Medicare Part F - Plan F: Do you have experience with these carriers

[REWahoo]

How many fricking letter levels are there in medicare

I am a few years away so I am sure it will change by the time I get there... but I never knew there were this many options!!!

The policies referred to here are Medicare Supplemental Insurance, also known as Medigap policies. Depending on the [-]alphabet letter[/-] policy you choose to purchase, these policies cover all or a portion of what Medicare does not pay for. You can see a list of Medigap policies here, along with a summary of what each covers:

How to compare Medigap policies | Medicare.gov

 

[audreyh1]

Maybe one day I'll understand the significance of "community rated".

But I'm still 10 years away. Well - DH is 5 years away.

 

[REWahoo]

Maybe one day I'll understand the significance of "community rated".

But I'm still 10 years away. Well - DH is 5 years away.

Good luck in finding a community rated Medigap policy in TX.

 

[audreyh1]

Good luck in finding a community rated Medigap policy in TX.

Well - I guess it doesn't matter then!

I guess I'll put that in the column of things that will increase in price as I age.

 

[REWahoo]

I guess I'll put that in the column of things that will increase in price as I age.

+1

The best Medigap option I've found is the high deductible (currently ~$2,100/yr) version of Plan F. F is one of the more comprehensive coverage plans and, unless you have some existing health issues, the HD version can be the most cost effective choice available.

Yes, it goes up every year, but it starts out under $50 per month.

 

[audreyh1]

+1

The best Medigap option I've found is the high deductible (currently ~$2,100/yr) version of Plan F. F is one of the more comprehensive coverage plans and, unless you have some existing health issues, the HD version can be the most cost effective choice available.

Yes, it goes up every year, but it starts out under $50 per month.

That's pretty nice. I do prefer to go high deductible rather than pay premiums.

$2100 deductible is one third of my existing deductible.

I just remember my in-laws dropping their Medigap policy because it was expensive, and then my MIL was diagnosed with cancer later that year. 20% co-pay on cancer treatment can still be a very high annual expense.

We were able to get them in some programs that essentially covered the co-pay on the most expensive drug. But it was looking pretty scary finance-wise there for a moment.

On Medigap F coverage - what are the issues if you relocate to a different state?

 

[REWahoo]

On Medigap F coverage - what are the issues if you relocate to a different state?

Since we have no plans to move, I've never looked into it. But a quick search shows Medicare supplements follow Medicare eligibility and are therefore portable:

...the Medicare supplement looks to traditional Medicare to dictate eligibility both in terms of provider (accepts Medicare) and claims eligibility (is the service covered by Medicare) and this holds true in all States equally.

Moving To Another State with Medicare Supplement

 

[Texas Proud]

This is not in Medicare, it is private Medigap policies, which can only be sold to Medicare parts A and B enrollees.

And the number of options within this system different from state to state, with certain minimums.

Ha

The policies referred to here are Medicare Supplemental Insurance, also known as Medigap policies. Depending on the [-]alphabet letter[/-] policy you choose to purchase, these policies cover all or a portion of what Medicare does not pay for. You can see a list of Medigap policies here, along with a summary of what each covers:

How to compare Medigap policies | Medicare.gov

But it is connected to Medicare and as such a decision that needs to be made when enrolling... and it looks like you need to know the pitfalls of choosing one way as opposed to the other.... not that I know anything about this.... as I said, I believe there will be changes by the time I get there (8 years)....

 

[audreyh1]

Since we have no plans to move, I've never looked into it. But a quick search shows Medicare supplements follow Medicare eligibility and are therefore portable:



Moving To Another State with Medicare Supplement

Thanks much!

 

[MBSC]

In past years, CDPHP UBI has developed premium rates using New York State Medicare sample data because credible plan experience data was not available due to the newness of the product. Now that CDPHP UBI has some plan experience data to rely upon, the proposed premium rates were developed through a blending of such plan experience data and the New York State Medicare sample data. The proposed rate increase is required as part of CDPHP UBI’s effort to ensure the long term ability of this product to be sustainable.
The rate adjustments proposed in this filing will be effective on January 1, 2015. There are currently 4,707 Individual Medicare Supplemental policyholders encompassing all regions.
...As a not-for-profit health plan, CDPHP prices its products and budget for slim margins so that we may continue to offer access to high-quality health care.

Source: https://www.cdphp.com/~/media/files/members/narrative-summary-med-supp.ashx?la=en

Prior 3/1/2014 Rate Increase: https://www.cdphp.com/~/media/files/home/individual-med-sup-narrative-summary.ashx?la=en

I wonder how many rate increases they will need in future years before the "newness" wears off.

 

[Texas Proud]

The policies referred to here are Medicare Supplemental Insurance, also known as Medigap policies. Depending on the [-]alphabet letter[/-] policy you choose to purchase, these policies cover all or a portion of what Medicare does not pay for. You can see a list of Medigap policies here, along with a summary of what each covers:

How to compare Medigap policies | Medicare.gov

OK.. now I see where all these letters are coming from.... not as hard of a decision... Just have to figure out what you want to cover and pick that letter and then get a price... (well, that is what I think)....

 

[mf15]

I have plan F high deductible, at 66 years old pay about 68/month.
If I have go to the ER I will take the 2100 hit,then the plan reverts to basically
regular plan F. Other than that once you hit the 147 part B deductible for say going
for a regular doc visit you pay 20% of the cost. If a doc visit cost is say 100 bucks you will pay 20,that means I could go to the doc 100 times in a year or so before hitting the 2100 plan full deductible. So far I am way ahead.
Some of the plan costs are really high, medicare is paying 80% of all costs regardless of plan.
if it is a qualified medicare cost.
Then don't forget part D your drug plan added to any supplement costs.
Also medicare does not pay much for vision problems unless a medical condition,routine stuff you are own your own.
Also their is not routine dental coverage,unless say surgery is involved,otherwise
fillings or cleanings are not covered.


Anytime there is a screw up say with billing or something else. Just call medicare,
if justified they will escalate your case with the insurance company.
The insurance company will now jump through hoops to get it corrected.
Old Mike

 

[aja8888]

Anytime there is a screw up say with billing or something else. Just call medicare,
if justified they will escalate your case with the insurance company.
The insurance company will now jump through hoops to get it corrected.
Old Mike

My one experience with a mis-billing by the Dr's billing company was not as easy as the above.

Billing service over deducted for Medicare by $20.

Medicare said I had to get it fixed myself. This was from an escalated rep.

Insurance company (with full Plan F in my case) stopped processing claims until I resolved it.

Six months later and scores of phone calls, 10 letters and a few voice mails, the billing company fixed it. (They are not that accessible and spoke with a heavy foreign accent).

Don't go believing it's always easy or that someone will fix a problem for you.

 

[REWahoo]

Don't go believing it's always easy or that someone will fix a problem for you.

+1

I got an anesthesiologist bill for $924 after a colonoscopy. My Medicare Summary Notice said the maximum I could be billed for the service was $0.00 with this explanation: "You didn't know this service isn't covered so you don't have to pay." My Medigap insurance (BC/BS) said Medicare didn't approve payment for this procedure and neither will we.

I sent a copy of the Medicare information to the billing office - I got back a past due bill. I sent a letter to them and a second copy of the Medicare paperwork - I got another past due bill along with a threat to turn the bill over to a collection agency if not paid within 30 days.

I called the billing office and stayed on the line until I was finally connected to (what I was told was) the billing supervisor. After listening to my "what's wrong with this picture?" explanation and question, she promised to investigate and get back to me.

Surprise! She called back the next day to say the bill was in error, disregard, I owed nothing.

PITA...

 

[ZMAN]

AJA Said: "Insurance company (with full Plan F in my case) stopped processing claims until I resolved it."

This is the type of real world experience that I am interested in for my Plan F choice. Was that a private carrier? If so which one if you do not mind saying.

So far it seems to me that people have no complaints over United Health Care.

NY is community rated and guaranteed issue, which is why it is so expensive. So I would not expect an individual increase as I age.

As I read some more literature in NY, if you switch Medigap carriers after the first year, the worst they can do to you is a 6 month waiting period for prior existing conditions. So I guess I will have to sit in a sterile room for 6 months if I do not like my initial choice.

My thinking was not to go with the high deductible Plan F since insurance premiums are an above the line deduction from income on my tax return [Line 29: I still practice law from time to time], whereas medical expenses are subject to the 2% floor on Schedule A, line 4.

 

[aja8888]

AJA Said: "Insurance company (with full Plan F in my case) stopped processing claims until I resolved it."

This is the type of real world experience that I am interested in for my Plan F choice. Was that a private carrier? If so which one if you do not mind saying.

So far it seems to me that people have no complaints over United Health Care.

NY is community rated and guaranteed issue, which is why it is so expensive. So I would not expect an individual increase as I age.

As I read some more literature in NY, if you switch Medigap carriers after the first year, the worst they can do to you is a 6 month waiting period for prior existing conditions. So I guess I will have to sit in a sterile room for 6 months if I do not like my initial choice.

My thinking was not to go with the high deductible Plan F since insurance premiums are an above the line deduction from income on my tax return [Line 29: I still practice law from time to time], whereas medical expenses are subject to the 2% floor on Schedule A, line 4.

From what I recall, not all Medicare deductibles are considerd an annual cost and can occur more than once. I recall that the hospital deductible cost of ~$1,100 is per admission over a short period (say 90 days). I don't have my Medicare plan near me so I am recalling this from memory.

ZMAN, please check your PM's.

 

[ZMAN]

I found similar inquiries as my initial post in bogleheads:

AARP Medicare Supplement Ins (United Healthcare - Bogleheads

Another Medigap Q: United versus BCBS - Bogleheads

It really seems that UHC is winning the race. With the astounding amount that they pay their CEO, I wonder how they provide low cost (they are the second lowest in my zip code) and apparently good customer service per the various posters on bogleheads.

 

[iac1003]

No problem with DH's AARP UHC Part F plan for the past 4 years. And when I was in private practice they paid very quickly after Medicare processed the claim.

Don't get an Advantage plan. There is no advantage - they only want well people and have quite limited networks. It isn't worth it. They want to make money. That's why several insurers have stopped offering them. You can't make that much money off older sicker people in the long run.

And a good Part F plan will cover emergency care for a 60 day period if you are vacationing abroad for a small fee (I think $9 for AARP Part F).


Sent from my iPhone using Early Retirement Forum