Medigap Plans to Rule Out?

[MBSC]

Several posts have mentioned that F is to be discontinued. I thought only the regular (low deductible) F was going away, and that the F High Deductible was sticking around. Am I wrong?

Both versions of F will not be available to those who become eligible for Medicare on 1/1/2020 or later. Those eligible prior to 2020 can keep their plan. HD-G becomes available in 2020.

18. What changes are made to High Deductible Plan options?
Since Plan F High Deductible cannot be sold to those "newly eligible" Medicare beneficiaries, a new Plan G High Deductible is created.

19. When can the new High Deductible Plan G be sold and who can buy it?
Plan G High Deductible can be made available beginning on January 1, 2020; "newly eligible" Medicare beneficiaries and current beneficiaries would be able to buy the new Plan G High Deductible.

Source: http://www.naic.org/documents/committees_b_senior_issues_170201_medigap_faq.pdf

Federal Register update: https://www.gpo.gov/fdsys/pkg/FR-2017-09-01/pdf/2017-18605.pdf

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.

If he is currently healthy enough to pass underwriting, you may want to revisit this for him. More companies are now offering G making it more competitive.

 

[JAB1950]

DW and I are also Plan G fans. Just look at premium cost difference between Plans F and G, subtract $183, and there is your cost savings Plan G vs Plan F.

 

[REWahoo]

For those of you who haven't seen it, you can get an idea on what rates are for plans in your area using this link: https://www.bestmedicaresupplement.com/

The price differential between insurers for the same plan can be substantial.

 

[NoMoreJob]

There is a whole category of "Advantage" plans offered by every carrier. Did the OP rule all of these out? Should we?

My objection to Advantage plans is that they often limit networks. Although I believe it may vary by area, where I live nearly every doctor accepts original Medicare and most accept assignment as well.

I had a very serious diagnosis almost immediately after going on Medicare - fortuitous timing since I had previously been on a terrible Obamacare plan which was the only one available in my area. I received tip of the arrow treatment at a nationally renown facility closeby. I'm now about a year out from treatment and my prognosis is very good.

I would not have been able to receive care at this provider under any Medicare Advantage plan. Also, had I not had Plan G (or F) the excess charges (which apply with this provider because they accept Medicare but not Medicare assignment) would not have been covered.

 

[nwsteve]

As a result of reading this thread, I checked the current rates for F vs G from my provider--a Blue. This is the first year they are offering a G plan and would generate 180/ea per year savings for us.
Planning on making the change to G, I called to see what was involved with the false belief that it would just be a matter of some key strokes by the provider. NOT A CHANCE! Seriously, if there is an industry that can make simple tasks hard and time consuming it has to be the insurance world.
Basically have to apply as a new applicant. Apparently there is a question if I am current plan holder but otherwise it is new application. I asked if that implied an underwriting and got a weasel answer that it could depending on underwriting. If completed application this week, new plan rate would start next month. The rep did emphasize not to cancel our current Plan F with them until I received the Plan G cards.
I also have to scan and send with the application the front and back of our current member card--yeah, the ones they sent to us.

I also confirmed that for any doc bills this year, I would also be on the hook for the $183 Medicare deductible. So from a timing point of view, probably best to wait to next calendar year.

Besides the hassle of the application paper work, we will also have to establish new payment authorizations for the new plan and cancel the old ones (get $5/mon discount for autopay). So lots of 'foo foo' stuff for what the insurance company already has the ability to do in their own systems.

Has anyone attempted to make this type of change of plans? Did you have jump through the same hoops? Any watchouts?
Thanks

 

[REWahoo]

As a result of reading this thread, I checked the current rates for F vs G from my provider--a Blue. This is the first year they are offering a G plan and would generate 180/ea per year savings for us.

If you haven't already done so, I strongly recommend you check the G rates from other carriers. As you see, there is no real advantage in staying with your current insurer because the hoops you have to jump through aren't any less burdensome than going with someone new. Plus, based on my recent experience, the Blue carrier's rates are significantly higher than many other Medigap providers, at least in my zip. One example - Blue's rates for G are $60/mo more than Mutual of Omaha's G rates.

As I've said, it really does pay to shop around on Medigap.

 

[travelover]

DW and I are also Plan G fans. Just look at premium cost difference between Plans F and G, subtract $183, and there is your cost savings Plan G vs Plan F.

Am I correct in thinking the $183 is yearly and the quotes are monthly?

 

[NoMoreJob]

Am I correct in thinking the $183 is yearly and the quotes are monthly?

Yes.

(Rate difference x 12) - 183 = Annual savings

 

[MBSC]

As a result of reading this thread, I checked the current rates for F vs G from my provider--a Blue. This is the first year they are offering a G plan and would generate 180/ea per year savings for us.

If you haven't already done so, I strongly recommend you check the G rates from other carriers. As you see, there is no real advantage in staying with your current insurer because the hoops you have to jump through aren't any less burdensome than going with someone new.

+1

It's an insurance agent's job to make the process seem easy and painless.

WA Medigap rates can be found here: https://www.insurance.wa.gov/media/1807

Loyal American (a Cigna company) Plan G is $158/month for ages 65+ because WA is community-rated. That compares to the Blue's F ($214) and Blue's G ($185).

WA Residents: If you're already enrolled in a Medigap plan B through N, you can switch at any time to another Medigap plan B through N. If you have a Medigap plan A, you can switch to any other Medigap plan A. In either of these situations, you do not have to take a written health screening questionnaire.

Source: https://www.insurance.wa.gov/when-can-i-sign-or-switch-medigap-plans

 

[nwsteve]

+1

It's an insurance agent's job to make the process seem easy and painless.

WA Medigap rates can be found here: https://www.insurance.wa.gov/media/1807

Loyal American (a Cigna company) Plan G is $158/month for ages 65+ because WA is community-rated. That compares to the Blue's F ($214) and Blue's G ($185).

All points well made! If we got to dance around and fill out forms, redo autopays, etc hard to see any reason not to go a qualified lowest cost provider. The Cigna price of 158/mon certainly seems superior to Premera's 185.

 

[Sue J]

I'm not eligible until 2/1/2020 so I will miss out on F plans. Sounds like a G would be what I'll be looking into.

What is the difference between "accepts Medicare" and "accepts Medicare assignment?"

To those of us who have been dealing with $6000+ deductibles with Obamacare, a $183 deductible sounds wonderful!

 

[MichaelB]

What is the difference between "accepts Medicare" and "accepts Medicare assignment?"

Some physicians take Medicare patients but do not accept assignment, and can charge 15% over the Medicare reimbursement rate. Plans F and G cover that as "excess charges).

To those of us who have been dealing with $6000+ deductibles with Obamacare, a $183 deductible sounds wonderful!

It sure does.

 

[grasshopper]

Has anyone attempted to make this type of change of plans? Did you have jump through the same hoops? Any watchouts?
Thanks

I switched starting 2018 with BCBS of AZ. Did it with just a phone call, I even called twice and Ms G once, because I couldn't believe it was that easy before I pulled the trigger.

 

[REWahoo]

I'm not eligible until 2/1/2020 so I will miss out on F plans. Sounds like a G would be what I'll be looking into.

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.

 

[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:

Plans C, D, F, HDF, M & N cover foreign travel emergencies. There is a $250 deductible and then the Medicare supplement will pay 80% of the cost of the care. The emergency must be within the first 60 days of your stay outside the USA. Lifetime benefits are $50,000. Plans A, B, G & K do not cover foreign travel emergencies.

If true that plan G doesn't cover foreign travel it would be a deal breaker for me. Is this correct?

 

[Sue J]

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]

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-other-insurance/compare-medigap/compare-medigap.html

 

[audreyh1]

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]

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.

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.

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/arti...to-denial-of-injunction-in-trade-secrets-suit

https://davidrutstein.com/

 

[omni550]

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]

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]

+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]

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]

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.