as well as prior to undertaking any specific exercise or dietary routine.

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