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Medicare Part F - Plan F: Do you have experience with these carriers
Old 05-03-2015, 11:55 AM   #1
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Medicare Part F - Plan F: Do you have experience with these carriers

I have been a member for some time, regularly review what is going on, but rarely post. However, I have a question for which I do not see any answers in the threads.

I am turning 65 later this year and am doing my Medicare research. Based on the threads I have read, I am going to start with Traditional Medicare with Parts A, B, D and F (Medigap) and will choose Plan F from the Part F Medigap choices. I like the idea of a wide open nationwide network and I want to avoid the underwriting later on if I opt for an Advantage Plan on initially going in, and thereafter want to change to Traditional Medicare.

Over the years here in Western NY I have been lucky enough to have one of Consumer Reports highest rated carriers, Independent Health for my medical insurance. Although they have an Advantage Plan, they do not write Medigap coverage.

For a few years through DW's Megacorp Cafeteria Plan we had United Health Care. And although that was our money, they were then a nightmare with loss of paper work, although faxed in, and other difficulties in trying to get our money back for allowed expenses.

What I find interesting is that although the policies are the same by law, the rates vary by as much as 100%. So I do not know really where the jokers are in the deck. BTW, United Health is the second least expensive, but I fear going with them. CDPHP is the cheapest at $162 per month. With two at the most expensive at $330 per month.

So my question for you, dear forum members, is what experiences have you had with any of the carriers below in handling Part F Medigap claims (Plan F or otherwise). These are the only carriers who write Medigap in my zip code. (Medicare Supplement Insurance Rate: Plan F)

Thank you all so much for your comments! Here is the list:

Aetna Life Insurance
American Progressive
Bankers Conseco
CDPHP Universal Benefits
Excellus Health Plan, Inc. (d/b/a Univera Healthcare)
First United American
Group Health Incorporated (a/k/a GHI)
HealthNow New York Inc. (d/b/a BC/BS of Western New York)
Humana
Mutual of Omaha
Sterling Life
United HealthCare Insurance (AARP Program)

Best regards, Zman
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Old 05-03-2015, 11:58 AM   #2
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Since the policies are the same by law, why not just go to the lowest bidder?

Or is there something I'm missing?
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Old 05-03-2015, 12:08 PM   #3
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I know those products as Medicare Advantage programs. There is a rating system out there. Take a look at this article: Best Medicare Advantage Plans 2015 - US News
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Old 05-03-2015, 12:16 PM   #4
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My initial thought was to go with the cheapest for Plan F. However, the price variance is so high, there may be other ways where the insured is "paying". The low bid is not necessarily the best bid.

My concern is that the devil may be in other details such as the claim handling or some aspect that I am not aware of, which will offset the savings.

I do not want to be put through the wringer every time I have a claim. Prompt, proper claim submission and handling has a great value.
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Old 05-03-2015, 12:22 PM   #5
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Originally Posted by ZMAN View Post
What I find interesting is that although the policies are the same by law, the rates vary by as much as 100%. So I do not know really where the jokers are in the deck. BTW, United Health is the second least expensive, but I fear going with them. CDPHP is the cheapest at $162 per month. With two at the most expensive at $330 per month.

So my question for you, dear forum members, is what experiences have you had with any of the carriers below in handling Part F Medigap claims (Plan F or otherwise). These are the only carriers who write Medigap in my zip code. (Medicare Supplement Insurance Rate: Plan F)

Thank you all so much for your comments! Here is the list:

Aetna Life Insurance
American Progressive
Bankers Conseco
CDPHP Universal Benefits
Excellus Health Plan, Inc. (d/b/a Univera Healthcare)
First United American
Group Health Incorporated (a/k/a GHI)
HealthNow New York Inc. (d/b/a BC/BS of Western New York)
Humana
Mutual of Omaha
Sterling Life
United HealthCare Insurance (AARP Program)
Medicare supplemental (MediGap) policies all have the same coverage, the primary difference between them is network breadth and depth. The insurers are required to provide a web based tool that allows you to search the network, so this should help you compare one vs another. If you are frequently away from home or want the best care to be found in the country, the national carries like Aetna, Humana, and UHC may have better options.

OTOH, if you tend to stay local and are satisfied with the health care options in your area, the regional providers may have less costly options.
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Old 05-03-2015, 12:44 PM   #6
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Michael B: Even though the content of the Plan F policy is the same, you are saying that the networks may differ? I did not realize that.

I had assumed both policy content and policy network were the same for all Plan F carriers who wrote coverage in my area. My understanding is that Parts A, B and D all provide for a nationwide network (Is that right). Thus I assumed that Part F and its various Plans, including Plan F, had congruent nationwide coverage.

That is a huge difference to me since I want a nation wide network.

Thanks for that insight!
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Old 05-03-2015, 01:01 PM   #7
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Originally Posted by ZMAN View Post
Michael B: Even though the content of the Plan F policy is the same, you are saying that the networks may differ? I did not realize that.

I had assumed both policy content and policy network were the same for all Plan F carriers who wrote coverage in my area. My understanding is that Parts A, B and D all provide for a nationwide network (Is that right). Thus I assumed that Part F and its various Plans, including Plan F, had congruent nationwide coverage.

That is a huge difference to me since I want a nation wide network.

Thanks for that insight!
I have never heard of a network constraint on a Medigap Policy. But I only know about Washington, which does not have anything like this.

Here is a Medicare Publication that mentioned Medicare Select Medigap policies, These are cheaper, and in the states where they are sold. make use of some sort of hospital and doctor networks.

https://www.medicare.gov/Pubs/pdf/02110.pdf I think the bit about medigap Select is about page 20.


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Old 05-03-2015, 01:06 PM   #8
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According to this Medicare open enrollment: What's the best Medigap policy?

medigap plans don't have networks.......assume that means that if doc accepts medicare, they would accept the medigap plan ....but not sure.

I've had UHC......both pre- and post- Medicare. Don't recall any problems. With Medicare, I've never had to send anything in. That was done automatically w/Medicare sending the info to UHC.

Does this have anything to do w/ the pricing differences you see?
https://www.medicare.gov/find-a-plan...-policies.aspx
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Old 05-03-2015, 01:33 PM   #9
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Medicare supplemental (MediGap) policies all have the same coverage, the primary difference between them is network breadth and depth. The insurers are required to provide a web based tool that allows you to search the network, so this should help you compare one vs another. If you are frequently away from home or want the best care to be found in the country, the national carries like Aetna, Humana, and UHC may have better options.

OTOH, if you tend to stay local and are satisfied with the health care options in your area, the regional providers may have less costly options.
Beg pardon. Brain phart. I was thinking Advantage but answering Supplemental. The network difference is a characteristic of Medicare Advantage programs.
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Old 05-03-2015, 02:07 PM   #10
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Does this have anything to do w/ the pricing differences you see?
https://www.medicare.gov/find-a-plan...-policies.aspx
+1

A community-rated policy (if available) may have a higher premium to start but sometimes has an overall lower premium in the long run.
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Old 05-03-2015, 02:43 PM   #11
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So my question for you, dear forum members, is what experiences have you had with any of the carriers below in handling Part F Medigap claims (Plan F or otherwise). ...

Aetna Life Insurance
American Progressive
Bankers Conseco
CDPHP Universal Benefits
Excellus Health Plan, Inc. (d/b/a Univera Healthcare)
First United American
Group Health Incorporated (a/k/a GHI)
HealthNow New York Inc. (d/b/a BC/BS of Western New York)
Humana
Mutual of Omaha
Sterling Life
United HealthCare Insurance (AARP Program)
After much research, DH picked Mutual of Omaha for his Plan F (I think it's F). He is in his second year with that company and so far everything has worked perfectly.

Since he signed up, several people we know who are our age have mentioned that they also chose Mutual of Omaha independently of each other. I will be signing up with that company too this month, with coverage to start later in the summer.
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Old 05-03-2015, 04:15 PM   #12
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According to the NYS Website Mutual of Omaha is $315 a month. One of the highest. United Health is (AARP) at $180 is one of the lowest. I believe all health insurance in NY is community rated. My sense also is that Plan F has a nationwide network since in some states there is "Plan F Select", which is cheaper because it specifically has a limited "select" network.

I come back to my original quandary. In a community rated state, with the same content in all policies, why is there such a divergence in pricing?

From the on-line literature it also seems that switching Plan F policies after the open enrollment period (in year one) might require underwriting. I am not sure of this since NYS is also a guarantee issue state. If switching does require underwriting after year one, it is important to choose the right carrier from the get go.
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Old 05-03-2015, 04:43 PM   #13
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According to the NYS Website Mutual of Omaha is $315 a month. One of the highest. United Health is (AARP) at $180 is one of the lowest.
Your response made me go look at the stuff I have from Mutual of Omaha. DH actually has a Plan G for $120/month, but Plan F's male non-tobacco premium for someone who is 65 in the northern Illinois area including Chicago is still "only" $152 (vs. $165 for tobacco users), substantially less than your quote of $315. (I think I am the only one who posted about experience with one of the carriers you listed, so sorry if it was not helpful.)

Quote:
I believe all health insurance in NY is community rated. My sense also is that Plan F has a nationwide network since in some states there is "Plan F Select", which is cheaper because it specifically has a limited "select" network.

I come back to my original quandary. In a community rated state, with the same content in all policies, why is there such a divergence in pricing?
I don't know the answer to this question.

Quote:
From the on-line literature it also seems that switching Plan F policies after the open enrollment period (in year one) might require underwriting. I am not sure of this since NYS is also a guarantee issue state. If switching does require underwriting after year one, it is important to choose the right carrier from the get go.
I don't think you are subject to underwriting if you change carriers during subsequent open-enrollment periods, but someone here probably has done this and can perhaps address this issue for you.
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Old 05-03-2015, 05:08 PM   #14
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Consider looking for a SHIP counselor (State Health Insurance Program counselor) who is assigned to your geographic area. Their sole mandate is to help consumers - particularly seniors - select the best prescription plans and supplemental insurance programs for themselves.

Because insurers often "switch out" what drugs they cover, it's advisable to give your list of medications and the name of your pharmacy to the SHIP counselor each year just before open enrollment in order to find out the best (cheapest) prescription plan. If you assume the plan that is good for you this year will also be good for the new year, you can get a nasty and expensive surprise.

These SHIP counselors often do presentations at senior centers and easily work by phone, fax, and email.

This person has been invaluable to a member of our family who is managing healthcare for a relative.

Kindest regards.
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Old 05-03-2015, 08:08 PM   #15
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According to the NYS Website Mutual of Omaha is $315 a month. One of the highest. United Health is (AARP) at $180 is one of the lowest. I believe all health insurance in NY is community rated. My sense also is that Plan F has a nationwide network since in some states there is "Plan F Select", which is cheaper because it specifically has a limited "select" network.
Have you tried inputting different ages? In my South Carolina zip code, AARP-UHC is the only community-rated option. They have an "early enrollment discount" of 30% for new, age 65 enrollees, and reduce the discount 3% per year for 10 years until age 75. On AARPMedicareSupplement.com, the rates based on age are:

Age 65; Premium $140
66 = $146
67 = $152
68 = $158
69 = $164
70 = $170...
...75+ = $200 (the community-rated rate)

More info: https://www.medicareservices.us/unit...hcare_aarp.pdf
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Old 05-03-2015, 09:12 PM   #16
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I don't think you are subject to underwriting if you change carriers during subsequent open-enrollment periods, but someone here probably has done this and can perhaps address this issue for you.
Switching Medigap policies | Medicare.gov

In general, there is only one initial open enrollment period for Medigap ......not subsequent annual ones like for Advantage plans. To change plans, underwriting is probably the general rule for Medigap.

There are a few exceptions by state. In CA, you have a limited period each yr around your birthday when you can change plans w/o underwriting but you can only move sideways into the same type plan e.g. "F" or downwards. You can not move "up" w/o underwriting.
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Old 05-03-2015, 09:22 PM   #17
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I know someone who is on the United HealthCare Insurance (AARP Program) plan in NY and she seems happy with it.
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Old 05-03-2015, 09:56 PM   #18
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Switching Medigap policies | Medicare.gov

In general, there is only one initial open enrollment period for Medigap ......not subsequent annual ones like for Advantage plans. To change plans, underwriting is probably the general rule for Medigap.

There are a few exceptions by state. In CA, you have a limited period each yr around your birthday when you can change plans w/o underwriting but you can only move sideways into the same type plan e.g. "F" or downwards. You can not move "up" w/o underwriting.
i am confused (not uncommon for me) so I appreciate this thread! This publication seems to say there is an annual open enrollment contrary to the above link? No?

https://www.medicare.gov/Pubs/pdf/11220.pdf

Quote:
October 15—Open Enrollment begins
This is the one time of year when ALL people with Medicare can make changes to their health and prescription drug plans for the next year.
Decide: October 15 is the first day you can change your Medicare coverage for next year.
December 7—Open Enrollment ends
In most cases, December 7 is the last day you can change your Medicare coverage for next year. The plan has to get your enrollment request (application) by December 7.
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Old 05-03-2015, 11:39 PM   #19
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i am confused (not uncommon for me) so I appreciate this thread! This publication seems to say there is an annual open enrollment contrary to the above link? No?

https://www.medicare.gov/Pubs/pdf/11220.pdf
Also from your link:

"Remember, during Medicare Open Enrollment, you can decide
to stay in Original Medicare or join a Medicare Advantage Plan.
If you’re already in a Medicare Advantage Plan, you can use
Open Enrollment to switch back to Original Medicare."

There also is some subtle confusing wording:
"Remember, Medicare plans can change each year"

Apparently Medicare plans includes original Medicare and Advantage plans (which "wrap around" original Medicare) but not Medigap plans which are considered supplements to original Medicare.

There is an annual open enrollment period but it only allows you to switch
between between original Medicare and Advantage plans. It does not allow you to switch Medigap plans at will.

http://www.aarp.org/health/medicare-...estion_76.html

other links here: https://www.google.com/?gws_rd=ssl#q...pen+enrollment
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Old 05-04-2015, 08:28 AM   #20
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I think I understand it. Thanks, kaneohe.
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