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Old 11-01-2015, 05:07 PM   #21
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Originally Posted by Bestwifeever View Post
We have Medigap plan G. Same benefits as F but we pay the annual defuctible (plan F pays that), but the G premiums save us more than the deductible.
My wife moved from a plan F to a Plan G. The plan F had a 17% premium increase while the plan G kept the premiums the same, the difference being the $147 deductible is no longer covered.
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Old 11-01-2015, 05:45 PM   #22
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Moving from F to G then would not appear to require underwriting nor would moving to another insurance company but staying within the same group e.g G. Correct?
I should have written that better. The point I was trying to make is switching between F-HD and regular F is not a lateral move as some think. Several states have special provisions for switching Medigaps and allow a lateral or downgrade to another company without underwriting. NY & CT are the only ones I can think of that let you go up to a higher level of coverage without underwriting.

If the state only follows the federal provisions, you can change Medigaps without underwriting if the insurance company goes bankrupt or otherwise stops offering your plan in your market. You can almost always downgrade within the same company. Downgrading or a lateral to another company almost always means underwriting in these states. This is why it's important to get it right the first time in these states.
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Old 11-01-2015, 05:47 PM   #23
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My Medicare supplement (TFL) pays my share of costs (whatever Medicare doesn't pay), so I'm a happy camper. But that said, I have to admire how much Medicare does take care of.

In the last few years since both DW and I have been on Medicare the costs have been as follows:

2013:
Billed: $19,796 Medicare paid: $4,669 TFL: $1,770

2014:
Billed: $4,548 Medicare paid: $1,138 TFL: $525

2015 ytd:
Billed: $7,441 Medicare paid: $1,909 TFL: $655

So my point is that even without the supplemental coverage it wouldn't have been a real problem to just pay the difference.
braumeister..........I don't understand the math for your numbers. If Medicare pays 80% and supplement pays the other 20%, then (ignoring the deductible),
Medicare payments should be 4x the supplement. If that's true, then whether you can handle the payments w/o the supplement kind of depends
on how big X is (where you pay 20% of X). In your example X is significant but not humungous; if X gets humongous, then 20% of X can still be a rather sobering number and you will be glad you have the supplement.
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Old 11-01-2015, 05:53 PM   #24
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I checked Florida BCBS F vs C pricing. The difference in premium is $21 x month. So, pay an additional $252 to avoid paying the deductible of $147.
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Old 11-01-2015, 06:40 PM   #25
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Originally Posted by braumeister View Post
My Medicare supplement (TFL) pays my share of costs (whatever Medicare doesn't pay), so I'm a happy camper. But that said, I have to admire how much Medicare does take care of.

In the last few years since both DW and I have been on Medicare the costs have been as follows:

2013:
Billed: $19,796 Medicare paid: $4,669 TFL: $1,770

2014:
Billed: $4,548 Medicare paid: $1,138 TFL: $525

2015 ytd:
Billed: $7,441 Medicare paid: $1,909 TFL: $655

So my point is that even without the supplemental coverage it wouldn't have been a real problem to just pay the difference.
So you paid no out of pocket? If that's the case these knockdown numbers are amazing. I'm trying to decide about my DH coverage our BSBC has no out of pocket payments for us, but on a hernia surgery..BSBC paid the grand total of the 580 dollars remaining after the Medicare knockdown. it's about a 210 monthly cost for the BC.....I really had no idea that the co-pays on Medicare were so small. Will you continue with your supplemental?
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Old 11-01-2015, 06:51 PM   #26
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I really had no idea that the co-pays on Medicare were so small.
ivinsfan,

It all depends on your Medigap policy as to whether you have any co-pays (some are $20/Dr. office visit & $50 for ER visit, like Plan N) and some are no copays (Plan F) and (Plan G = no copays after $147 Plan B deductible is met at a 20% contribution /'event').

omni
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Old 11-01-2015, 08:55 PM   #27
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I checked Florida BCBS F vs C pricing. The difference in premium is $21 x month. So, pay an additional $252 to avoid paying the deductible of $147.
Michael...........this chart suggests that the difference is not the deductible but the coverage of excess charges https://www.medicare.gov/supplement-...e-medigap.html
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Old 11-01-2015, 09:03 PM   #28
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Michael...........this chart suggests that the difference is not the deductible but the coverage of excess charges https://www.medicare.gov/supplement-...e-medigap.html
I'm not Michael but the chart you attached shows no difference between F and G for excess charges ?
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Old 11-01-2015, 09:39 PM   #29
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I'm not Michael either but I believe he compared F with C, not with G?
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Old 11-01-2015, 09:47 PM   #30
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ivinsfan,

It all depends on your Medigap policy as to whether you have any co-pays (some are $20/Dr. office visit & $50 for ER visit, like Plan N) and some are no copays (Plan F) and (Plan G = no copays after $147 Plan B deductible is met at a 20% contribution /'event').

omni
I understand, what I meant to say was I didn't realize that balance left to pay after Medicare payments was so small, such as after a hernia surgery and all bills connected with it, my payments without a supplement would have been only around 450 I just rechecked my bills and BCBS paid 450 not the 500+ I estimated.
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Old 11-02-2015, 07:13 AM   #31
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I checked Florida BCBS F vs C pricing. The difference in premium is $21 x month. So, pay an additional $252 to avoid paying the deductible of $147.
Sorry, I meant F vs G. Not sure if that was a typo or a vision problem.
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Old 11-02-2015, 07:51 AM   #32
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braumeister.....I don't understand the math for your numbers. If Medicare pays 80% and supplement pays the other 20%, then (ignoring the deductible), Medicare payments should be 4x the supplement.
TFL includes prescription drug coverage excluded from Medicare's 80%, so that probably skewed the numbers. The annual billing probably includes the retail prescription price, Medicare paid $0, and TFL paid something close to Part D.

Edit to Add: I also want to thank Michael for splitting the threads.
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Old 11-02-2015, 07:53 AM   #33
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Sorry, I meant F vs G. Not sure if that was a typo or a vision problem.
I think you were just trying to see if we were paying attention (or if our vision was as good as yours) Guess we passed.
btw.......nice job on the split.....I would have bet $$ that it wouldn't be split....too much work.
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Old 11-02-2015, 08:12 AM   #34
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It was a good idea to separate the threads. The process of choosing Medicare coverage is not at all similar to getting coverage for us youngsters.
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Old 11-02-2015, 08:30 AM   #35
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I checked Florida BCBS F vs C G pricing. The difference in premium is $21 x month. So, pay an additional $252 to avoid paying the deductible of $147.
DH did the research on this for us and said even if you didn't use Medicare for a year at all that plan G was still better, so I signed up for it as well. The insurance company said it is their most popular plan (and dropped our premiums another 15 percent for being on the same plan with them--I swear it's like we're getting paid to be old). Who knows what the future will hold re premiums, of course.

And another thanks for the most skillful thread split to Michael--I've not looked at the ACA open enrollment thread since the split, so good call.
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Old 11-02-2015, 09:22 AM   #36
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DH did the research on this for us and said even if you didn't use Medicare for a year at all that plan G was still better, .....................................
Not sure I understand this.........if you don't have any medical expenses, you won't have to pay a deductible,just premiums and G is cheaper. If you have a lot of medical expenses, F doesn't have to pay deductible but G does so the advantage over F decreases ..........so perhaps you meant the opposite?.....
that even with "heavy" Medicare use, G still was better?
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Old 11-02-2015, 09:32 AM   #37
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I have a BCBS Sup F plan and a Humana drug plan. No deductible and a good network of Drs. That decision was a no brainer for me compared to the various medicare advantage plans
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Old 11-02-2015, 09:45 AM   #38
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I have a BCBS Sup F plan and a Humana drug plan. No deductible and a good network of Drs. That decision was a no brainer for me compared to the various medicare advantage plans
Would you mind explaining a little why it was a no brainer..I now realize my spouse in on a BCBS F plan and was thinking of going cheaper. But from what I have been reading, he would have to be underwritten to go back to F if we decided to switch back at some point.He went on the F with no problem the month he turned 65, but he does have an underlying health that we need to watch forever.
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Old 11-02-2015, 10:49 AM   #39
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My SO has been very happy with his Humana Medicare advantage plan . He was orginally in a HMO but we switched to a PPO last year . He had a total knee last year and Humana paid out $100,000 . He paid $1100. The problem with the HMO is doctors would leave the plan and the coverage would change plus you needed a referral for everything . He was on the HMO when he ended up having a triple bypass and they paid all but a small amount .
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Old 11-02-2015, 11:03 AM   #40
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Not sure I understand this.........if you don't have any medical expenses, you won't have to pay a deductible,just premiums and G is cheaper. If you have a lot of medical expenses, F doesn't have to pay deductible but G does so the advantage over F decreases ..........so perhaps you meant the opposite?.....
that even with "heavy" Medicare use, G still was better?
m

Both plans are exactly the same except F pays the deductible, G doesn't. The G premiums are $200+ less than the F premiums over the year. Pay the $147 (this year) deductible on G, you are still ahead $50+ on G. Don't go to the doc at all, ahead by the $200+. I'm not very good at explaining things, but I meant we end up ahead in either scenario.
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