Understanding Medicare Supplement Plan B

Understanding Medicare Supplement Plan B

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Like most states, there are ten standardized Medicare Supplement Plans each identified with a letter from A-N. One of those plans available for beneficiaries to choose from is Medicare Supplemental Plan B, also called Medigap Plan B. This is not to be confused as Medicare Part B as Part B is the medical insurance of Original Medicare which covers preventative services and medically necessary services.

What is Medicare Supplement Plan B?

Medicare Supplement Plan B provides basic benefits for Medicare Part A and B with a little bit more coverage on hospitalization (Part A). Medigap Plan B is accepted by physicians who accept Original Medicare coverage.

  • Part A Hospital Coinsurance
    • Pays for days 61-90 of a hospital stay in each Medicare benefit period
    • Pays for days 91-150 of a hospital stay. Medicare will only pay for these 60 days once during your lifetime
  • Additional Part A Hospital Benefits
    • An extra 365 days of inpatient hospital care after your use your Original Medicare hospital benefits
  • Part A Hospice Coinsurance and Copayment: Pays for outpatient prescription drug and inpatient respite care coinsurance
  • Part A Deductible (Hospital Insurance)
  • Part B Coinsurance or Copayment: Pays for the Part B coinsurance after you meet your annual deductible
  • Part A and B Blood Coverage: Pays for the first three pints of blood per calendar year

What Medicare Supplement Plan B does not cover are Medicare Part B excess charges, Part B deductible, skilled nursing coinsurance, and foreign travel emergencies.

Is Medicare Supplement Plan B right for you?

When choosing a Medicare Supplement, it is important to purchase one that fits your needs medically and financially. Consider calculating your budget and determine what monthly Medigap plan will be more economical in your situation. Medigap plans are to help you but not to hurt your bank.

Another factor when choosing a Medicare Supplement is to look at your medical and family history. If you have health issues or any pre-existing conditions you might want to consider looking at a plan that provides more coverage for any possible large medical expenses. If you do have good health and family history, you could take a chance in getting a plan with less coverage which could possibly save you money on premiums.

When can I enroll in Medicare Supplement Plan B?

Medicare Supplement Plans, such as Medigap Plan B, works in conjunction with Original Medicare. The best time to enroll in a Medicare Supplemental Plan B is during the six-month Medigap Open Enrollment Period (OEP). This period begins on the first day of the month you turn 65 or older and enrolled in Medicare Part B. If you enroll during the Medigap Open Enrollment Period, private insurance companies cannot deny you coverage, charge you a higher premium, or delay your coverage if you have health issues or disabilities.

If you wait to purchase a Medigap policy after your OEP, insurance companies can use medical underwriting to determine your qualification for a policy, which then they do not have to sell you a policy if you do not meet medical underwriting requirements.

Guaranteed-Issue Rights

If you do miss your Open Enrollment window and have guaranteed-issue rights, you are able to enroll in a Medigap plan without being charged a higher premium or denied coverage.

By having guaranteed-issue rights, Medigap insurance companies must sell you a Medigap policy at the best available rate regardless of your health and cannot deny you coverage.

If you are the age of 65 or older, you have a guaranteed-issue right within 63 days of when you lose or end certain health coverage. It also prevents companies from enforcing a waiting period for coverage on pre-existing conditions. Guaranteed-issue right include:

  • Losing a group health plan that covered Medicare cost-sharing (at no personal fault)
  • When first eligible for Medicare, you joined Medicare Advantage and disenrolled
  • within 12 months
  • Your previous Medigap plan, Medicare Advantage or PACE programs ends its coverage

It is important to keep any necessary documents (letters, emails, notices, etc.), for proof of guaranteed-issue rights.

Costs of Medicare Supplement Plan B

The cost of a Medigap Plan B policy can vary. Policies are sold by private insurance companies and each set their own premiums. Plan rates can be priced in three ways:

  • Community-Rated (Non-Age Related): Individuals in a given area are charged the same rate, regardless of age
  • Issue-Age Rated: Charged based on the age of the applicant, but price does not increase as policyholder ages
  • Attained-Age Rated: Rates are cheaper at 65, but prices scale as policyholder ages

Contact our representatives to learn about the benefits of Medicare Supplemental Plan B.

What is Medicare Supplement Plan D

What is Medicare Supplement Plan D?

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Medicare Supplement Plan D is one of the 10 standardized plans available in most states (Wisconsin, Minnesota, and Massachusetts have their own standardized plans.)

Medicare Supplement Plan D is designed to work in conjunction with your Original Medicare coverage (Part A and B). Having a Medicare Supplement can assist in some of the additional out-of-pocket costs such as deductibles, co-payments, and coinsurance. Even though there are 10 standardized Medigap plans available, each plan covers different portions of these costs.

Remember to not confuse Medicare Supplement Plan D with Medicare Part D. These are two entirely different subjects relative to Medicare. Medicare Part D is associated with Prescription Drug Coverage while Medicare Supplement Plan D is a Medigap Policy designed to provide additional coverage on healthcare costs. Medicare Supplement plans do not have a prescription drug benefit. If you are enrolled in Original Medicare (Part A and B) and need assistance with prescription drug costs, you may consider in enrolling in a stand-alone Medicare Prescription Drug Plan.

Medicare Supplement Plan D provides the following benefits:

  • Medicare Part A coinsurance and hospital costs up (to an additional 365 days after Medicare Part A benefits are used up)
  • Medicare Part B coinsurance or co-payment after meeting your annual deductible
  • Medicare Part A hospice care coinsurance and co-payment
  • Covers first three pints of blood per calendar year
    Skilled Nursing Facility (SNF) care coinsurance
  • Part A deductible (hospital insurance)
  • 80% of foreign travel emergency costs after the first $250 (lifetime maximum $50,000)

Medicare Supplement Plan D does not cover Medicare Part B deductible payments or excess charges. You will be responsible for these costs. There are is no-out-pocket maximum in Medicare Supplement Plan D.

Where can I enroll in Medicare Supplement Plan D?

Medicare Supplement Plans are offered by private insurance companies. At Plan Medigap, we can help find the right coverage for your needs by comparing plans and rates from top carriers in your area.

Contact one of our friendly representatives to see if Medicare Supplement Plan D is right for you.

We can also assist you in signing up for a Prescription Drug Plan (Medicare Part D)!

CMS to Issue New Medicare Cards Beginning April 1, 2018

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CMS (Centers for Medicare and Medicaid Services) has announced that they will begin to issue new Medicare cards next month. Concerns about the risk of fraud and identity theft has encouraged CMS to revamp and create a new look for the Medicare cards.

For many years, Medicare cards have included a beneficiaries Social Security number. With this number visible, possibilities for Medicare-related fraud and identity theft could occur if the card was lost or stolen.

The Medicare Access and CHIP Reauthorization Act (MACRA) of 2015 has required CMS to remove all Social Security Numbers (SSNs) from all Medicare cards by April 2019. Instead of a SSN-based Health Insurance Claim Number, a new 11-character Medicare Beneficiary Identifier (MBI) will take place. Any part of a participant’s SSN will longer be visible on the new Medicare card.

Current Old-format Medicare Card vs New Revamped Medicare Card

Current Old-format Medicare Card vs New Revamped Medicare Card – Images are provided by CMS.gov

 

 

 

 

 

 

 

CMS will begin to mail new cards April 1, 2018 until April 1, 2019. There will be seven waves which are determined by geographic location. View CMS’s new Medicare Mailing Strategy by geographic location.

As a Medicare beneficiary CMS will send the new cards automatically and there is so NO required action for the participant to do. Medicare eligibility and benefits will NOT be affected.

Once received, participants will be able to utilize the card as needed. There is a 21-month transition period where both the new and old-format cards can be used. This period will end at the end of year 2019. All Medicare beneficiaries are expected to use ONLY their new Medicare card beginning of 2020.

More info on the new Medicare card can be found on the CMS website.

Plan Medigap can help answer any questions regarding Medicare and Medicare Supplements.  Call us today at (800) 750-2407 to speak to one of our representatives.

Best Medigap Plans

How to Choose the Best Medicare Plan

By | Medicare Supplemental Plans | No Comments

Medicare is a government health insurance program for individuals 65 and older, people with certain disabilities, or those with End-stage Kidney Failure (ESRD).

Most individuals who are covered under Original Medicare have Parts A and B. Although having Original Medicare is valuable, there are some healthcare expense not fully covered 100% (such as out-of-pocket and prescription drug costs.)

There are a few options for Medicare beneficiaries to help alleviate some of these costs. One of them being the Medicare Advantage program. Although the Advantage program includes all parts of Medicare coverage (Parts A-D), there can be some DISADVANTAGES to it. It is possible that having the Medicare Advantage Program can cost you more in the long run.

That is why many turn to enroll in a Medicare Supplement Plan or Medigap Insurance. Medicare Supplement Plans, which are sold by private insurances companies, are designed work along with Medicare Parts A and B and to help pay some of the out-of-pocket expenses not covered by Original Medicare such as deductibles, copayments, and coinsurance. Nearly 1 in 4 Medicare beneficiaries have a Medicare Supplement Plan.

All Medicare Supplements Plans typically require a monthly premium in exchange for coverage.

How to determine the best Medicare Supplement Plan

Like most states, there are 10 Medicare Supplement Plans with standardized benefits. Meaning, Medigap Plan G will have the same benefits regardless if you live in Texas or California. There are a few states such as Massachusetts, Minnesota, and Wisconsin with different standardized plans.

The best way to determine which Medicare Supplement Plans are best for you is to think about what services you could possibly use the most and where most of your Medicare out-of-pocket costs have been. Medicare supplement plans offer different levels of coverage.

There are a few factors to think about when choosing a the best Medigap Plans. Here are some great examples with a few things to consider:

  1. Do you think you would spend time in a skilled nursing facility?
    • Medicare Supplemental Plans C, D, F, G, M, and N cover these Medicare-approved costs at 100%
  2. Do you travel a lot?
    • Plans C, D, F, G, M, and N offer to pay 80% of certain medically necessary emergency care in foreign countries after you have met your annual $250 deductible. You are typically covered the first 60 days when you travel. Foreign travel emergency coverage with Medicare Supplemental Plans has a lifetime limit of $50,000.
  3. Do you want maximum coverage?
    • Plan F gives the most comprehensive coverage of all Medicare Supplement Plans. Those covered under Plan F are covered 100% for all Medicare Supplement benefits except foreign travel coverage being 80%. There is also a high-deductible Plan F that comes with a lower premium, but there is no coverage until your deductible has been met. Plan G is also a great choice as it only has a small Part B deductible ($183 a year) and has a lower monthly premium.

Comparing the Best Medicare Supplement Plans and Costs

View our compare medicare plans chart showing the different Medicare Supplement Plans along with percentage of coverage.

All private insurance companies offer the same benefits for each Medigap Plan. Each private insurance does have the ability to charge different premiums for each plan. To fit your medical and financial necessities, it is wise to shop around for the best medigap plans that will fit your medical and financial needs. Private insurance companies can possibly price their premiums based on

  1. Community no-age rated: Regardless of age, Medicare Supplemental Plans premiums are the same across the board
  2. Issue-age-rated: Medicare Supplemental Plans premiums based on your age when first enrolled. With that said, the younger you enroll the lower the premium.
  3. Attained-age-rated: Medicare Supplemental Plans premiums based on age when you first enrolled in the policy, but unlike issue-age-rate, premiums increase as you get older.

What Doctors Can You See?

If you have a Medicare Supplement Plan, you can choose to see any physician or healthcare provider that accepts Medicare.

Call one of our representatives at (800) 750-2407 today to find out which is the best Medicare Supplemental Plan to choose in your area.

Enroll for Medicare during The General Enrollment Period – January 1st to March 31st

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General Enrollment Period

Enroll for Medicare during The General Enrollment Period – January 1st to March 31st

 

Did you miss your Medicare Initial Enrollment Period?

You have another chance to enroll in Medicare Coverage if you missed your Initial Enrollment Period or your Special Enrollment Period!

Typically, Medicare Initial Enrollment Period (IEP) is when you first qualify for Medicare (three months before your 65th birthday, your birthday month, and three months after yours 65th birthday.) During the IEP, this is an important time to make sure you get the Medicare coverage you need when you turn 65.

There are times when one is unaware or misses opportunities like these. From January 1 – March 31 of each year, or the General Enrollment Period, seniors who missed their Initial Enrollment Period can enroll in Medicare during this time!

 

Medicare Part A During General Enrollment Period

For most Medicare beneficiaries, if you or your spouse worked at least 10 years while paying Medicare taxes, you qualify for premium-free Medicare Part A. If you do not qualify for premium-free Medicare Part A and enroll during the General Enrollment Period, you typically have to pay a late-enrollment penalty (typically 10% of the premium). The length of your delay determines how long you will be paying the penalty on your monthly premium.

 

Medicare Part B During General Enrollment Period

Initial Enrollment Period for Medicare Part B is the same as Part A. General Enrollment Period for Part B is the same as Part A as well. There is a late-enrollment penalty for Medicare Part B if you enroll during the General Enrollment Period but with some differences. The penalty (10% of your premium) is added in your monthly premium but unfortunately, there is no end to your late-enrollment penalty. The costs will carry as long as you have Part B.

It’s very important to enroll into Medicare Parts A and B during your Initial Enrollment Period to avoid any additional costs such as a higher premium.

You may be able to delay enrollment in Medicare Part A and B without being subject to a late-enrollment penalty if you have group health coverage through your or your spouse’s employer or union.

 

If you enroll in Medicare during the General Enrollment Period, coverage will begin in July! Help fill in the gaps that Medicare Parts A and B do not cover by getting Medigap coverage! July is earliest you can have a Medicare Supplement. Give Plan Medigap a call at (800) 750-2407 or visit our quote page. We can find competitive rates and plans from multiple carriers in your area!

Disenroll from Medicare Advantage and Enroll into a Medicare Supplement!

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Medicare Advantage Disenrollment Period

Every year, many Medicare beneficiaries enroll in a Medicare Advantage plan during the Annual Election Period with the thought of having a lower premium and additional “benefits” of the plan. During the annual election period, many overlook parts of the Medicare Advantage Plan and find out that they no longer want it due to the restrictions of drug formularies and physician networks. Also, many who do enroll in the Advantage Plan do not verify with their current physician if they participate in the network or if their current medications are covered.

Fortunately, Congress created a Medicare Advantage Disenrollment Period (January 1-February 14) where those who no longer want to be on a Medicare Advantage plan, have the option to switch back to Original Medicare (Parts A and B). With that, they can also add-on a Part D drug plan and a Medicare Supplement policy.

(If it was your first year on an Advantage Plan and you have been on the plan for less than 12 months, you can return to Original Medicare and to your prior Medicare Supplement with no additional underwriting!)

Going back to Original Medicare and also adding a Medicare Supplement plan can help you save more in long run. With a Medicare Supplement, you are not limited to a network of doctors and possibly lower out-of-pocket health costs! If your current physician takes Medicare, they should also take your Medicare Supplement Policy!

Plan Medigap can help answer questions regarding switching back to Original Medicare and getting a Medicare Supplement. Call us at 800-750-2407 to speak to one of our licensed professionals or visit our quote page.

Medicare Supplement Plan F or Plan G?

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Plan F or Plan G?

If you’re of “Medicare Age” then you’ve probably heard the debate or maybe even participated in it.  Which Medicare Supplement is better?  Plan F or Plan G?  For years, the answer has been easy, but we’re starting to see a shift.  Let’s start by looking at the differences between these two plans.

Differences between “F” and “G”

  • Medicare Part B Deductible ($183 in 2017)
    • Plan F – The plan pays the deductible
    • Plan G – You pay the deductible

That’s it!

Conventional wisdom would suggest that because Plan F is the more comprehensive plan that it would be “better”, but “better” is certainly relative.  Let’s take a closer look.

For example, John is 66 and wants to enroll in a Medicare Supplement.  He is interested in F and G only – which should be buy?

  • Plan F = $135 a month (no deductible)
  • Plan G = 105 a month ($183 deductible)

Plan G would save him $30 a month or $360 a year!  Once John accounts for the deductible, he has true savings of $177 a year (or about $15 a month).  By enrolling in G, John gets the “best bang for his buck” and doesn’t sacrifice on coverage.

Clients often ask us if this is the case in every state and we say that generally, Plan G is going to be a better buy than Plan F.  If the savings are less than $15 from F to G, then you can make a stronger case for Plan F.

That’s not all, we have even more reasons to recommend Medicare supplement Plan G over Plan F.  Rate increases on Plan F are more aggressive.  Why? It’s simple, really.  There are significantly more claims which always translate to higher rate increases.  Policy holders have better behavior on Plan G because they are thinking about the deductible and how it interacts with their budget.  If you have Plan F, why wouldn’t you use it?  There is no reason not to, and that’s the attitude of most Plan F policyholders.

One more reason to buy Plan G: For the reasons cited above, Plan F will be discontinued as of January 1, 2020 as part of the Medicare Access and CHIP Reauthorization.  If you’ve already purchased Plan F, you’ll have the option to keep your plan, but we believe rate increases on Plan F will be even more aggressive as no new 65 year olds are paying in to the system.

So what does this mean for you?  If you’re aging into Medicare, take a close look at Plan G and see if it makes financial sense in your market.  You’re likely to save some money.  If you’re already on Plan F, give us a call and let us talk about the process to get you switched over.  There are very few hurdles, and it can be done anytime.

At Plan Medigap, we specialize in the Medicare Supplement and we’ve helped thousands of seniors find the right coverage at the lowest price.  Give us a call or pay us a visit and “Let’s Plan Together”.  Receive a free quote here: http://www.planmedigap.com/medicare-supplement-quote/

 

 

Medicare Supplement Rate Increase?

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Medicare Supplement Rate Increase?

You’re healthy. You exercise. You watch your diet. You don’t even visit the doctor all that often – “So why the rate increase?“. Death and Taxes? How about Death, Taxes, and Rate Increases?!

Loss Ratio – Predicting Increase

Every company will raise their rates at some point.  They will not be able to stay in business if they don’t.  When companies set their rates, they do so with a specific “loss ratio”. What this means is they try to predict what their claims will be for a given geographical area.  If you live in a state that has many Metropolitan areas, there will be more claims, thus higher rate increases for that specific state. As your agent, we do our best to anticipate companies that are struggling with losses outside of the norm and to steer our clients away from those companies.  We are a direct reflection of that insurance company and if they are raising rate aggressively, then that will affect a large portion of our clients across the country.

What’s an average rate increase?

Our clients often ask us, “What’s an average rate increase?“. This can be difficult to answer because your age has a lot to do with it, but we typically see anywhere from 4% to 10% year over year. This can be an emotional topic for any Medicare Supplement policy holder so it’s important to remember that regardless of what company you have, your rate will rise at some point.  Keep in mind that this is the best coverage on the market for seniors and rarely does a rate increase warrant a cancellation of the entire Medicare Supplement product.

What are my options?

This is where we come in! If your rate increase has you concerned, give our office a call and we’ll see what other companies are offering rates in your area that might be able to save you money. We’ll take care of all the legwork and handle the underwriting.  All we need is 30 minutes of your time and your signature.  That’s it.  We’ll make sure there is no interruption in your current coverage and no duplication of premiums.  In many cases, your rate will still be competitive and a move will not be necessary.

Give us a call anytime at 800-750-2407 or click here.  We have agents that will take a one-on-one approach and give you the level of service you deserve.

We value your business and hope to serve you for many years to come.

Medicare Advantage or Disadvantage?

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Top Misconceptions about Medicare Advantage Plans

 

“I’m still on Medicare.”

If you are on an Medicare Advantage Plan, you are not covered by Medicare A and B.

How we can help:  Medicare Supplement plans work in tandem with original Medicare, meaning your medical expenses can be covered at 100%.

“My medical needs are covered.”

Under Medicare Advantage plans, claims for medical services, surgical procedures, primary care visits, specialist visits, home health care, physical therapy, mental health services, and perscription drugs are frequently denied.

How we can help: Any doctor or hospital that accepts Medicare will accept your Supplement plan, and any procedure, service, or therapy your doctor recommends will be covered by Medicare. Compare Medicare Plans now for more information

“My coverage is clearly outlined.”

Without clear criteria, insurers have wide discretion in determining coverage. Medicare Advantage customers express frequent concerns about coverage gaps and hidden costs. Coverage information is not readily available or easily explained, leading to customer confusion and denied claims.

How we can help: Each Medicare Supplement plan has clearly defined benefits.  Our customers easily review the costs and benefits of each plan before selecting the plan best suited to their needs.

“I can choose my doctor.”

Medicare Advantage covers a limited network of doctors, hospitals, and nursing facilities. Your approved list of providers will change year to year, potentially leaving you with fragmented care. Finding care while traveling may be difficult, too.

How we can help: Supplement plans cover any provider who accepts Medicare.  Your coverage goes where you go, giving you freedom to travel.  Some Supplement plans even provide limited medically necessary emergency care outside the country.

“I’ll save money with Medicare Advantage.”

While most Advantage plans have low premiums, out-of-pocket maximums range from $4,000-$9,000. Patient costs of Medicare Advantage plans can easliy climb higher than those of combined Medicare and Medigap coverage.

How we can help:  Medicare Supplement’s low monthly premiums allow customers to plan financially.  Without hidden costs, our customers enjoy peace-of-mind, knowing exactly how much their care will cost when health issues inevitably arise.

“My health may change, but my coverage won’t.”

“The insurer might want to keep you enrolled only as long as you’re relatively healthy.” Read more from Wendell Potter outlining the danger of staying with an Advantage plan once health needs change.

How we can help: Medigap coverage is guaranteed renewable. Your plan will stay with you regardless of changes in your health. Any doctor or hospital that accepts Medicare will accept your Supplement and any procedure, service, or therapy your doctor recommends will be covered by Medicare.

“I’m covered in an emergency.”

Medicare Advantage beneficiaries commonly complain about denied benefits during emergency or urgent care.  On top of a health crisis, customers are hit with enormous out-of-pocket costs.

How we can help: A Medicare Supplement plan ensures coverage wherever medicare is accepted, including emergency facilities.

“The ‘Affordable Care Act’ won’t affect me.”

As a result of changing health care laws, Medicare Advantage plans have been de-funded. Premiums are  increasing, benefits are decreasing, and doctors are leaving networks. Changing benefits leave Medicare Advantage patients with less coverage while they scramble to find new providers.

How we can help: Medicare Supplements are not annual contracts.  The government has standardized each plan for simplicity, guaranteeing the exact same benefits year after year.

“I can switch to a Medicare Supplement whenever I need to.”

If your health deteriorates while you are a Medicare Advantage customer, you risk becoming ineligible for  the comprehensive coverage of a Medicare Supplement plan when it is needed most.  Medicare Supplement plans require the insured to pass medical underwriting. Don’t wait until it’s too late!

How we can help: Plan Medigap contracts with over sixteen major insurance carriers, each with different eligibility requirements.  Let us help you find a plan to meet your needs, regardless of your current health.

Marines and Medicare

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Plan Medigap Welcomes Marine Veteran Sgt. Tim Bergeron!

Texas Small Business Growing with Key Leadership from Marine Veteran

“I married my wife six weeks before my second deployment to Iraq,” recalls Marine Sgt. Tim Bergeron.  She was only 19 and I was 21.  We met in our church youth group several years earlier, and after “dating” through my first deployment, we just knew we needed to get married before I left for Iraq again.  Leaving my young wife that day… that was probably the hardest day of my life.”

Sgt Bergeron spent both deployments on the front lines, right in the thick of conflict and violence.  “Those years were tough.  I lost some very good buddies. Then, in the course of a few months, I went from conducting peace-keeping efforts and border security in Al Qaim, Iraq, to working algebra equations in a college classroom in North Texas. Adjusting to my “normal” life again took a while.  It was a bit surreal.”

In 2009, Tim graduated from the University of North Texas with a degree in Finance. “I immediately went to work in the finance department of a large retailer.  I spent four years there, learned a lot, loved the people I worked with, but didn’t feel fulfilled by the work day-to-day. My wife and I began praying about what God might have ahead of us.”

“When the opportunity arose for me to join the Plan Medigap team, it was so apparent to us that God had lead us to this place.  Plan Medigap is a small company that is investing in our community. Plan Medigap’s core values (Integrity, Humility, Insight, Generosity) align with the values that were so important to me during my military career. Individuals and families often hold to these values, but it is a rare, neat thing to see a business set such high standards.”

Tim joined Plan Medigap as the Director of Operations in early 2014. “I’m excited about helping lead Plan Medigap towards a bright future. The mission is well-defined. There are big things ahead, and I thank God for the opportunity to be a part of this team.”

Marines and Medigap