New Sub-types for Plan F

[Another Reader]

As part of figuring out which Plan F to buy during my initial enrollment window, I looked at all the Plan F prices at One Exchange/Via Benefits. To my surprise, I found new versions of Plan F, Plan F Extra, offered by Blue Shield, and Innovative Plan F, offered by Aetna Blue Cross and Health Net. They are similar but slightly different.

Plan F Extra from Blue Shield includes hearing aids at a set price, some vision coverage, and a Personal Emergency Response Device, similar to Life Alert. The initial premium is $140.00 You also get a $25 discount off the premium for the first 12 months if you are new to Medicare.

Innovative Plan F from Anthem Blue Cross offers a routine vision benefit and an exam and hearing aid allowance. Dollar amounts are shown. The initial premium is $142.62.

Innovative Plan F from Health Net appears to be similar to Anthem's, but no details are included. The initial premium is $150.00.

For reference, the inital premium for Plan F from UHC/AARP is $130.40.

Has anyone gotten an enhanced Plan F? Thoughts?

ETA: Why are these plans less expensive than their regular Plan F counterparts??

 

[REWahoo]

Since Medigap offerings vary by state, this may be something unique to your location.

 

[MBSC]

Has anyone gotten an enhanced Plan F?

ETA: Why are these plans less expensive than their regular Plan F counterparts??

In California, Anthem Innovative F started 1/1/18, Health Net Innovative F started 8/1/18 and Blue Shield Innovative (Extra) F just started 10/1/18. Since they are so new, the enrollees are expected to be younger and healthier than the current regular F pool translating into lower premiums. Also, new plans have no claims history for the insurance commissioner to use in determining if the rates are sustainable. Some carriers take advantage of this and set rates artificially low while they can to attract enrollees.

Health Net has designated their Innovative F as having equal benefits to regular F so a person can use the CA Birthday Rule to lateral from any insurer's regular F to their Innovative F.

Anthem and Blue Shield have designated their Innovative/Extra F as having greater benefits than a regular F so a person needs to pass underwriting to upgrade from another insurer's regular F.

 

[Another Reader]

In California, Anthem Innovative F started 1/1/18, Health Net Innovative F started 8/1/18 and Blue Shield Innovative (Extra) F just started 10/1/18. Since they are so new, the enrollees are expected to be younger and healthier than the current regular F pool translating into lower premiums. Also, new plans have no claims history for the insurance commissioner to use in determining if the rates are sustainable. Some carriers take advantage of this and set rates artificially low while they can to attract enrollees.

Health Net has designated their Innovative F as having equal benefits to regular F so a person can use the CA Birthday Rule to lateral from any insurer's regular F to their Innovative F.

Anthem and Blue Shield have designated their Innovative/Extra F as having greater benefits than a regular F so a person needs to pass underwriting to upgrade from another insurer's regular F.

Thank you for the information, particularly that critically important part about underwriting. We now have annual open enrollment without underwriting in California, but that could change at any time. It's my understanding that that you can upgrade and downgrade plans during open enrollment without underwriting. Please let me know if my understanding is incorrect.

I'm always suspicious of an insurance company's motivations in coming up with a new product. In this case, they are enhancing a product and offering it at a lower cost to a pool of customers that will close in 2020. On the surface, it makes no sense. Are they trying to trap people in plans that can be withdrawn? Is the intent to undermine the uniformity within the letter plans imposed by Medicare to make shopping for a supplement as difficult and confusing as it is for the Part D drug plans?

This does not make sense to me and I don't want to pick a plan that will reduce my options in the future. Have you seen any industry articles or analyses from the industry critics that explain why they are doing this?

 

[MBSC]

We now have annual open enrollment without underwriting in California, but that could change at any time. It's my understanding that that you can upgrade and downgrade plans during open enrollment without underwriting. Please let me know if my understanding is incorrect.

The annual open enrollment period only applies to Medicare Advantage and Part D, not Medigap. That is why CA has a Birthday Rule for Medigap policy holders.

How Medigap plans work in California

The best time to buy a Medicare Supplement plan is during your Medigap Open Enrollment Period. This six-month period starts the first day a beneficiary is age 65 or older and is also enrolled in Medicare Part B.

Outside of your one-time Medigap Open Enrollment Period, it’s generally harder to switch plans.

California is one of the few states that have state-specific guidelines to make it easier to switch Medicare Supplement plans outside of your Medigap Open Enrollment Period. Under the California “birthday rule,” a Medicare beneficiary who already has a Medicare Supplement plan can switch to a different Medicare Supplement plan for a period of 30 days following his or her birthday each year. During this time, Medicare beneficiaries in California are allowed to change Medigap plans with guaranteed issue as long as their new plan provides equal or lesser coverage than the Medicare Supplement plan that they’re currently enrolled in.

Reference: https://www.planprescriber.com/medicare-california/medigap/

 

[Another Reader]

The annual open enrollment period only applies to Medicare Advantage and Part D, not Medigap. That is why CA has a Birthday Rule for Medigap policy holders.

I obviously did not understand the rule. Thanks for the references.

The question becomes is it better to buy plain vanilla Plan F, or go for one of the enhanced versions? If the companies discontinue the enhanced Plan F, that would create a special enrollment period, would it not? It would then be possible to switch to the plain vanilla Plan F, although it's not clear to me if you can switch after the plan closes in 2020. Perhaps they will just raise the price until it's unaffordable and you have to change plans. If you can't switch and are permanently locked out of Plan F, then maybe just buying Plan F vanilla now is better.

There's a reason that the enhanced plans are offered at a lower price, and my guess is it's not the lack of claims history or the likelihood that a younger cohort will make up the insured pool. This has to benefit the insurance company in some substantial way.

 

[Potstickers]

How long do you need to be living in California before being eligible for this birthday rule? If you have a Medigap plan from another state and move to California are you still eligible without underwriting?

 

[MBSC]

How long do you need to be living in California before being eligible for this birthday rule?

You can use the rule the first birthday after becoming a resident and each birthday thereafter.

If you have a Medigap plan from another state and move to California are you still eligible without underwriting?

Yes, but you can only switch to a Medigap plan being sold in the new location. The new plan cannot have greater benefits.

Oregon has the same birthday rule. CT, MA, NY, and WA are even more consumer friendly when it comes to switching Medigaps.

 

[DeborahB]

I have not researched it but was told Plan F was being discontinued in a couple of years, but people already on it can keep it. I’ve been on it 5+ years. No co-pays, I love it. I pay more monthly for the insurance but I think I’m ahead anyhow. Do3s any one know about this?

 

[MBSC]

I have not researched it but was told Plan F was being discontinued in a couple of years, but people already on it can keep it. I’ve been on it 5+ years. No co-pays, I love it. I pay more monthly for the insurance but I think I’m ahead anyhow. Does any one know about this?

You are correct. Those who enroll in Part B in 2020 or later will not be able to enroll in your Plan F. Some believe premiums will increase by not having these younger, healthier people enrolling.

You can keep your Plan F after 2020 if you want but Plan G is a better value in most markets. The savings on Plan G premiums is usually greater than the Part B deductible, which is not paid by G.

 

[SumDay]

You can keep your Plan F after 2020 if you want but Plan G is a better value in most markets. The savings on Plan G premiums is usually greater than the Part B deductible, which is not paid by G.

Exactly. The annual Part B deductible is $183. In our market, Plan G premiums are $600 are less annually than Plan F. That was an annual savings of $417 for us, with no decrease in coverage.