I want to go over What is the Medicare High Deductible Plan G? I have a feeling that the numbers for this plan are going to explode in 2023. More and more people are calling about this plan, and more and more people are signing up for the High Deductible Plan G. If you don’t know who I am, my name is Brian Monahan. I’m licensed in 46 states throughout the country, and I’ve been working with people going on to Medicare and people on Medicare for the past 15 plus years. And in my videos I try to give you raw data to show you the numbers about these different plans.
What is Medicare High Deductible Plan G
So in this video, I want to jump into the High Deductible G Plan. So the first thing that we want to know is what is the maximum out of pocket, meaning how much am I going to spend if I go to the hospital or doctor’s 15 times during the year?
Medicare High Deductible Plan G has a $2,700 deductible for the year. Now what that means is you will keep paying until you reach $2,700 and then you will not pay anymore for inpatient hospital coverage or outpatient meaning doctors, ambulance, specialists, physical therapy, that sort of thing. So $2,700 is the max that you will pay plus your premium. So let’s dive into the numbers.
So the premium on average for a 65-year-old is going to be around $40 to $50 per month. Now I have a chart on this. I went and did some numbers so that people would kind of understand, well, if I’m paying that at 65, what will I be paying at 70 or 75 years old? If we look at this chart where I did some different states from around the country. Now if your state’s not on here, it doesn’t matter. These are averages and the average is pretty much going to be the same no matter what state you’re in. Let’s just take Florida for instance. $52 on average for the 65-year-old. Now there are plans that I’ve seen for $40 a month and then 10 years later with that same plan, it would be $94. It only went up $40 in 10 years for this High Deductible plan. That’s number one.
The rates that I’ve seen have been kept extremely low over the years. They do not increase the way that some of the other plans do. Now, the reason for this is because a lot of the increases go by percentages, so if you take 5% or even 10% of $52, it’s only going to raise $5.20 for that year. That’s why it’s kept so low, but let’s go back to this chart and explain the High Deductible G.
If your premium is $40, you’re going to pay that each month to the company no matter what. That’s just to have the plan. Now, what does that cover? Well, basically that $2,700 is your deductible for the year. You’re going to pay 20% of everything that Medicare part A and B does not cover up to the $2,700. Let’s say you go to the doctor and the bill is a hundred dollars, you’re going to pay the $20 Medicare A and B. Your original Medicare is going to pay the $80 and then you’re going to pay the $20, and if you went to the doctors a hundred times, you would keep paying that until you reach $2,700.
If you notice here I have a hospital and I put zero in here because it depends on if it’s an inpatient, outpatient, how much you’re going to pay, but it’s going to be approximately 20%.
This is the same thing for CAT scans, skilled nursing, but the thing about this is, let’s just say you never did anything. You’re going to take 40 times 12, and that’s going to be down here if you see this, $480. So this is what your cost is going to be, even if you did this to the extreme level, meaning you went to the doctor and hospital 50 times during the year, you’re going to pay your premium to the company, which is going to equal $480, if it’s $40 a month, then if you max this out, the most you’re going to pay is $3,180 for hospital and doctor visits. Now, that might sound like a lot compared to these other plans, but a lot of people are saying to themselves, well, I only go to the doctor a couple times. I want to save this money. It’s very unlikely that I’m going to max this out.
And the best thing about this plan is that it works like the G plan. There’s no network. You can go anywhere throughout the entire company. It is accepted anywhere that Medicare is accepted. So once you have your Medicare A and B card like this over here, then you have your High Deductible G plan, you’re taken care of by the hospital and doctor up until that... You have to pay up until that deductible, but then you’re taking care of a hundred percent. And most of the time that I’ve seen people go nowhere near this deductible, $2,700. Most people said to me, they said, “Brian, I mean I literally only spent $480 for the premium and then $500 more. I went to the doctor or the specialist a couple times. I spent less than a thousand dollars for my Plan G High Deductible in 2023 coverage, and I had the maximum benefits.”
Plan G High Deductible Payments
Now here’s the thing, people have made comments on the videos. They want me to explain all the details of what people are going to pay. Now, the first thing in 2023 to have this Medicare A and B card that’s given to you by the government, you pay for your part B, but we’ll just say you pay for part A and B, just to make it simple. To have this card, you’re going to pay on average $164.90. Then you would add this $40 if that’s what you’re going to be paying for the Plan G High Deductible in 2023 per month. So it would be $164 a month plus $40 a month. Now what else do you need to pay for? Well, you will have to pay for a stand alone prescription drug plan. They call it Part D.
Now, with these plans, the lowest I’ve seen is a little bit over $5 per month, and most people, and I have a lot of clients throughout the entire country, most people are not paying over $35 for this plan. As a matter of fact, most people that I’ve seen are not paying over $20 for this plan. So really I should have between $5 and $20, but I just put $35 in here just to be, I guess on the safer side. But if you’re not taking any drugs or you’re taking a few generic drugs, let’s say you’re taking a blood pressure medication and a cholesterol medication like a lisinopril and a simvastatin, most likely you’re going to pay $5 to $10 for your drug plan. So you would take the $164 plus the $40 plus $10, and that would be it except for dental, vision and hearing. Now, this is optional. These once again are standalone plans. Let me slide down here a little bit.
These are standalone. You can get this from any company you like. I always say ask your dentist what plans that they take and what the best plans are and then go from there, but the way that the Plan G High Deductible in 2023 also works is that let’s say you get a High Deductible G plan from UnitedHealthcare or from Aetna. You can get a drug plan from WellCare, let’s say for $5 or $10 a month, let’s say $11 a month from WellCare, and then you can get a dental vision and hearing plan from Humana. Or you can get a High Deductible G plan from UnitedHealthcare, get a UnitedHealthcare drug plan and a UnitedHealthcare Dental vision hearing plan.
You can mix and match or you can get the same company, but you can group it together yourself. They don’t group it together for you, which is great because some people want to save money. Some people say, I don’t really need a drug plan, just give me the cheapest one and that’s when you have the flexibility of mixing and matching. Now, another thing that I’ve seen, and this is very important, is when I get a phone call about the High Deductible G plan, usually people say, I’m looking at a Medicare Advantage plan or a High Deductible G plan. I want to know which one is better.
This is kind of… It’s not a tough question to answer, but I have to dig into the numbers of both of the plans that you’re looking at or at least know your zip code for this. But if you look at this, here’s the difference. If you look at this chart. So the Advantage plans and this really goes by your state that you’re in and definitely the zip code that you’re in, because I have up here… So if we go through the Advantage plan, most of these are zero premium. This is for HMO and PPO plans.
I have a hospital stay at $250. Now, if you live in New York City, even if you live in Brooklyn or wherever, or Queens or one of these places, you’re going to pay for the hospital. I’ve seen a lot of these Advantage plans for $560 a day and so forth. Now, I’ve also seen $195 a day in different states, so this really depends on where you live. But for doctor’s visits, a lot of times the Advantage plans are zero to see your primary care, and then they might be $35 to see a specialist.
Another thing that you want to look at, excuse me, is the CAT scans and the PET scans and MRIs. A lot of times these will be between $195 to $300 each time you go. And then the skilled nursing, of course you’ll get days one through 20 a lot of times for zero cost to you, and then the max out of pocket.
Medicare High Deductible G Plan Max out of Pocket
This is the question that I get or the comment that I get all the time when people call. They said, you had up there $7,550 for your max out-of-pocket. I’m looking at a plan that says $1,900 max out of pocket or $3,500. Well, here is the major, major thing about that. The higher the max out-of-pocket that I’ve seen most of the time, the better the plan, the more flexibility. And I’m going to get into the High Deductible plan versus the Advantage plan, but I just want to explain this. Most of the time that I’ve seen, oh, the max out of pockets $1,900, depending on the HMO or PPO, you have to realize this, most likely is going to narrow the pool of doctors that accept this and the hospitals that accept it and the insurance companies a lot of times fight with people about what coverage they’ll get.
For instance, they want to get a knee replacement and the insurance company will say, “Well, you don’t need one. You need to do therapy for six months and then we’ll see if you should get the knee replacement.” I hear this stuff all the time. The good things about the Advantage plans are they give you a drug plan with it. They give you dental, vision and hearing. Not that it’s the best, but they give it with it most of the time and a gym membership is what people talk to me about all the time. A free gym membership people are really interested in that for some reason. I get it, some gyms are $150 a month, they have the coffee machines and it’s kind of a hangout center plus a workout, and they have saunas and everything, so I do understand that. These can be very expensive and it can lower the cost.
But the one thing I have to tell people is, this is health insurance. This is not gym membership so the major thing that you have to look at before you look at all the gimmicks and what they’re giving for free and everything is what is your hospital and doctor coverage, especially the hospital coverage because when I get calls throughout the entire country and they say, “I’m on an Advantage plan, this happened to me, I want to go to a Medigap plan or a Medicare supplement plan.”
The biggest thing is they had something happen to them and now they don’t like their Advantage plan. It’s very hard for them to switch into either a High Deductible G plan, G plan, or an N plan.
So here’s the difference between these plans. Yes, you have a zero premium with the Medicare Advantage. The High Deductible will be $40. What is the difference? Freedom. I always tell people this, you will never call me or your agent and say they didn’t. I went, excuse me. I went to a different part of the country and needed to see a doctor. I needed to go have something done in the emergency room then the hospital, and they did not accept my High Deductible Plan G. This is very unusual. 99%, maybe 98% of the hospitals and doctors in the United States accept Medicare, so this is not, most likely not going to happen.
With the Advantage plans, you have got to call ahead, make sure they accept it. Sometimes they don’t. You have to go to specific places and even if you have a PPO, that does not mean that they accept the plan. Just means you’re going to pay a higher price for the procedure or whatever it is that you do.
Now, the max out of pocket, as I showed you before for the High Deductible G plan, $2,700 plus your premium, plus your drug plan and your dental, vision and hearing, and that’s going to be your max out of pocket. Now I have $1,480 here. This is just a number that I put in here. If you spend a thousand dollars on the deductible plus your premium payment, but I didn’t include with this $1,480, the drug plan or the dental, vision and hearing. If you really want the numbers for the High Deductible plan, I would say on average $40 for the premium, maybe $50.
If you’re 65, most likely you’ll spend less than a thousand dollars from what I’ve seen, unless you have to go to the hospital and so forth. Even then you might spend a thousand dollars, so this will be your total for your Plan G High Deductible in 2023 for hospital or inpatient and outpatient. But then you’re going to tack on your drug plan, which might be $10 a month or $20 a month, and then your vision, dental, and hearing if you want one of those, which will be between $40 and $60 a month.
Where is Medicare Plan High deductible G accepted?
Now with all this included, most likely it’s going to be less than $2,000 for the year, most likely. When you have these… But here’s the thing, you will be covered throughout the entire United States and you’ll be able to go anywhere. They will look at that plan and say, “Okay, you’re accepted here” at 98%.
I’m just actually being somewhat conservative with 98. There’s very few hospitals and doctors that do not accept Medicare, original Medicare with a gap plan. Now the Medicare Advantage is totally different. The only calls I get throughout the entire United States are people that are unhappy. They’re either unhappy with the price of their Medigap plan and they want to switch companies and so forth, or switch plans. Maybe they want to go from a High Deductible plan to a Plan N or vice versa. But the Advantage plans, I get calls throughout the United States saying, “I thought this was a great plan. It’s zero premium. It gave me all these things. Then I had to use it for something serious and I really paid out.” Now here’s the thing, if you go years without doing anything, going to the hospital and so forth, you can save a lot of money with Medicare Advantage.
But this is basically Plan G High Deductible in 2023 versus the Advantage plans and what the difference is, is your choice. Which one do you like better?
Let’s go back to these top three Medicare plans. I want to make sure that people understand. A lot of people will call me and say, “I saw your videos. You seem to really like the G plan, or you seem to really like the N plan.” This specific video happens to be about High Deductible G, but I like all three of these plans. I think they’re fantastic. I have family members on Plan G, I have tons of people on Plan N, I have family members on Plan N also. High Deductible G, my family just doesn’t seem to like High Deductible G. I don’t know why, they don’t like High Deductible plans. If I was getting on Medicare, I might get on this High Deductible plan for a couple different reasons.
Number one, because I don’t take any drugs, no prescriptions, and I go to the doctors once or twice a year, so I would take a shot with a High Deductible plan and if I had to go to the hospital, I would pay it out. That’s how I like my health insurance or if I was on Medicare. I have some years to go. But also there’s a company, and I don’t mention the name of the company here, where you can get on the plan, the High Deductible G plan, and after two years, go into a G plan if you want, without underwriting. So you really can’t beat this. You get on a High Deductible plan, you try it for two years. If something really goes wrong, you can go into a G plan, no questions asked and if you’re healthy, you can switch to a G plan or an N plan anyway.
So this is the High Deductible G plan. I think this is going… The percentages of how many people have the High Deductible G plan is pretty low. I think it’s going to explode in 2023 because when you actually look at the numbers, it is for you to spend what you’re going to spend with the actual G plan, for a lot of people is unlikely. One last thing I want to show you. I wrote a book, it’s 38 pages long. I’m going to leave this link. It’s Medicare Without Confusion. Now don’t worry about that. I’ll leave it here for a second. Some people want to write that down.
All you have to do is go to the description box below. I’ll have the link in there, just click on the link and you can always call my office and request it to be sent out to you. There’s no forms, we’re not going to ask for your email. Nothing like that. Just, “Hey, I’d like the book, can you send it to me?” Well, we have to have your email because we’d have to send you the link, but we’ll send it out to you.
If you look at this book, it’s very simple. It’s 38 pages long. I’m going to scroll down a little bit. It’s 38 pages but really if you look at the font, it’s so big and there’s pictures and graphs and charts in here that it’s about 20 pages. This is only going to take you less than an hour to read the whole thing. And if you look at this, you can click on different chapters. It’ll take you right to the chapter that you want to go to. Let’s just go back up to the top.
I clicked on chapter, let’s click on chapter one, goes right to it, “How and when to sign up for Medicare.” If you look, I have videos in here that you can just click on and watch the video on these different subjects.
There’s a lot of good information. Like I said, it’s free. No, we don’t want your phone number for it, whatever it is. The link is in the description box below. Just click on it, go to the book. Sorry, I’m scrolling way up. I hope this really helps you. I’ve sent this to a lot of my clients that have been my clients for 10 years and they said, “Oh, this really helped with certain things that I didn’t realize.” It’s a short read.
Thanks so much for watching this video. I hope this helped. Remember, the High Deductible G plan is just one of the three plans that I recommend. All three of these plans are fantastic, and my number is on the screen, give me a call. I’d love to hear from you and help you out with your Medicare confusion on different plans.
Thanks for watching the video. I’ll see you in the next video.