Latest news with #MedicareSupplement
Health Line
9 hours ago
- Business
- Health Line
Understanding Medicare Plan G Supplemental Coverage
Key takeaways Plan G is a Medicare Supplement Insurance (Medigap) policy that helps cover out-of-pocket costs associated with Original Medicare (parts A and B), including copayments, coinsurance, and deductibles (except for the Medicare Part B deductible). Medigap Plan G provides 100% coverage for Part A coinsurance, hospital costs, Part A deductible, hospice care coinsurance, blood (first 3 pints), and skilled nursing facility care coinsurance, plus 80% coverage for foreign travel emergencies up to plan limits. Medigap Plan G does not cover prescription drugs, the Part B annual deductible, or benefits like dental, hearing, and vision that are not covered under Original Medicare. 'Medigap' is another term for Medicare supplement insurance. Medicare Supplement Plan G is extra insurance you can buy to help cover your portion of costs for medical services with Original Medicare, such as: copayments coinsurance deductibles (with the exception of the Medicare Part B deductible) Original Medicare includes Part A (hospital insurance) and Part B (medical insurance). Medigap Plan G is one of the most popular of the 10 Medigap policies because of its broad coverage, including coverage for Part B excess charges. Keep reading to learn more about Medicare Part G and what it covers. What are Medicare Part B excess charges? Medicare Part B only covers services from healthcare professionals who participate in Medicare. If you choose a doctor who doesn't participate in Medicare, they may charge up to 15% more than the standard Medicare rate. If your Medigap plan does not cover Part B excess charges, you will pay these charges — known as excess charges — out of pocket.
Medical News Today
a day ago
- Business
- Medical News Today
Medicare and preexisting condition waiting periods
Original Medicare and Part C plans cannot deny coverage based on preexisting conditions. However, a waiting period for enrolling in Medicare due to preexisting conditions can apply to a Medigap plan. Due to the Affordable Care Act (ACA), Original Medicare (parts A and B), Medicare Advantage (Part C), and Part D drug plans cannot impose waiting periods for preexisting conditions or deny coverage based on such conditions. However, Medicare supplement (Medigap) plans are not subject to the ACA. For this reason, people who wish to sign up for a Medigap plan should be aware of enrollment and waiting periods where preexisting conditions might be applicable. Medigap initial enrollment period Private companies approved by Medicare offer Medigap plans, which are also called Medicare supplement plans. These plans cover costs that Original Medicare does not cover, such as deductibles, coinsurance, and copayments. Since Medigap plans do not provide direct medical coverage and do not meet the ACA's minimum essential coverage requirements, insurers can deny coverage due to preexisting conditions. However, other federal laws impose certain restrictions, one of which applies during the initial enrollment period. When a person turns 65 and enrolls in Medicare Part B, they enter a six-month Medigap open enrollment period. During this time, they can choose any Medigap policy without undergoing medical underwriting. Insurers cannot deny them coverage based on preexisting conditions, allowing the person to select the plan that best fits their needs. If a person misses this enrollment period, they may face higher costs or experience coverage denial. Additionally, those under 65 who qualify for Medicare due to a disability might have to wait until they reach 65 before Medigap insurers must legally offer them coverage. » Learn moreDoes Medicare cover preexisting conditions? Insurance companies can refuse to enroll a person in a Medigap plan based on preexisting conditions if the person applies outside the initial 6-month enrollment window. However, exceptions exist in which a person can get protection from coverage denial even after this period ends. These exceptions, called 'guaranteed issue rights,' apply in the following specific circumstances: A Medicare Advantage Plan either changes, becomes unavailable in the person's area, or the person moves outside its service zone. A person with Original Medicare and an employer or union plan that offers coverage after Medicare, including the Consolidated Omnibus Budget Reconciliation Act (COBRA), loses that coverage. A person with Original Medicare and a Medicare SELECT policy moves out of the policy's service area. A person who initially joined a Medicare Advantage Plan or Programs of All-Inclusive Care for the Elderly (PACE) when they first became eligible for Medicare decides to switch to Original Medicare within the first year. A person who switched to a Medicare Advantage Plan (or Medicare SELECT) within the past year now wants to switch again. A person's Medigap insurance provider goes bankrupt or cancels a person's policy through no fault. A person changes or cancels their Medicare Advantage plan or Medigap policy due to a violation or misleading information from the provider. Additionally, some states may have additional 'guaranteed rights' beyond what federal regulations require. » Learn more:What to know about Guaranteed Issue in Medicare Ten Medigap plans offer different levels of coverage. A person who has held their current Medigap policy for more than 6 months and wants to switch to the same Medigap plan offered by another insurance plan cannot experience coverage denial based on preexisting conditions, nor do they have to wait for coverage. But if a person wants to switch between different Medigap plans, they may have to wait 6 months for coverage. This is known as the preexisting condition waiting period. However, their new insurer should account for the period when the person has had coverage from their existing Medigap plan. For example, if a person has had 2 months of coverage before switching, their new policy should only impose an additional 4-month wait. Medicare Advantage trial period Medicare Advantage (Part C) plans must offer coverage equivalent to Original Medicare (parts A and B). According to the ACA, insurers providing Part C plans cannot deny coverage based on preexisting conditions. However, since a person can only have Medigap for Original Medicare expenses, they must discontinue their Medigap plan if they choose a Part C plan. For this reason, Medicare grants a 12-month trial period to allow a person to test a Part C plan without losing their Medigap coverage. The person may leave the Part C plan and return to Original Medicare within this period. In that case, they can rejoin their previous Medigap plan or select a new one without medical underwriting. Original Medicare (parts A and B), Medicare Advantage (Part C), and Part D prescription plans have no preexisting conditions waiting periods. This means these plans cannot deny coverage because of preexisting conditions. However, specific enrollment and waiting periods for preexisting conditions might apply to a Medicare supplement (Medigap) plan. These include a 6-month initial enrollment period, guaranteed issue rights, and a 12-month trial period to test a Part C plan. The information on this website may assist you in making personal decisions about insurance, but it is not intended to provide advice regarding the purchase or use of any insurance or insurance products. Healthline Media does not transact the business of insurance in any manner and is not licensed as an insurance company or producer in any U.S. jurisdiction. Healthline Media does not recommend or endorse any third parties that may transact the business of insurance.
Yahoo
6 days ago
- Business
- Yahoo
Mark Farrah Associates Analyzed the 2024 Medicare Supplement Market
CANONSBURG, Pa., May 28, 2025--(BUSINESS WIRE)--In the latest Healthcare Business Strategy report, Mark Farrah Associates (MFA), provided an overview of the 2024 Medicare Supplement market with insights about competitive positioning and standardized plan type preferences. Medicare Supplement plans, also known as Medigap or Med Supp plans, covered over 13.54 million seniors as of December 31, 2024, representing a year-over-year enrollment decline of 0.3%. Many leading managed care organizations, Blues plans, regional plans, and multiline carriers compete in the Medicare Supplement space. Highlights Include: MFA's assessment of standardized plan type preferences for 2024 found Plan G remained the most popular plan type, enrolling approximately 5.7 million members. Approximately 4.5 million Med Supp members were enrolled in Plan F and accounted for 30% of the market in 2024. Medicare Supplement plans collectively earned approximately $37 billion in premiums and paid out $31.3 billion in claims during 2024. The aggregate loss ratio (incurred claims as a percentage of earned premiums) was 84.4% as of December 2024. UnitedHealth continued to lead in this segment with 4.3 million members and covered 32% of the market as of December 31, 2024. To read the FREE full text of "Medicare Supplement Enrollment Down Slightly in 2024", visit the MFA Briefs on Mark Farrah Associates' website. You can also follow us on LinkedIn. About Med Supp Market Data Med Supp Market Data, a Health Coverage Portal option offered by Mark Farrah Associates, presents the latest market share and financial performance data for Medicare Supplement plans. The product includes state-by-state membership, premiums, claims and loss ratios for plans nationwide. Online tables also include claims contacts as reported in the financial statements as filed with the National Association of Insurance Commissioners (NAIC). California managed care plans do not file financial statements with the NAIC and are not included in this analysis. For more information about Med Supp Market Data, please visit our website ( or call 724.338.4100. About Mark Farrah Associates (MFA) MFA is a leading data aggregator and publisher providing health plan market data and analysis tools for the healthcare industry. Committed to simplifying analysis of health insurance business, our products include: Health Coverage Portal™, Medicare Business Online™, Medicare Benefits Analyzer™, County Health Coverage™, Health Plans USA™ and 5500 Employer Health Plus. View source version on Contacts Mark Farrah AssociatesAnn Marie Wolfe, amwolfe@ Error in retrieving data Sign in to access your portfolio Error in retrieving data Error in retrieving data Error in retrieving data Error in retrieving data
Business Wire
6 days ago
- Business
- Business Wire
Mark Farrah Associates Analyzed the 2024 Medicare Supplement Market
CANONSBURG, Pa.--(BUSINESS WIRE)--In the latest Healthcare Business Strategy report, Mark Farrah Associates (MFA), provided an overview of the 2024 Medicare Supplement market with insights about competitive positioning and standardized plan type preferences. Medicare Supplement plans, also known as Medigap or Med Supp plans, covered over 13.54 million seniors as of December 31, 2024, representing a year-over-year enrollment decline of 0.3%. Many leading managed care organizations, Blues plans, regional plans, and multiline carriers compete in the Medicare Supplement space. Highlights Include: MFA's assessment of standardized plan type preferences for 2024 found Plan G remained the most popular plan type, enrolling approximately 5.7 million members. Approximately 4.5 million Med Supp members were enrolled in Plan F and accounted for 30% of the market in 2024. Medicare Supplement plans collectively earned approximately $37 billion in premiums and paid out $31.3 billion in claims during 2024. The aggregate loss ratio (incurred claims as a percentage of earned premiums) was 84.4% as of December 2024. UnitedHealth continued to lead in this segment with 4.3 million members and covered 32% of the market as of December 31, 2024. To read the FREE full text of " Medicare Supplement Enrollment Down Slightly in 2024", visit the MFA Briefs on Mark Farrah Associates' website. You can also follow us on LinkedIn. About Med Supp Market Data Med Supp Market Data, a Health Coverage Portal option offered by Mark Farrah Associates, presents the latest market share and financial performance data for Medicare Supplement plans. The product includes state-by-state membership, premiums, claims and loss ratios for plans nationwide. Online tables also include claims contacts as reported in the financial statements as filed with the National Association of Insurance Commissioners (NAIC). California managed care plans do not file financial statements with the NAIC and are not included in this analysis. For more information about Med Supp Market Data, please visit our website ( or call 724.338.4100. MFA is a leading data aggregator and publisher providing health plan market data and analysis tools for the healthcare industry. Committed to simplifying analysis of health insurance business, our products include: Health Coverage Portal™, Medicare Business Online™, Medicare Benefits Analyzer™, County Health Coverage™, Health Plans USA™ and 5500 Employer Health Plus.
Yahoo
6 days ago
- Business
- Yahoo
Elevance Looks Cheap Now: But is it Time to Buy or Dodge?
Elevance Health, Inc. ELV, a leading U.S. health benefits provider, appears to be trading at a discount. Its forward 12-month P/E ratio stands at just 10.35X, significantly below its five-year median of 13.46X and the industry average of 13.86X. Compared to peers, UnitedHealth Group Incorporated UNH and Humana Inc. HUM, which trade at 12.06X and 14.73X, respectively, ELV looks attractively valued. It currently holds a Zacks Value Score of A, highlighting strong valuation fundamentals. But is this discount a sign of hidden opportunity, or a red flag? Let's explore the drivers behind Elevance's valuation and its long-term outlook. Image Source: Zacks Investment Research Headquartered in Indianapolis, Elevance is well-positioned for sustained growth, underpinned by strategic initiatives across its commercial and government segments. Elevance continues to see steady growth in its commercial segment. In 2024, risk-based and fee-based commercial memberships grew 4.6% and 1% year-over-year. Its Individual Commercial business is especially strong, reporting a 14.2% surge in the first quarter of 2025 alone. By exiting underperforming markets, Elevance has streamlined its government business, improving overall efficiency. It also has room to expand its Medicare Advantage footprint in underpenetrated states, which could unlock future and dental memberships continue to witness growing momentum. With a Return on Invested Capital of 9.94%, far above the industry average of 5.79%, Elevance demonstrates superior capital deployment. Its $84.1 billion market cap gives it the scale to pursue strategic acquisitions and reallocations toward higher-margin businesses. ELV remains committed to returning capital to shareholders. In the first quarter of 2025 alone, it repurchased $880 million worth of shares and had $8.4 billion remaining under its buyback authorization. Its dividend yield of 1.82% also exceeds the industry average of 1.40%. Despite headwinds in the broader market, ELV shares have gained 1.9% year to date, outperforming both the industry and the S&P 500. In contrast, UnitedHealth and Humana have posted declines, reflecting broader sectoral pressure. Image Source: Zacks Investment Research The Zacks Consensus Estimate for Elevance's 2025 and 2026 EPS implies a 4.2% and 13.8% uptick, respectively, on a year-over-year basis. The estimates remained stable over the past week. Moreover, the consensus mark for 2025 and 2026 revenues suggests an 11.2% and 7.1% increase, respectively. The company beat earnings estimates in three of the past four quarters and missed once. This is depicted in the figure below. Elevance Health, Inc. price-eps-surprise | Elevance Health, Inc. Quote Despite its strengths, Elevance faces some notable challenges. A key concern is the decline in Medicaid and Medicare Supplement membership, leading to both overall membership losses and reduced revenues. A drop in government funding could put additional pressure on profitability. Increasing medical costs pose a massive challenge as industry players continue to struggle with rising utilization and squeezing margins. The company's benefit expense ratio, measuring the portion of premiums spent on claims, has been increasing, rising from 87% in 2023 to 88.5% in 2024. Our estimate suggests it could reach 88.7% in 2025, signaling further pressure on earnings. Policy shifts such as the Most Favored Nation drug pricing model introduced by the Trump administration have rattled the Pharmacy Benefit Management (PBM) industry. With major PBM exposure, Elevance — like UnitedHealth, CVS and others — faces uncertainty in this space. Elevance Health offers an appealing valuation and demonstrates strong fundamentals in its commercial business, capital efficiency and shareholder returns. However, ongoing pressures from rising medical costs, government program headwinds, and regulatory uncertainties temper the bullish case. With a Zacks Rank #3 (Hold), the stock reflects a balanced risk-reward profile. It may not be a screaming buy at the moment, but it remains a solid name to watch, especially for long-term investors seeking stability, value and consistent execution in the healthcare space. Patience may be warranted until clearer signals on regulatory outcomes emerge. You can see the complete list of today's Zacks #1 Rank (Strong Buy) stocks here. Want the latest recommendations from Zacks Investment Research? Today, you can download 7 Best Stocks for the Next 30 Days. Click to get this free report UnitedHealth Group Incorporated (UNH) : Free Stock Analysis Report Humana Inc. (HUM) : Free Stock Analysis Report Elevance Health, Inc. (ELV) : Free Stock Analysis Report This article originally published on Zacks Investment Research ( Zacks Investment Research
