Best Medigap plan G insurance for rare diseases and getting into top hospitals (Mayo, Cleveland, John Hopkins, etc) ?

[his_delight]

I'm buying supplemental medicare insurance for a family member. They have a rare disease so there will probably be a lot of work regarding approvals, denials, etc. Sometimes I see health insurance deny highly recommended doctor treatment, so trying best to avoid insurance with those types of issues. We're also trying to get them to a top hospital.

Which company would be best for this?

The top two seem to be Aetna and Blue Cross Blue Shield. We are currently in California, but I'm trying to get them to the Mayo Clinic. Doctors seem to like Blue plans better, but it's not clear if it's completely nationwide, also Blue Cross and Blue Shield seem to be be different companies in California, at least there's a plan being offered by each.

 

[ajharmon89]

@his_delight Medigap is a different beast from what you're used to. As long as your provider accepts Medicare, the Medigap (aka Med Supp) plan will cover the claim. Medigap plans do not have any additional utilization management functions (approvals/denials) over traditional Medicare. Medigap basically just fills in the gaps in Medicare.

All Medigap plans are standardized. You can shop based on price. There's very little difference between the Medigap providers.

 

[his_delight]

@ajharmon89 great!

 

[linaa1]

@his_delight As stated, Medigap is a very different beast from most secondary insurance. Medigap will cover the 20% co-insurance for anything that Medicare covers. You'll usually get an ABN if a provider thinks Medicare won't cover something.

So really, in that sense, it doesn't matter that much which insurance company you pick for Medigap.

 

[toofly4u]

@his_delight There’s absolutely no reason to choose one Medigap plan over another rather than price. There’s no networks so you can go to any Medicare provider. The provider gets the same reimbursement because the rates are determined by Medicare. They just cover the percentage that Medicare usually has you pay.