CNBC article: Key Things To Know About Medigap

[jim584672]

In New York, a person on original Medicare can enroll in a Medigap plan anytime. They can switch Medigap plans anytime.

So if you are on the young side get a High Ded G and once you get older / sicker get a regular G. Seems very hackable.

 

[pb4uski]

I haven't started a deep analysis of Medicare yet (63 this month). A question though.... On traditional Medicare, can one buy a supplemental/gap policy that serves as an excess policy of sorts? For example, insurer covers the entire 20% once insured has spent $X0,000 out of pocket.

That would be perfect for us, but based on the rest of the consumer insurance market, I'm guessing that it doesn't exist.

Yes, that is exactly what Medicare supplemental insurance plans aka Medigap is.... it covers the Medicare Parts A deductibles and copays. My Plan G costs ~$200/month and covers everything except the Part B deductible which is $226 for 2023. So for ~$2,400 a year I can access any medical provider in the US that accepts Medicare and everything except $226 is covered by insurance. The other thing is that typically the annual changes in the plan are minimal.

While MA plans vary, most require you to stay within network to be covered so if the provider that you want to see is out of network then you are not covered or have higher deductibles and copays which can total as much as $8,500 annually out of pocket.

I view it as paying $2,400 a year for peace of mind and not having to wonder how the MA provider is going to screw me with plan changes. Also, the MA system is rife with fraud with ongoing government lawsuits against the major MA carriers for fraudulent charges.

We looked at it a lot since DBIL has a no-premium MA plan and DW wanted to join it to avoid the $2,400 premium that we pay.

 

[pb4uski]

My only complaint is that Part G does not include the deductible (Like F Did/does). Seems like just an excuse for more paperwork and work for the providers. They should simply add the cost and include it.

I agree. It would be much simpler to include the Part B deductible in what is covered and increase the premium by $20/month.

While I see Telly's point about a small deductible mitigating people running to the doctor for every little thing I have to wonder how real that is as most people that I know dislike going to the doctors.

 

[pb4uski]

So if you are on the young side get a High Ded G and once you get older / sicker get a regular G. Seems very hackable.

And that is why it cost more... adverse selection.

 

[REWahoo]

So if you are on the young side get a High Ded G and once you get older / sicker get a regular G. Seems very hackable.

That's basically the switch DW and I made when we were in our early 70's. Although we had to go through underwriting, we were fortunate to able to move from a high deductible Plan F to a Plan N. YMMV

 

[RetMD21]

I thought this was interesting regarding supplemental coverage for part B

39% MA
21% Medigap
18% employer sponsored plan
12% Medicaid
10% nothing

2021 report of 2018 data https://www.kff.org/medicare/issue-...overage-among-medicare-beneficiaries-in-2018/

 

[Midpack]

Well, if Plan G included the deductible like Plan F, it would be called Plan F. It was decided by your and my representatives and Senators that Plan F should be sunsetted. I personally don't agree with the reasoning, but so it is. Sunsetting of Medigap plans has been done before, so it is not new.

+1. Back when I enrolled for a supplement, the annual cost for Plan F was almost exactly the same as Plan G plus the deductible ($233 iirc). So it didn’t make any difference. Since I knew Plan F was being discontinued and on the hope I might have a year with less than $233 in medical expenses I enrolled in Plan G from the start.

 

[Teacher Terry]

I am going to switch from plan f to g during my birthday month because it will save me 50/month in premiums. I can’t pass medical underwriting and can only change to plans with less coverage not more. The person I talked to about it through via benefits said when you choose your medigap plan it should be for life. Yikes!!

 

[ncbill]

If 23% are enrolled in Medigap plans and 48% are enrolled in Medicare Advantage plans, both of which limit exposure to a huge medical bill, doesn't that means that 29% are leaving themselves on the hook for the 20% that Part B doesn't cover, which could be quite large.

The last relative I buried thought most doctors were out to scam people.

Didn't add Part B (& Plan G) until she started having back pain in her mid-70s.

Which ultimately led to a diagnosis of untreatable breast cancer which killed her less than 6 months later.

I'm very thankful for Hospice, covered under Part A.

Heaviest smoker I've ever known (& both my parents smoked) with a family history of breast cancer but AFAIK never had a single mammogram.

 

[meleana]

We have Plan G. Would never have an Advantage plan. Now that I’m facing spine surgery glad I have it.

 

[5Miler]

I have had plan G since starting Medicare 4.5 years ago but have never really used it as I use the VA for my healthcare. Since I use the VA I am not required to have a Plan D as I use the VA pharmacy and will not face a penalty if I later elect to enroll in Plan D. Medicare B or Advantage is different as I would face a penalty if I did not enroll and later elected to enroll.

The VA also covers my vision care (Ophthalmologist vs Optometrist) and regular Dermatologist visits after my MOHS surgery 2 years ago. I get a mini physical every 9 months and even was given an ultrasound screening for Abdominal Aneurysm in November based upon my age and HBP. I don't really mind paying the approx $300 each month for Medicare and Plan G. It gives me flexibility for my medical choices.

I can say in talking with other vets while at the clinic I sometimes find they have no other coverage than the VA. Wonder how they are counted.