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Old 05-10-2016, 12:12 PM   #41
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Be aware that the 2015 "Doc Fix" legislation states no new Plan F policies will be sold after Jan 1, 2020 - although existing policy holders will be grandfathered. Also, there is a high deductible Plan F that may continue to be available (no ruling on that yet).

Consider Plan G as a close alternative.
I notice that plan G is not yet offered by several companies in TX. I assume that will replace Plan F when time comes closer? Just surprised that it is not already available.
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Old 05-10-2016, 12:19 PM   #42
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This is beyond outrageous and well into immoral if you ask me.
At first I was shocked when I realized the previous bills I had seen weren't THE big bill. Then just shrugged it off, laughed and acknowledged that this is how our broken medical system works - there is no way he would ever be able to pay it (at age 68 on $950 of SS per month and at the time disabled and barely hanging on to life). The upside is that the care he received seemed pretty good and he would almost certainly have died without medical intervention.

My MIL was uninsured at that time (too poor to hit the 100% of FPL to qualify for ACA subsidies in our non-medicaid extension state of NC). Her healthcare plan for anything over a thousand dollars was to seek emergency treatment and not pay the bills (or die). Fortunately she's on the same type of gold plated silver UHC plan that my family is on with $0 deductible so she can actually get care at a primary care doc before it becomes acute and an emergency (and costs many tens or hundreds of thousands).
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Old 05-10-2016, 12:25 PM   #43
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I notice that plan G is not yet offered by several companies in TX. I assume that will replace Plan F when time comes closer? Just surprised that it is not already available.
Not sure why either. A lot of agents appear to be trying to convince people to switch from F to G for fear F rates will increase more in the future with no new, healthy people entering into the pool. They suggest making the move now, while healthy enough to pass underwriting requirements. I suspect the motivation is actually based more on drumming up new sales commissions than watching out for their customer's best interests, but what do I know.

Another unknown is the fate of the High Deductible Plan F. The govt has made no determination on whether it will also be excluded from new sales starting in 2020. I've seen speculation both ways but nothing official yet.
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Old 05-10-2016, 12:39 PM   #44
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Not sure why either. A lot of agents appear to be trying to convince people to switch from F to G for fear F rates will increase more in the future with no new, healthy people entering into the pool. They suggest making the move now, while healthy enough to pass underwriting requirements. I suspect the motivation is actually based more on drumming up new sales commissions than watching out for their customer's best interests, but what do I know.

Another unknown is the fate of the High Deductible Plan F. The govt has made no determination on whether it will also be excluded from new sales starting in 2020. I've seen speculation both ways but nothing official yet.
I've already decided I'm not going on any high deductible plan once I'm eligible for Medicare. The reason - it really complicates things at the doctor's office. They're always asking "have you met your deductible?" or calling the insurer about it. With a very low deductible you can take care of that in one or two visits, and the rest of the year no more hassle.

Plan G will be fine. But I looked at pricing recently for TX (for future cost estimation/modeling purposes) and no one in my area was offering it.
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Old 05-10-2016, 12:48 PM   #45
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I've already decided I'm not going on any high deductible plan once I'm eligible for Medicare. The reason - it really complicates things at the doctor's office. They're always asking "have you met your deductible?" or calling the insurer about it. With a very low deductible you can take care of that in one or two visits, and the rest of the year no more hassle.
Interesting. DW and I both have had HD Plan F for the past 3+ years and neither of us has ever been asked that question by any of the several doctors we've seen. And by my calculation we've saved almost $8K $5K so far through lower premiums.
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Old 05-10-2016, 02:55 PM   #46
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Plan G will be fine. But I looked at pricing recently for TX (for future cost estimation/modeling purposes) and no one in my area was offering it.
The following are Plan G rates for age 65 female in McAllen, TX area.

TransAmerica Premier Life: $92.62
Individual Assurance Company (IAC Group): $93.96
State Mutual Insurance Company: $94.42
Sentinel Security Life: $95.57
Equitable: $95.75

As for why more companies are not yet offering Plan G, why sell plans at these rates when you can sell the regular 'F' at $125+ for a few more years.
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Old 05-10-2016, 04:14 PM   #47
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The following are Plan G rates for age 65 female in McAllen, TX area.

TransAmerica Premier Life: $92.62
Individual Assurance Company (IAC Group): $93.96
State Mutual Insurance Company: $94.42
Sentinel Security Life: $95.57
Equitable: $95.75

As for why more companies are not yet offering Plan G, why sell plans at these rates when you can sell the regular 'F' at $125+ for a few more years.
I guess the quote I ran didn't show those. The "big" insurance companies like Humana weren't offering it. I also noticed that BCBS offers plan G in TX, but not here?
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Old 05-10-2016, 04:17 PM   #48
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Interesting. DW and I both have had HD Plan F for the past 3+ years and neither of us has ever been asked that question by any of the several doctors we've seen. And by my calculation we've saved almost $8K $5K so far through lower premiums.
It's a real hassle with regular insurance. Maybe they don't bother with Medicare? There is often a discrepancy, usually minor, between what the insurance allows them to charge me and what they actually do. It would be easier to reconcile after the fact, but most of them want it up front of course.
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Old 05-10-2016, 04:23 PM   #49
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Interesting. DW and I both have had HD Plan F for the past 3+ years and neither of us has ever been asked that question by any of the several doctors we've seen. And by my calculation we've saved almost $8K $5K so far through lower premiums.
I like that option, and would take, except it's not offered by any insurer in my zip code. The closest we can get is Plan G, which I'll sign DW up for when she becomes eligible later this year.
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Old 05-10-2016, 04:30 PM   #50
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It's a real hassle with regular insurance. Maybe they don't bother with Medicare? There is often a discrepancy, usually minor, between what the insurance allows them to charge me and what they actually do. It would be easier to reconcile after the fact, but most of them want it up front of course.
I think you are correct that Medicare is a bit different.

We pay nothing up front. The medical providers run all charges through both Medicare and our BCBS medigap plan. We then get a bill from the medical provider showing what Medicare allowed, what was paid by Medicare and BCBS, followed within a few weeks by an EOB from Medicare. Only once over the past three years have the provider's bill and the EOB not both agreed to the penny, and in that case the Medicare Explanation of Benefits specified we did not owe one of the items we were billed for and instructed us not to pay it.

Pretty simple and straightforward, even with the deductible(s).
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Old 05-10-2016, 04:32 PM   #51
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I like that option, and would take, except it's not offered by any insurer in my zip code. The closest we can get is Plan G, which I'll sign DW up for when she becomes eligible later this year.
G is Good.

I may wish we had G if it turns out HD F is also going to be an orphan plan.
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Old 05-10-2016, 04:36 PM   #52
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Practical advice from my (even older) neighbor re health costs and medicare:

"Things aren't going to change. Best advice is to not pay any of the bills you receive for at least three months, while the doctor, Medicare, and your supplement straighten out the details."

The "You may be billed..." part of the invoice is meaningless, and any payment made based on that statement, has a fair chance of being lost along the way.

But then, you already knew that, didn't you.
I think you're mixing up EOB and invoice.
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Old 05-10-2016, 04:39 PM   #53
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G is Good.

I may wish we had G if it turns out HD F is also going to be an orphan plan.
Anything is possible, but a high deductible plan is still more likely to be the better deal, even if orphaned. If the policyholder group does shrink too far they'll close the plan, which should give you a free pass into another MediGap. I think.
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Old 05-10-2016, 04:46 PM   #54
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I guess the quote I ran didn't show those. The "big" insurance companies like Humana weren't offering it. I also noticed that BCBS offers plan G in TX, but not here?
I have limited access to rate quotes for some, but not all, companies. I only listed the most competitive of those I have access to. BCBSTX Plan G is $130.00.
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Old 05-10-2016, 04:51 PM   #55
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I have limited access to rate quotes for some, but not all, companies. I only listed the most competitive of those I have access to. BCBSTX Plan G is $130.00.
Hey, thanks!
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Old 05-10-2016, 04:54 PM   #56
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I think you are correct that Medicare is a bit different.

We pay nothing up front. The medical providers run all charges through both Medicare and our BCBS medigap plan. We then get a bill from the medical provider showing what Medicare allowed, what was paid by Medicare and BCBS, followed within a few weeks by an EOB from Medicare. Only once over the past three years have the provider's bill and the EOB not both agreed to the penny, and in that case the Medicare Explanation of Benefits specified we did not owe one of the items we were billed for and instructed us not to pay it.

Pretty simple and straightforward, even with the deductible(s).
That's good to know. Wish it worked differently for us now.

At an opthamologist's office I did hear them ask if they had met their Medicare deductible for the year, so I assumed it worked the same way. It sounded to me like they were going to charge them the deductible up front.
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Old 05-10-2016, 05:07 PM   #57
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At an opthamologist's office I did hear them ask if they had met their Medicare deductible for the year, so I assumed it worked the same way. It sounded to me like they were going to charge them the deductible up front.
Maybe we've just been fortunate in selecting doctors who didn't check. But even if they asked I'd probably say, "Yes, I believe we have..."

I doubt they would bother calling Medicare to verify since the Part B deductible is only $166, plus I imagine that could be a phone tree from hell.
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Old 05-10-2016, 05:15 PM   #58
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Here are my "Astonishing Medical Bills". Codes are 30520 and 30140 are to improve my nasal passages. ENT and Anest will charge about $2,500. ENT's suggested I go to another practice as the hospital his practice uses costs a discounted rate of about $20,000. This is after insurance for a one hour procedure. Another hospital has a PRE-discount rate of ONLY $20,000. Don't know what the discounted rate is. I do have a high deductible so I would end up paying a few grand. My problem is that this is highway robbery. My online search says that $20,000 is about what other facilities charge for hosting this one hour procedure.
Is this where I fly to XXX vacation spot and have the procedure done?
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Old 05-10-2016, 11:35 PM   #59
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....The whole system is simply broken.
+1 we need to blow it up and start over. There is no way it could be any worse than what we have now.
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Old 05-11-2016, 07:44 AM   #60
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+1 we need to blow it up and start over. There is no way it could be any worse than what we have now.
I wasn't too thrilled about being shut out from any medical insurance at all due to a pre-existing condition, so that would be a critical element to me of any new, improved system.
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