Blue Shield Supplemental Plans Quotes

[Disappointed]

Anybody with Blue Shield of California?

Talked to a rep yesterday, and here are some of the quotes she gave me.

Plan F $183
Plan F Extra which includes vision $163

She said that while Plan F Extra has more coverage it is cheaper because of more younger subscribers. Both plans get $25 discount for the first year.

Drug plans
Silver Script $34.80
Blue Shield Plus $81.10
Enhanced Plus $117.8

The drug plans are confusing and I will have to get more information for each plan.

I think I will choose Plan F Extra but for the Drug Plan the rep said that I should explore other carrier as well. I am on one of the medication that is quite costly.

Anybody with Blue Shield of California? Comments, opinions?

MP

 

[Another Reader]

I'm having a hard time understanding why three insurance companies decided to offer upgraded policies at lower cost than regular Plan F in California. Plan F closes to new enrollment in 2020. What is the strategy behind this approach?

I have vision coverage from the pension system already. The most attractive features of two of these plans are the lower premiums and hearing exam and hearing aid coverage.

Two of the companies stated the enhanced plans are superior to regular Plan F and you will not be able to switch from regular Plan F without underwriting. The third says the plans are equivalent and participants in regular Plan F will be able to switch without underwriting.

I just don't trust the insurance companies and I want to understand their game plan before I commit. Any insight from the industry insiders here?

 

[TwoByFour]

Plan F $183
Plan F Extra which includes vision $163

She said that while Plan F Extra has more coverage it is cheaper because of more younger subscribers. Both plans get $25 discount for the first year.

MP

There is something amiss. If two plans are identical and one costs less than the other nobody would buy the more expensive one. Insurance companies are not dumb and they would not offer two plans like that. There is something else going on, like they are not actually identical. You need to read the details rather than accept everything a sales rep told you.

 

[MBSC]

There is something else going on, like they are not actually identical.

The plans are not identical because the regular F has been around for decades. The pool of enrollees are old and unhealthy and the premiums reflect their high utilization of medical services.

The sales rep was incorrect in saying Extra F "has" younger enrollees. The plan just started 10/1/2018. They don't have anything yet. What the rep should have said is that there is an "expectation" that the majority of enrollees will be those aging in to Medicare (turning 65) and the plan is priced accordingly.

It is a well-known, common tactic in the industry to create a "new block of business", "new book of business", or "new risk pool". It goes by many names. It allows the carrier to offer a competitively priced product for a few years until that block becomes old and unhealthy. Rinse and repeat as needed to prevent competitors from gaining market share. They are trying to squeeze the last drop of [-]blood[/-] profit from the F turnip.

Fortunately, California has a "Birthday Rule" allowing enrollees to escape from the unhealthy blocks and their rising premiums. In most other states, the unhealthiest of enrollees become trapped in the high premium block because they cannot pass underwriting to change plans.

If two plans are identical and one costs less than the other nobody would buy the more expensive one.

You would be surprised at the number who will continue to enroll in regular F because that's what their relative/friend/neighbor has. They will not even look at the 'Extra' plan because 'something must be wrong with it.'

 

[Another Reader]

The plans are not identical because the regular F has been around for decades. The pool of enrollees are old and unhealthy and the premiums reflect their high utilization of medical services.

The sales rep was incorrect in saying Extra F "has" younger enrollees. The plan just started 10/1/2018. They don't have anything yet. What the rep should have said is that there is an "expectation" that the majority of enrollees will be those aging in to Medicare (turning 65) and the plan is priced accordingly.

It is a well-known, common tactic in the industry to create a "new block of business", "new book of business", or "new risk pool". It goes by many names. It allows the carrier to offer a competitively priced product for a few years until that block becomes old and unhealthy. Rinse and repeat as needed to prevent competitors from gaining market share. They are trying to squeeze the last drop of [-]blood[/-] profit from the F turnip.

Fortunately, California has a "Birthday Rule" allowing enrollees to escape from the unhealthy blocks and their rising premiums. In most other states, the unhealthiest of enrollees become trapped in the high premium block because they cannot pass underwriting to change plans.

You would be surprised at the number who will continue to enroll in regular F because that's what their relative/friend/neighbor has. They will not even look at the 'Extra' plan because 'something must be wrong with it.'

My concern is being trapped when the ability to enroll in regular Plan F goes away. If the insurance companies discontinue or dramatically increase the price of the enhanced products at some point, there is no ability to move to the old Plan F as I understand it. Plan G is almost the same, but more detail work when you are less able to fool with it.

 

[MBSC]

My concern is being trapped when the ability to enroll in regular Plan F goes away. If the insurance companies discontinue or dramatically increase the price of the enhanced products at some point, there is no ability to move to the old Plan F as I understand it.

Anyone enrolled in Part B before 1/1/2020 can still enroll in Plan F on or after 1/1/2020. It only closes to those who enroll in Part B on or after 1/1/2020.

In CA, a person already in regular F on or after 1/1/2020 can lateral to another regular F after 1/1/2020 under the Birthday Rule. They can also downgrade to a lesser plan, such as Plan G.

In CA, a person already in an Anthem or Blue Shield Innovative (Extra) F on or after 1/1/2020 can downgrade to a lesser plan, such as regular F or Plan G, after 2020 under the Birthday Rule. Health Net's Innovative F is considered equal to a regular F so it would be a lateral to regular F under the Birthday Rule after 2020.

 

[FIRE'd@51]

Won't Plan F Extra be closed to new enrollees in 2020 since it covers the part B deductible?

 

[MBSC]

Won't Plan F Extra be closed to new enrollees in 2020 since it covers the part B deductible?

All Plan F's close to new enrollees in 2020. A new enrollee is defined as a person who enrolls in Part B on or after 1/1/2020.

 

[Disappointed]

Very educational, thanks guys.

Any recommendation on drug plan?

 

[Another Reader]

Anybody with Blue Shield of California?

Talked to a rep yesterday, and here are some of the quotes she gave me.

Plan F $183
Plan F Extra which includes vision $163

She said that while Plan F Extra has more coverage it is cheaper because of more younger subscribers. Both plans get $25 discount for the first year.

Drug plans
Silver Script $34.80
Blue Shield Plus $81.10
Enhanced Plus $117.8

The drug plans are confusing and I will have to get more information for each plan.

I think I will choose Plan F Extra but for the Drug Plan the rep said that I should explore other carrier as well. I am on one of the medication that is quite costly.

Anybody with Blue Shield of California? Comments, opinions?

MP

Having talked to the Via Benefits people, the local SHIP person. and both of the large national agencies frequently mentioned here, they all seem to use use similar software or manual calculations to recommend a Part D plan. They price all the prescriptions that you currently take, incorporating your drug delivery and pharmacy preferences, and get a total annual cost for the premium and the drugs on each plan. The idea is that you will pick the lowest overall cost plan after both premiums and drug co-pays are added up. For those people in California that take no prescription drugs, the recommendation is to purchase an inexpensive plan to avoid the penalty for not buying a plan and to provide coverage if your needs suddenly change. If you need a more comprehensive plan later, you can use the annual enrollment window to change your plan.

Nothing about the behavior or responsiveness of the insurer is considered in these analyses. If you look at the various ratings for the drug plans, most of them are three out of 5 stars. Not much help differentiating good from not so good.

 

[Another Reader]

Based on the information provided by Via Benefits, in addition to vision benefits, Blue Shield Plan F Extra offers specific hearing aids at fixed prices and a "Personal Emergency Response System" which I assume is a clone of Life Alert. If you are new to Part B, you also get a $25 a month 12 month premium reduction.

The SHIP volunteer I spoke with was pleasant but was unaware of the Plan F Extra and the Innovative Plan F variants. They were not covered in their training and the brochures they were given were outdated.

The SHIP counselor might be able to help you with a Part D plan recommendation. You can do a similar search at Medicare.gov by inputting your zip code and searching drug plans. Input the drugs you take and the site will make the calculations.

 

[SumDay]

For your Part D drug plan, have you entered your drugs on the Medicare website? https://www.medicare.gov/find-a-plan/questions/enter-your-information.aspx Gather all your bottles and see what it shoots back. It will compare all plans available and what the plan will pay along with your annual out-of-pocket.

We did this, and ended up using Silver Scripts. It was $24 a month this year, and goes up to $30 next year. Very good customer service, an intuitive app to order refills and price new meds, and it pays better than when DH was on my megacorp plan.