My "Best" Medigap options - Approval issues?

[Scuba]

Thank you for this information, MichaelB. We have an appointment with a consultant tomorrow to begin exploring options for DH. I'm still almost 2 years away from being eligible for Medicare, but he has to sign up by 3/1. Thinking we will go with Plan G - the AARP/UHC option - for him as it seems like the best possible coverage/choice, but we will see what the consultant has to say. Your point about not being able to "downgrade" or "upgrade" later without underwriting is a good one. Our current grandfathered health insurance plan (pre-ACA) allowed us to downgrade but not upgrade so I wasn't sure if Medicare supplements were similar, but it sounds like it's a long-term commitment.

 

[Scuba]

Just an update. We live in Florida and met with two independent consultants. We told each of them before the meetings that we wanted traditional Medicare. They each independently recommended Plan G with the AARP/UHC supplemental insurance, and WellCare for Part D. Now DH just has to sign up. I am really looking forward to being able to sign up too. We are going to save a lot of $$$ vs paying for our own PPO privately for many years.

 

[audreyh1]

DH has those plans too and I will sign up for same next year, checking on prescriptions for Part D first.

We too save a lot compared to pre-Medicare plus paying Part B premiums out of the HSA and no longer contributing to the HSA means less cash tied up monthly.

 

[spirit4earth]

Is anyone in NC? I need to sign up for a Medigap Plan N. Aetna is cheapest, but is that just a lure, and then they raise their prices higher than others? Looking at Aetna, AARP/UHC, Humana

 

[meleana]

Is anyone in NC? I need to sign up for a Medigap Plan N. Aetna is cheapest, but is that just a lure, and then they raise their prices higher than others? Looking at Aetna, AARP/UHC, Humana

I’m not in NC, but they all raise their prices a bit each year. I would go with the company with the best reputation for customer service and paying claims, as well as least expensive price.

 

[spirit4earth]

I’m not in NC, but they all raise their prices a bit each year. I would go with the company with the best reputation for customer service and paying claims, as well as least expensive price.

That information is hard to come by, it seems.

 

[meleana]

That information is hard to come by, it seems.

.


I do know no one has ever had a bad thing to say about AARP/UHC.

 

[sengsational]

That information is hard to come by, it seems.

There are the "star ratings" on medicare.gov, but I'm not sure how helpful those are. Did you contact the NC SHIIP people with your questions? I made one inquiry, and they had a solid answer (they answered that nobody knows the answer to my question, LOL).

You have got to decide if you want to pay more now and have smaller increases, or less now, and larger increases. The "attained age" priced policies means you'll always be in a group of people your age, so young=cheaper, old=more expensive. You can try to "jump ship", but you just can't know before a condition will appear that will make jumping impossible or cost prohibitive. The AARP/UHC (modified community pricing) has all ages in the pool and discount more the younger you are. The benefit to that pricing is that it's top end is more stable. Probably more stable, anyway. Being in a big group is good, I think, and this is a big group.

 

[Pluperfect]

The "attained age" priced policies means you'll always be in a group of people your age, so young=cheaper, old=more expensive.

Are you saying that everyone with a given attained-age policy is the same age? I've never heard that before. I thought everybody who buys a Humana Plan G supplement, for example, is in the same group, but the individual members of the group have premiums that differ based on their age.

Seems to me if everybody in a given Plan G supplement is the same age, you'd have the same problems that closed books present--younger healthier people will never join to counteract the older sicker ones.

Or maybe I'm making a grievous mistake by trying to make Medicare make sense.

 

[RetMD21]

There are the "star ratings" on medicare.gov, but I'm not sure how helpful those are. Did you contact the NC SHIIP people with your questions? I made one inquiry, and they had a solid answer (they answered that nobody knows the answer to my question, LOL).

I think the stars just exist for MA plans. Medigap plans are inherently simple so there shouldn't be problems with claims.

Is anyone in NC? I need to sign up for a Medigap Plan N. Aetna is cheapest, but is that just a lure, and then they raise their prices higher than others? Looking at Aetna, AARP/UHC, Humana

Mutual of Omaha is the most notorious for "closing the book" and raising rates but Aetna apparently does it too. ( at least according to threads over at insurance-forums.com) OTOH I looked at a thread over at Reddit where folks defended the MOO supplements recommended by their broker.

 

[audreyh1]

I think I will go direct to UHC/AARP this year rather than through Boomer Benefits. I know what I want - matching DH for both plans. The only thing is that I’m not clear on the UHC/AARP Household Discount for TX. We paid for a 5 year family AARP membership when DH signed up 4 years ago and we thus share an AARP number.

 

[sengsational]

Are you saying that everyone with a given attained-age policy is the same age? I've never heard that before. I thought everybody who buys a Humana Plan G supplement, for example, is in the same group, but the individual members of the group have premiums that differ based on their age.

Seems to me if everybody in a given Plan G supplement is the same age, you'd have the same problems that closed books present--younger healthier people will never join to counteract the older sicker ones.

Or maybe I'm making a grievous mistake by trying to make Medicare make sense.

So I think we agree on our observation that when someone shows-up to buy an example policy (say Humana Plan G medigap policy) which is registered as an attained age pricing policy, the younger the buyer, the lower the price.

The pressure to close the book is indeed present whenever the attained age pricing methodology is used. This is especially true if the cohort is smaller and an unexpectedly large fraction of the cohort starts having high utilization. That, along with the company realizing they are no longer competitive, but still want to sell more policies to that age group.

But back to the point that the price will be cheaper for younger people for attained age pricing. How does the insurance company decide how much more to charge older people? I think they probably look at last year's claims from each age group and make sure they set the price for next year's policies such that the expected claims will get paid (plus overhead and profit). So we're back at having everyone who has "attained a specific age" being in a separate "group" (cohort). So although the insurance company could stay profitable by allowing, say, younger people to pay more so older people could pay less, I don't think that's what they typically do. If they could get away with it, they'd probably charge the older group MORE (because they can't pass underwriting and would be uninsurable if they left) and use a low price to get lots of young healthy people in the door. But I don't think they're allowed to do that. Each insurance company has to open their financial books to each state's insurance commissioner and justify their actions, I think. So if the insurance company says they're offering an attained age policy, they probably need to follow specific guidelines, and I suspect that means using expected claims data by age to set prices.

I'm no expert at this, and could be wrong about it. If so, I'd be happy to have someone clear-up any misunderstanding I might have.

 

[sengsational]

I was doing some Internet research before posting the post above and came across a paper (Dissertation_MathisSchroeder.pdf) that used a company called Weiss that collects data about Medigap policies. This dissertation mentioned "Weiss Ratings Shopper’s Guide to Medicare Supplemental Insurance" and I looked it up. It now costs $99, and I don't know if it's worth it, but thought I'd toss it out there: https://weissmedigap.com/

We don't sell insurance (and never will), so we can tell you things your broker can't or won't... And we show you ALL your options, unlike other guides that only show you a few choices from Medicare supplement providers typically paying them a fee or commission.

 

[RetMD21]

So I think we agree on our observation that when someone shows-up to buy an example policy (say Humana Plan G medigap policy) which is registered as an attained age pricing policy, the younger the buyer, the lower the price.

The pressure to close the book is indeed present whenever the attained age pricing methodology is used. This is especially true if the cohort is smaller and an unexpectedly large fraction of the cohort starts having high utilization. That, along with the company realizing they are no longer competitive, but still want to sell more policies to that age group.

But back to the point that the price will be cheaper for younger people for attained age pricing. How does the insurance company decide how much more to charge older people? I think they probably look at last year's claims from each age group and make sure they set the price for next year's policies such that the expected claims will get paid (plus overhead and profit). So we're back at having everyone who has "attained a specific age" being in a separate "group" (cohort). So although the insurance company could stay profitable by allowing, say, younger people to pay more so older people could pay less, I don't think that's what they typically do. If they could get away with it, they'd probably charge the older group MORE (because they can't pass underwriting and would be uninsurable if they left) and use a low price to get lots of young healthy people in the door. But I don't think they're allowed to do that. Each insurance company has to open their financial books to each state's insurance commissioner and justify their actions, I think. So if the insurance company says they're offering an attained age policy, they probably need to follow specific guidelines, and I suspect that means using expected claims data by age to set prices.

I'm no expert at this, and could be wrong about it. If so, I'd be happy to have someone clear-up any misunderstanding I might have.

The way they get around it is to close the plan to all new enrollees and start a new plan under a different subsidiary. The healthier people in the original plan may switch so the ones who are left are an unfavorable pool. The insurer can use claims history to legitimately justify the increase in premiums for that group. The pricing for attained age policies accounts for increasing age but the magic is in eliminating the high cost folks of any age.