My "Best" Medigap options - Approval issues?

DH goes onto Medicare January 1st and me on September 1st 2024. We are only looking at Plan G and Plan N through AARP. Why? Because every other plan (including G and N) charges more based on your age. I have healthy longevity genes, and DH is adopted and knows a bit about his bio family. Other than smoking and alcoholism, which are not issues with us, longevity is happily where we might be headed.
 
teej1985 said:
Not sure why you'd compare Humana's products rather than the cheapest G vs cheapest G HD. BTW, the $2700 includes the $226. It's not in addition. Paying $2700 would mean that you have ~$50k of negotiated Medicare approved charges. The bigger gamble is if you get hospitalized and have to pay the $1600 Part A deductible.
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I chose that comparison because some of the insurers listed with the cheapest monthly premiums are IMO lesser quality and stature than the more well known Medicare Supplement providers that the OP is focused on in the OP like BCBS, Humana, Cigna and United Healthcare.

How are you getting the $50,000 of Medicare approved charges?

If you had only Part A hospital care then you would be responsible for the first 6.75 days @$400/day to satisfy the $2,700 deductible with Plan G-HD vs 0 days for Plan G.

The Part B copay is typically 20% after the $226 deductible is met so $2,700 only covers $12,596 of medical services if you only had Part B for the entire year ($12,596-$226)*20%=$2,474+$226=$2,700. So for example, if you had $13,000 of Part B medical services for the year then with Plan G you would pay $226 and with Plan G-HD you would pay $2,700.

Obviously with a mix of Part A and Part B services it gets more complicated.

The typical copay for Medicare Part A and Part B depends on the service you receive. However, in general, you can expect to pay a 20% copay for most doctor visits and outpatient services after you have met your deductible.

For Medicare Part A, the deductible in 2023 is $1,600 per benefit period. After you have met your deductible, you will pay a copay of $400 per day for days 61-90 of a hospital stay and $800 per day for days 91-150. You have a total of 60 lifetime reserve days that you can use for hospital stays beyond day 150. For each lifetime reserve day, you will pay a copay of $800.

For Medicare Part B, the deductible in 2023 is $226. After you have met your deductible, you will pay a copay of 20% for most doctor visits and outpatient services. There are some exceptions to this rule, such as preventive care services, which are typically covered at 100% with no copay.

It is important to note that these are just general guidelines. Your actual copay amounts may vary depending on your specific Medicare plan and the services you receive. You should always check with your Medicare provider or insurance company to confirm your copay amounts for specific services.
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pb4uski said:
I chose that comparison because some of the insurers listed with the cheapest monthly premiums are IMO lesser quality and stature than the more well known Medicare Supplement providers that the OP is focused on in the OP like BCBS, Humana, Cigna and United Healthcare.

How are you getting the $50,000 of Medicare approved charges?

If you had only Part A hospital care then you would be responsible for the first 6.75 days @$400/day to satisfy the $2,700 deductible with Plan G-HD vs 0 days for Plan G.

The Part B copay is typically 20% after the $226 deductible is met so $2,700 only covers $12,596 of medical services if you only had Part B for the entire year ($12,596-$226)*20%=$2,474+$226=$2,700. So for example, if you had $13,000 of Part B medical services for the year then with Plan G you would pay $226 and with Plan G-HD you would pay $2,700.

Obviously with a mix of Part A and Part B services it gets more complicated.
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You have to pay the $1600 Part A Deductible (for each hospitalization) before you are subject to any sort of Part A "per day" charges.

You are right about $12k rather than $50k.
 
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"For Medicare Part A, the deductible in 2023 is $1,600 per benefit period. After you have met your deductible, you will pay a copay of $400 per day for days 61-90 of a hospital stay and $800 per day for days 91-150. You have a total of 60 lifetime reserve days that you can use for hospital stays beyond day 150. For each lifetime reserve day, you will pay a copay of $800."
I am not yet 65, so I am just looking for clarification on the above quote. If all you had was Part A, is the most you would have to pay for a 50 day hospitalization $1,600?
 
Katsmeow said:
AARP UHC supplement plans do not select plan providers. That works with traditional Medicare where you can select anyone who takes Medicare. There are AARP UHC Medicare Advantage plans but this thread is not about them.
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I meant SUPPLEMENT PLAN Providers, AKA UHC. Not healthcare service providers.
 
N02L84ER said:
"For Medicare Part A, the deductible in 2023 is $1,600 per benefit period. After you have met your deductible, you will pay a copay of $400 per day for days 61-90 of a hospital stay and $800 per day for days 91-150. You have a total of 60 lifetime reserve days that you can use for hospital stays beyond day 150. For each lifetime reserve day, you will pay a copay of $800."
I am not yet 65, so I am just looking for clarification on the above quote. If all you had was Part A, is the most you would have to pay for a 50 day hospitalization $1,600?
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60 days.

See here: https://www.medicare.gov/basics/costs/medicare-costs
 
It looks like for 2024 you are looking at a few $ more. "The Centers for Medicare & Medicaid Services has released the 2024 Medicare Part A deductible ($1,632) and Part B deductible ($240)." https://www.ncoa.org/article/what-is-the-medicare-deductible

Not significant but I found it when I went to look up more info on part A.

I didn't realize you could be on the hook for Part A deductible more than once in a years time if you were unfortunate. And by the time I get there (2033), I wonder what it will be.
 
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Our Medicare Supplement is thru Blue Cross/Blue Shield. (Illinois). VERY satisfied with them. No hassles and their support staff is here in the US. Each BC/BS is a franchise but if BC/BS in CO is anything like the IL chapter you won't go wrong.
 
I have Via Benefits and the prescription drug plans this year are underwhelming. The cheap Wellcare plan does not cover many drugs, but the other choices from Via Benefits are not much better. Because of Covid, I need to use Cromolyn Sodium solution, which is expensive. Wellcare does not cover it, but Good RX has a decent price. Atorvastatin is cheap or free on Wellcare, as I recall.

AARP UHC has had no issues.
 
N02L84ER said:
"For Medicare Part A, the deductible in 2023 is $1,600 per benefit period. After you have met your deductible, you will pay a copay of $400 per day for days 61-90 of a hospital stay and $800 per day for days 91-150. You have a total of 60 lifetime reserve days that you can use for hospital stays beyond day 150. For each lifetime reserve day, you will pay a copay of $800."
I am not yet 65, so I am just looking for clarification on the above quote. If all you had was Part A, is the most you would have to pay for a 50 day hospitalization $1,600?
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A couple of things to consider:

There may be other charges when in a hospital which are not covered by Part A, such as every doctor who is involved? When my spouse was in and out of the hospital multiple times there was a doctor bill for every day and who knows what other charges. The total charges for multiple stays was approx $1.3 million. Of course Medicare did not approve all that amount. We were glad we had Medicare A&B and FEHB. I saw bills for huge amounts at a time such as approx $140,000 for days. And many more huge bills.

The other thing is that during her multiple stays, the hospital sometimes did not "admit" her which would have been under Part A but instead kept her "for observation" for 5 days at a time which DOES NOT fall under Part A, but rather Part B and whatever else. Five days in a hospital is very expensive no matter what.

I would never go with Part A only.
I would never go with Parts A and B only.
Another secondary insurance is a must for us since there is no out of pocket max with Medicare A/B.
 
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Katsmeow said:
All Plan Gs cover the same thing. The only time I have spoken with UHC is when we moved and needed to update.
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Exactly. I wonder if the insurance satisfaction scores cited above are for other products like MA or commercial plans.
 
RetMD21 said:
Exactly. I wonder if the insurance satisfaction scores cited above are for other products like MA or commercial plans.
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OP here:
Yes the reviews were only written against the provider. I could not tell for sure if they were targeted to G plans.
 
zl55lz said:
<snip>

The other thing is that during her multiple stays, the hospital sometimes did not "admit" her which would have been under Part A but instead kept her "for observation" for 5 days at a time which DOES NOT fall under Part A, but rather Part B and whatever else. Five days in a hospital is very expensive no matter what.
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This is sneaky (on the hospital's part) and well worth emphasizing. It also affects Medicare coverage for rehab; you're covered for a rehab facility after a hospital stay ONLY if you've been admitted, not if you were there "for observation".
 
pb4uski said:
While I like the excel spreadsheet, I can't find one for Florida, but I go to https://www.medicare.gov/medigap-supplemental-insurance-plans/#/m?year=2024&lang=en

and then when I get to plans just scroll down the list... and that should work in every state and zip code.
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Medicare plan compare is great. In addition to comparing medigap if you go to this link you can choose to compare MA plans and part D plans. Star ratings, of course apply to MA and part D but not supplements

https://www.medicare.gov/plan-compare/#/?year=2024&lang=en
 
RetMD21 said:
seems like a bunch of confused people complaining about things that they really don't understand. Did you have something specific in mind?
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I've been trying to track down previous rate increases and what sign-up discounts were "provided" since I'm signing up for Medigap for the first time. Specifically for the four providers I originally posted. Yes, I do understand that past performance does not indicate future performance ... but what other information do we have to work from? Bottom line is that I would like to make a selection while at least making some assessment of where the rates "might" go in the future.

Web search pulled up this discussion about AARP/United and frankly, I have no idea if these people have no understanding or if they actually had reasonable analysis.

I'll be poking my agent to see if she can provide some valid input.
 
DH has been on the AARP UHC Medigap plan since he turned 65 almost 7 years ago. We signed him up for Plan F (no longer available) since he was more likely to need maximum health care coverage. I turned 65 last year and signed up with them also only plan N. We also got a discount for both of us being on their plans.

We picked the AARP UHC plan because the premiums are "community rated" not "age attained". Premiums increase slightly each year - expected and planned for. Here is the definition of the 3 types of pricing. Note that not all are available in each state.

Attained Age Plan: Monthly premiums for attained age medigap plans are based on your current age when you enroll, and will increase as you age. This is the most common form of payment plans for Medigap.

Issue Age Plan: Monthly premiums for issue age medigap plans are based on your age when you apply, so it will be cheaper per month if you apply when you're 65 rather than 80. These plans will generally increase in price annually, but the increase isn't based on your age, but rather market factors. These plans aren't offered in every state.

Community Rated Plan: Community rated medigap plans are based on your specific geographical location. Everyone in a specific community or area will pay the same premium price. Less than 10 states offer community rated medigap plans.

I felt like paying the slightly higher premium for UHC initially would be worthwhile in the long run. I hope that's the case. Zero issues with them - as someone else mentioned, if Medicare covers it, UHC pays their share no issues.
 
As I understand it, without the decreasing discount, the AARP community-rated plan would be non-competitive for those who are just entering Medicare. That initial discount makes the plan more competitive with, for example, an age-attained plan. I think where a community-rated plan looks best is when you are much older and past the point where there is no longer a discount.

As for AARP making a profit off their name, I don't have a problem with that. Their advocacy for things like Medicare and Social Security is fine by me. The vast majority of seniors are not rich and don't have much of a chance for influencing the powers that be. I think it's good that they have an effective voice in the AARP.

Finally, I think UHC also does well from the association with AARP and just maybe puts a little more effort into doing a good job else they lose the franchise to someone else.
 
To further advance the discussion, I'd like to ask --

Is it difficult to move from Plan G-HD over to Plan G ??
 
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