Medigap Plans to Rule Out?

[Sue J]

Quote:

Originally Posted by REWahoo You might want to also consider N, especially if you live in one of the states that don't permit excess charges: Connecticut, Massachusetts, Minnesota, New York, Ohio, Pennsylvania, Rhode Island or Vermont. Plan N does not cover excess charges (F and G do) and therefore has lower premiums. I don't live in one of those states but the number of health care providers in my area that don't take assignment is very small - I've never run across one. That's why we opted for the lower premium costs of plan N. We're willing to assume the slight risk of having to pay an excess charge, knowing the amount is limited to no more than 15% of the amount Medicare allows.

We are in Ohio so this is relevant. So what is Medicare assignment?

[MichaelB]

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Originally Posted by fosterscik REWahoo posted this pricing link: https://www.bestmedicaresupplement.com/ Very useful. I'm not eligible for a few more years but like to plan ahead, so I looked. Many here seem to be gravitating to plan G, BUT I'm concerned by this statement on the above web site: If true that plan G doesn't cover foreign travel it would be a deal breaker for me. Is this correct?

MediGap G covers foreigh emergency care. See the MediGap policy comparison table here https://www.medicare.gov/supplement-...e-medigap.html

[audreyh1]

Quote:

Originally Posted by fosterscik REWahoo posted this pricing link: https://www.bestmedicaresupplement.com/ Very useful. I'm not eligible for a few more years but like to plan ahead, so I looked. Many here seem to be gravitating to plan G, BUT I'm concerned by this statement on the above web site: If true that plan G doesn't cover foreign travel it would be a deal breaker for me. Is this correct?

No, that is a rather egregious error on that site. I also don’t think they showed all available plans for my area last time I looked.

[REWahoo]

fosterscik, the foreign travel coverage info on that website is incorrect - Plan G does have coverage. The statement should read, "Plans A, B, K & L do not cover foreign travel emergencies."

[MBSC]

Quote:

Originally Posted by fosterscik REWahoo posted this pricing link: https://www.bestmedicaresupplement.com/ Very useful. I'm not eligible for a few more years but like to plan ahead, so I looked.

Quote:

Originally Posted by audreyh1 I also don’t think they showed all available plans for my area last time I looked.

The information from the linked website is from 2015-16. Insurers have entered and left various markets since then. The website is associated with NAAIP, which copied life insurance and Medigap rate files from Compulife. Compulife sued for copying a term life rate file but lost.

Quote:

Judge Rosenberg also found that “based on Mr. Barney’s testimony that his customers are very attuned and responsive to inaccurate quotes, and his testimony that the quotes produced on the NAAIP websites are inaccurate and outdated, the Court finds it unlikely that any existing customers will leave Compulife — whose quotes Mr. Barney testified are generally accurate — for NAAIP. “Indeed, in light of Mr. Barney’s testimony, the scraped information was likely stale and producing inaccurate quotes by the time Compulife filed the Motion presently before the Court. The continued use of scraped information therefore will not result in irreparable injury,” Judge Rosenberg stated. References: https://www.lexislegalnews.com/artic...e-secrets-suit https://davidrutstein.com/

[omni550]

Quote:

Originally Posted by REWahoo fosterscik, the foreign travel coverage info on that website is incorrect - Plan G does have coverage. The statement should read, "Plans A, B, K & L do not cover foreign travel emergencies."

+1

fosterscik,

If you are traveling internationally, you may wish to consider additional travel insurance, mostly for the medical evac/repatriation coverage. We've had several threads on this in the past year or so.

Some frequent travelers here just purchase an annual travel insurance policy, which is what I do.

omni

[NoMoreJob]

Quote:

Originally Posted by REWahoo We're willing to assume the slight risk of having to pay an excess charge, knowing the amount is limited to no more than 15% of the amount Medicare allows.

It's actually not even that much but it's a long and complicated story.

The brief version is that reimbursements for providers who don't accept assignment are less (95% I believe) so 15% of the excess becomes more like 10% of the excess as calculated on the larger reimbursement for those accepting assignment. On top of that a few years ago Congress created a 2% "sequestration" of unassigned claim amounts paid to claimants.

Oh, and then more complication is added by the fact that unassigned claims are paid directly to the claimant rather than the physician so figuring whether or not billings are correct is a real job for the claimant who must pay the provider.

I'm still glad I had G to cover these charges when going through long and expensive treatments but it couldn't have been made much more difficult.

Okay, not so brief.

[nwsteve]

Quote:

Originally Posted by omni550 +1 fosterscik, If you are traveling internationally, you may wish to consider additional travel insurance, mostly for the medical evac/repatriation coverage. We've had several threads on this in the past year or so. Some frequent travelers here just purchase an annual travel insurance policy, which is what I do. omni

+1 especially regarding travel insurance. Personally, I prefer finding travel insurance plans with Primary Medical since you are spared not only the hassle of the paper work of filing the claim with your Medigap provider but, more importantly for us, the primary has the insurance company deal with foreign medical providers directly from the get go. We have medical evac so we can get home after any major medical need--think traffic accident, severe fall etc,
BTW, having filed a claim for foreign medical, my experience was anything but comforting. The paperwork demands for translation, documentations, foreign exchange games and calculation of the actual benefits will drive you nuts. Keep in mind the 80% coverage is the insurance company's schedule for "usual and customary" not necessarily what you paid.

[Dawg52]

Quote:

Originally Posted by REWahoo You might want to also consider N, especially if you live in one of the states that don't permit excess charges: Connecticut, Massachusetts, Minnesota, New York, Ohio, Pennsylvania, Rhode Island or Vermont. Plan N does not cover excess charges (F and G do) and therefore has lower premiums. I don't live in one of those states but the number of health care providers in my area that don't take assignment is very small - I've never run across one. That's why we opted for the lower premium costs of plan N. We're willing to assume the slight risk of having to pay an excess charge, knowing the amount is limited to no more than 15% of the amount Medicare allows.

Didn't you have F-HD at one time? Did you find you were paying more with the out of pocket deductible($2240)?

[REWahoo]

Quote:

Originally Posted by Dawg52 Didn't you have F-HD at one time? Did you find you were paying more with the out of pocket deductible($2240)?

Yes, both DW and I had F-HD for the first several years of Medicare. The deductible wasn't a problem - neither I nor DW ever came anywhere close to meeting it.

The problem was discovering our insurer, BC/BS of TX, was charging 50% higher premiums than many other insurers for our F-HD policies. I had been thinking about moving away from F due to concerns about future rate increases, so this was my wake up call to make the change to both an insurer with competitive rates and a new plan. I set out to purchase plan G, but after looking at the premium savings vs benefits of plan N, decided to choose that instead.

[REWahoo]

Quote:

Originally Posted by Sue J So what is Medicare assignment?

Accepting what Medicare pays and not charging more (excess charges).

[fosterscik]

Thanks for all the help on travel coverage! Medicare supplements are complicated enough without glaring errors in posted information. I appreciate the travel supplement suggestions. Lots to think about.

[aja8888]

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Originally Posted by Katsmeow That is interesting. When DH went on Medicare several years ago I checked then and the cost difference of the two was basically identical to the G deductible. So, for simplicity, he just selected F since G didn't really save anything. I go on Medicare next year and will revisit it for myself. I will likely choose F or G. I do agree with the post about simplicity. I remember during my mom's last couple of years when she had a lot of medical needs. She had Plan G and she could manage that. I think it would have been very difficult for her to manage some of the more complex plans with lots of co-payments.

I changed plans at age 72 as the full plan F premium was getting very expensive vs. G AT THAT TIME. The rate of premium increase each year of F was much higher than the rate of increase of G making the decision obvious. There was a thread here at the time where that was being discussed.

I wouldn't try this switch unless one can qualify medically. It's pretty hard to qualify unless you have a very clean medical history and no ongoing conditions (diabetic, COPD, heart issues, etc). If I would have known about the rate of premium increase difference when I enrolled in Plan F at age 65 (7 years earlier), I would have probably chosen G instead.

[Sue J]

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Originally Posted by REWahoo Accepting what Medicare pays and not charging more (excess charges).

Thanks. Sounds like that is comparable to a provider accepting the negotiated rate in pre-medicare insurance like our Obamacare.

[ShokWaveRider]

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Originally Posted by aja8888 I changed plans at age 72 as the full plan F premium was getting very expensive vs. G AT THAT TIME. The rate of premium increase each year of F was much higher than the rate of increase of G making the decision obvious. There was a thread here at the time where that was being discussed. I wouldn't try this switch unless one can qualify medically. It's pretty hard to qualify unless you have a very clean medical history and no ongoing conditions (diabetic, COPD, heart issues, etc). If I would have known about the rate of premium increase difference when I enrolled in Plan F at age 65 (7 years earlier), I would have probably chosen G instead.

How can this be? Here is what I read.

What is the Medigap Open Enrollment Period?

Your Medigap Open Enrollment Period is a 6-month period that starts the day you are both 65 years old and enrolled in Medicare Part B.
During the 6-month Medigap Open Enrollment Period, you do not have to undergo medical underwriting and you can change insurance plans or companies without getting penalized.

[MichaelB]

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Originally Posted by ShokWaveRider How can this be? Here is what I read. What is the Medigap Open Enrollment Period? Your Medigap Open Enrollment Period is a 6-month period that starts the day you are both 65 years old and enrolled in Medicare Part B. During the 6-month Medigap Open Enrollment Period, you do not have to undergo medical underwriting and you can change insurance plans or companies without getting penalized.

Right. When you are first eligible your enrollment is not subject to underwriting. After that period, you can apply for a new or different MediGap policy, but it is subject to underwriting.

[ShokWaveRider]

Quote:

Originally Posted by MichaelB Right. When you are first eligible your enrollment is not subject to underwriting. After that period, you can apply for a new or different MediGap policy, but it is subject to underwriting.

But open enrolment is every year? I am very unclear on this. My insurance agent says as long as you have insurance and are in open enrolment you can change without medical checks.

I also read this, but it does not say without underwriting, but it does not say otherwise either.

What’s the Medicare Open Enrollment Period?

Medicare health and drug plans can make changes each year—things like cost, coverage, and what providers and pharmacies are in their networks. October 15 to December 7 is when all people with Medicare can change their Medicare health plans and prescription drug coverage for the following year to better meet their needs.

[MichaelB]

Quote:

Originally Posted by ShokWaveRider But open enrolment is every year? I am very unclear on this. My insurance agent says as long as you have insurance and are in open enrolment you can change without medical checks. I also read this, but it does not say without underwriting, but it does not say otherwise either. What’s the Medicare Open Enrollment Period? Medicare health and drug plans can make changes each year—things like cost, coverage, and what providers and pharmacies are in their networks. October 15 to December 7 is when all people with Medicare can change their Medicare health plans and prescription drug coverage for the following year to better meet their needs.

Open enrollment for Medicare Supplemental is once, when you first become eligible. It's a 7 month window - 3 months before birth month to 3 months after, Period, that's it for Florida residents with regard to guaranteed enrollment to MediGap.

After that, any request to change MediGap policy is subject to insurance underwriting and approval. That's it for Florida residents.

Medicare Plan D pharmaceutical plans have an annual open enrollment period, you are free to change plans at that time, and you have guaranteed acceptance.

[ShokWaveRider]

Quote:

Originally Posted by MichaelB Open enrollment for Medicare Supplemental is once, when you first become eligible. It's a 7 month window - 3 months before birth month to 3 months after, Period, that's it for Florida residents with regard to guaranteed enrollment to MediGap. After that, any request to change MediGap policy is subject to insurance underwriting and approval. That's it for Florida residents. Medicare Plan D pharmaceutical plans have an annual open enrollment period, you are free to change plans at that time, and you have guaranteed acceptance.

I am sorry to keep on about it, but I just called AARP United HealthCare. I asked the specific question. They said currently if you change plans between the OE dates that "Currently" there is NO Underwriting.

Please feel free to call them and ask too. That is with UHC of course I cannot speak for anyone else.

BTW er.org seems really slow to post today.

[MichaelB]

Quote:

Originally Posted by ShokWaveRider I am sorry to keep on about it, but I just called AARP United HealthCare. I asked the specific question. They said currently if you change plans between the OE dates that "Currently" there is NO Underwriting. Please feel free to call them and ask too. That is with UHC of course I cannot speak for anyone else. BTW er.org seems really slow to post today.

That is specific to UHC policyholders, and does make their policies worth consideration. Mentioned a number of times in MediCare discussions - here are a few.

http://www.early-retirement.org/foru...f-g-87496.html

http://www.early-retirement.org/foru...ml#post2064657

UHC is under no obligation to provide this and can withdraw or change it at any time.

Have you read other threads on Medicare, or all the posts in this thread? Lots of good advice, and many of these questions have been addressed.