Open enrollment for Medicare

[frayne]

Although I am not medicare elgible yet I would be interested in hearing what people are opting for and why ? I realize there are many variables but for someone who is just six months out from medicare the options seem many and the products confusing in their different offerings. Thank you in advance.

 

[MichaelB]

Edit to add: splitting off posts into separate Medicare and ACA Open Enrollment threads

Although I am not medicare elgible yet I would be interested in hearing what people are opting for and why ? I realize there are many variables but for someone who is just six months out from medicare the options seem many and the products confusing in their different offerings. Thank you in advance.

DW turns 65 next year. We will take the Medigap BCBS low deductible F.

We'll choose BCBS because they already deal with most of the physicians we will eventually use and I hope for fewer processing and administrative hang-ups than with other insurers. We'll choose Medigap F because I want the expanded coverage, and it is difficult to change options once coverage begins.

 

[REWahoo]

DW turns 65 next year. We will take the Medigap BCBS low deductible F.

We'll choose BCBS because they already deal with most of the physicians we will eventually use and I hope for fewer processing and administrative hang-ups than with other insurers. We'll choose Medigap F because I want the expanded coverage, and it is difficult to change options once coverage begins.

Similar to MichaelB, we choose a BCBS Plan F Medigap supplement, but ours is the high deductible version.

We are both in relatively good health (thankfully) so neither of us has come anywhere close to meeting the $2,180 high deductible amount. Since the premium cost of the high deductible Plan F vs. the standard (low deductible) Plan F would be roughly an additional $2,000 annually for each of us, the high deductible version is more cost effective for us - at least so far.

Each year I run DW's prescription drugs through the Medicare.gov online program to see what Part D plans are the least expensive. (I take no prescription drugs so I choose the least expensive Part D plan available.) Her current plan crept up a few dollars last year, but not enough to consider changing. This year it increased again and we will change it to a different insurer, saving approximately $300 in increased drug costs.

 

[MichaelB]

Similar to MichaelB, we choose a BCBS Plan F Medigap supplement, but ours is the high deductible version.

We are both in relatively good health (thankfully) so neither of us has come anywhere close to meeting the $2,180 high deductible amount. Since the premium cost of the high deductible Plan F vs. the standard (low deductible) Plan F would be roughly an additional $2,000 annually for each of us, the high deductible version is more cost effective for us - at least so far.

Each year I run DW's prescription drugs through the Medicare.gov online program to see what Part D plans are the least expensive. (I take no prescription drugs so I choose the least expensive Part D plan available.) Her current plan crept up a few dollars last year, but not enough to consider changing. This year it increased again and we will change it to a different insurer, saving approximately $300 in increased drug costs.

The Medicare D tool on the website that prices all the plans is the best online tool for insurance I have seen anywhere.

I know MediGap policies are underwritten, so there is no guarenteed issue. Can you move from the high to the low deductible F during any open enrollment, or is that too subject to underwriting? I like the high-deductible options but I don't see it available for us.

 

[REWahoo]

The Medicare D tool on the website that prices all the plans is the best online tool for insurance I have seen anywhere.

I know MediGap policies are underwritten, so there is no guarenteed issue. Can you move from the high to the low deductible F during any open enrollment, or is that too subject to underwriting? I like the high-deductible options but I don't see it available for us.

The high deductible plan isn't offered in all areas or by all insurers. I would have thought living in the Big City, you could get it.

[-]I understand you can switch to the regular Plan F (or any other supplement Plan) during the annual enrollment period - without underwriting.[/-]

Edit to delete incorrect info

 

[MichaelB]

The high deductible plan isn't offered in all areas or by all insurers. I would have thought living in the Big City, you could get it.

I've heard that said, but don't remember where. Last time I looked there were lots of plans, but most were offered by companies I don't recognize as health insurance providers, and that doesn't inspire me.

[-]I understand you can switch to the regular Plan F (or any other supplement Plan) during the annual enrollment period - without underwriting.[/-]

That makes the choice much easier - even if just to change the deductible.

 

[REWahoo]

Additional research says I was incorrect about switching to any other Medicare supplement plan without underwriting during open enrollment. I edited my post above to delete.

 

[MBSC]

DW turns 65 next year. We will take the Medigap BCBS low deductible F.

We'll choose BCBS because they already deal with most of the physicians we will eventually use and I hope for fewer processing and administrative hang-ups than with other insurers. We'll choose Medigap F because I want the expanded coverage, and it is difficult to change options once coverage begins.

Are you aware new enrollees will not be allowed onto low deductible Plan F after 2019? When this happened to Plans E, H, I, and J in 2010, their premiums rose because there were no young/healthy members to offset the cost of the older/sicker members left behind. Some fear the same could happen to F and are leaving now while they can still pass medical underwriting. Of course, not everyone has a good alternative to F in their market.

Google search results: https://www.google.com/search?q=Medigap+F+premiums+rise+in+2020

 

[REWahoo]

Are you aware new enrollees will not be allowed onto low deductible Plan F after 2019?

Thanks for the heads up.

I'm seeing where new enrollments in Plan F (both regular and high deductible) won't be allowed beginning in 2020? Most of the info I can find is written by insurance agents, who I fear may be trying to scare current Plan F folks like me into changing plans thus drumming up a commission.

More digging needed...

 

[Gotadimple]

OTOH, a friend has BCBS Medicare Advantage and loves it. He said that they pay everything and if he gets bills from providers for amounts that supposedly aren't covered he just tells them to go deal with BCBS.

That's the advantage of a Medicare Advantage plan, everything is in one place. The provider cannot balance bill (bill for what isn't covered), most include Part D coverage, and overall most have low co-pays and deductibles. This disadvantage is that most are HMOs - so you have a restricted network. But that can be a non-issue if the network is very broad (has lots of GPs, specialists, and hospitals contracted in your area).

To the OP, check out a local carrier who is putting on Medicare Advantage seminars and go to one. There is no obligation, the sales people are happy to make a presentation and share info.

What they present is carefully vetted by CMS so they are not providing info that is inaccurate. They will tell you your options. The alternative is to look for a presentation at a local library from a licensed agent. Again, they simply present info without obligation - a great introduction to the options available.

Third choice: Medicare.gov or the AARP site.

- Rita

 

[kaneohe]

I understand you can switch to the regular Plan F [-](or any other supplement Plan)[/-] during the annual enrollment period - without underwriting.

REW........I'm not sure that even your edited statement is correct. There is no annual enrollment for Medigap plans. Even in CA which allows a limited time period each yr to switch w/o medical underwriting(birthday rule) , you are only guaranteed to move to an equal or lesser plan. You can't move to a "higher" plan w/o medical underwriting. F is the highest, most comprehensive plan.

 

[rbmrtn]

I know MediGap policies are underwritten, so there is no guarenteed issue. Can you move from the high to the low deductible F during any open enrollment, or is that too subject to underwriting? I like the high-deductible options but I don't see it available for us.

It looks like from the info on the medicare site that underwriting is not done during open enrollment

https://www.medicare.gov/supplement...can-i-buy-medigap/when-can-i-buy-medigap.html

 

[Bestwifeever]

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.

 

[MBSC]

It looks like from the info on the medicare site that underwriting is not done during open enrollment

https://www.medicare.gov/supplement...can-i-buy-medigap/when-can-i-buy-medigap.html

The open enrollment referred to in the link is your initial enrollment period. Federal regulations do not provide an "annual" enrollment period to change between Medigaps. You can change anytime if you can pass the underwriting. This is why it's so important to get it right the first time in most states. States can be more generous than federal requirements when it comes to changing Medigaps.

Moving from F-HD to low deductible F is considered moving to a "higher level of coverage" and would be subject to underwriting unless your state has provisions.

 

[Ian S]

The open enrollment referred to in the link is your initial enrollment period. Federal regulations do not provide an "annual" enrollment period to change between Medigaps. You can change anytime if you can pass the underwriting. This is why it's so important to get it right the first time in most states. States can be more generous than federal requirements when it comes to changing Medigaps.

Moving from F-HD to low deductible F is considered moving to a "higher level of coverage" and would be subject to underwriting unless your state has provisions.

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?

 

[rbmrtn]

The open enrollment referred to in the link is your initial enrollment period.

Thanks for the clarification ( I'm still a ways out from medicare ). So medigap is pretty much a one shot deal. I can't image a 65+ year old passing underwriting.

 

[MichaelB]

Are you aware new enrollees will not be allowed onto low deductible Plan F after 2019?

Thanks for the heads up.

+1

 

[REWahoo]

REW........I'm not sure that even your edited statement is correct. There is no annual enrollment for Medigap plans. Even in CA which allows a limited time period each yr to switch w/o medical underwriting(birthday rule) , you are only guaranteed to move to an equal or lesser plan. You can't move to a "higher" plan w/o medical underwriting. F is the highest, most comprehensive plan.

Yep, you are correct.

When I was researching I must have hit on one of the few states who will let you go from high deductible F to regular F without underwriting and did not realize it wasn't the norm. I changed my earlier incorrect post.

 

[braumeister]

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.

 

[kaneohe]

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 wouldn't bet on this........your state may have laws that mandate this but I don't think it's the general rule.

 

[ejman]

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.

 

[MBSC]

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.

 

[kaneohe]

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.

 

[MichaelB]

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.

 

[ivinsfan]

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?