Another Medigap question

[pirsquared]

DH starts Medicare June 1. He chose original Medicare and is already signed up for parts A and B. We have Medigap narrowed down to AARP/UHC Plan G or Priority Health Plan G. Priority Health gets good reviews but operates only in our state. It is connected to major hospitals in our area. We currently have PH through the ACA and have been very happy. However, my instinct is to go with AARP/UHC which is also $15 less per month. But is there any reason it would be better to go with a more local (very large in this area) company?

Thanks!

 

[lawman]

DH starts Medicare June 1. He chose original Medicare and is already signed up for parts A and B. We have Medigap narrowed down to AARP/UHC Plan G or Priority Health Plan G. Priority Health gets good reviews but operates only in our state. It is connected to major hospitals in our area. We currently have PH through the ACA and have been very happy. However, my instinct is to go with AARP/UHC which is also $15 less per month. But is there any reason it would be better to go with a more local (very large in this area) company?

Thanks!

None I can think of

 

[MichaelB]

MediGap insurers don’t have networks, they have to accept claims from all providers with Medicare agreements, so no coverage differences between the two insurers. It’s also not easy to project future price increases.

One area where some forum members have expressed unhappiness is a MediGap provider that closes to new members and opens a new policy offering under a different subsidiary. The old group then gets hit with substantial price increases, and members are locked in. See this thread for one example https://www.early-retirement.org/fo...-provider-selection-for-my-plan-g-100099.html

My guess is UHC/AARP would be less likely to do this and that is one reason I chose them for my MediGap policy.

 

[Dash man]

^^^^This

It’s also why we went with AARP/UHC Plan N. Plan G for any carrier is by far the most popular, but price increases in the future is different between companies. Plan G is also a guaranteed issue plan for those joining Medicare later, which possibly will also affect price increases, so we chose to go with Plan N. Note I live in PA where excess charges aren’t permitted. I also have yet to pay a copay, though I’m only in the fifth month of Plan N or about five doctor visits.

 

[Katsmeow]

What MichaelB said

 

[CardsFan]

What MichaelB said

+1.

Also, in MO, we can change providers annually without underwriting (birthday rule). I suspect this will keep the AARP/UHC price competitive. If not, we can change.

 

[pirsquared]

The AARP/UHC plan is community rated, while the Priority Health is attained age. This is another pro for AARP/UHC. The only reason we were considering PH at all was that it is local. But it seems that a company with a presence in multiple states would be less likely to close plans. I think...

 

[CRLLS]

MediGap insurers don’t have networks, they have to accept claims from all providers with Medicare agreements, so no coverage differences between the two insurers. It’s also not easy to project future price increases.

One area where some forum members have expressed unhappiness is a MediGap provider that closes to new members and opens a new policy offering under a different subsidiary. The old group then gets hit with substantial price increases, and members are locked in. See this thread for one example https://www.early-retirement.org/fo...-provider-selection-for-my-plan-g-100099.html

My guess is UHC/AARP would be less likely to do this and that is one reason I chose them for my MediGap policy.

True for all but Medigap "select" plans. Those plans are much like the regular Medigap plans except they have networks. Non-emergency services are limited to in-network providers. For some, that could mean a lot. The opposite side of that coin is that Medicare still covers the 80%. You could be stuck with the 20% coinsurance. and possibly the 15% additional for providers who do not accept Medicare "assignment"

 

[youbet]

True for all but Medigap "select" plans. Those plans are much like the regular Medigap plans except they have networks. Non-emergency services are limited to in-network providers. For some, that could mean a lot. The opposite side of that coin is that Medicare still covers the 80%. You could be stuck with the 20% coinsurance. and possibly the 15% additional for providers who do not accept Medicare "assignment"

Not exactly, at least for my BCBS "Select" F policy. Networks only apply to hospitals. And my maximum exposure for using a non-network hospital is limited to my max OOP. Here all the major hospitals in my area, including the major teaching hospitals, are on the "OK" list. And I can switch from Select to regular with a month's notice. It seems like a no -brainer.

 

[CRLLS]

Here is direct from Medicare.gov regarding Select Medigap plans:

A type of Medigap policy that may require you to use hospitals and, in some cases, doctors within its network to be eligible for full benefits.

My comment was more towards the previous statement of Medigap insurers having no networks, not the details of any particular "Select" policy. Clearly, some Medigap policies do have networks. My advice for anyone even considering a "Select" plan is to read and understand the details of the specific policy as these plans are different from the more familiar and traditional Medigap plans.

 

[pirsquared]

MediGap insurers don’t have networks, they have to accept claims from all providers with Medicare agreements, so no coverage differences between the two insurers. It’s also not easy to project future price increases.

One area where some forum members have expressed unhappiness is a MediGap provider that closes to new members and opens a new policy offering under a different subsidiary. The old group then gets hit with substantial price increases, and members are locked in. See this thread for one example https://www.early-retirement.org/fo...-provider-selection-for-my-plan-g-100099.html

My guess is UHC/AARP would be less likely to do this and that is one reason I chose them for my MediGap policy.

Thanks, this is helpful. This is also what we are thinking.

 

[Midpack]

One area where some forum members have expressed unhappiness is a MediGap provider that closes to new members and opens a new policy offering under a different subsidiary. The old group then gets hit with substantial price increases, and members are locked in. See this thread for one example https://www.early-retirement.org/fo...-provider-selection-for-my-plan-g-100099.html

The link was alarming to me since it involves Mutual of Omaha but...

Three years ago I enrolled in a Mutual of Omaha plan G and they billed me as MoO. One year later I was surprised when United World Life billed me, though they are an affiliate of MoO. Last year DW signed up with MoO, and they are billing her as MoO. When she was shopping, MoO told her we'd both get a "family" discount. And indeed my rate came down a little, and hers was lower still. Maybe there's another shoe to drop, but so far so good with service and premiums. However, it is odd to me that MoO bills her, and UWL bills me?

 

[ShokWaveRider]

The difference between Plan N and Plan G. for me is $25 a month. A cheap price to pay for no copays or other Plan N vs G deficiencies. A whopping $300 a year. Will that really make a difference to anyone here?

 

[Dash man]

The difference between Plan N and Plan G. for me is $25 a month. A cheap price to pay for no copays or other Plan N vs G deficiencies. A whopping $300 a year. Will that really make a difference to anyone here?

Between the two of us, we save more than $300, but the future price increases are likely to be lower with Plan N than G. The copays required are very limited to a few office visit codes, so they are rare. We’re not concerned with excess charges in PA because they are not permitted. So we will take the savings for Plan N over G.

 

[harllee]

The link was alarming to me since it involves Mutual of Omaha but...

Three years ago I enrolled in a Mutual of Omaha plan G and they billed me as MoO. One year later I was surprised when United World Life billed me, though they are an affiliate of MoO. Last year DW signed up with MoO, and they are billing her as MoO. When she was shopping, MoO told her we'd both get a "family" discount. And indeed my rate came down a little, and hers was lower still. Maybe there's another shoe to drop, but so far so good with service and premiums. However, it is odd to me that MoO bills her, and UWL bills me?

DH and I have had a bad experience wit Mutual of Omaha here in NC. We started with their plan G when we turned 65. At age 67 the premiums for both of our policies increased by about 30%. I was able to switch to AARP UHC plan G with a substantially lower premium, DH was stuck with Mutual of Omaha because of a preexisting health condition. Now at age 70 DH's Mutual of Omaha policy is twice as expensive as my AARP UHC policy. We wish we had never signed up with Mutual Of Omaha.

 

[Happyras]

We wish we had never signed up with Mutual Of Omaha.

For this very reason we chose the local Premera BCBS plan over MoO. The teaser premium was lower, but would update in April. The Premera plan increased a few dollars, which was fine. MoO was also very difficult to get a rep on the phone and Premera has been great. (We had Premera as our pre-retirement insurance and had no issues).

Our gamble was to take Plan G HD for both of us as last year we had no benefit from our Plan G with Aetna.

So...of course in January my wife ended up in the hospital, sweeping the max co-pays and deductible for part A, and B. But that is a one and done for the year now since she has now met the HD of Plan G. For myself, I am yet to use any Medicare this year, so the Plan G HD so far has been cheap, about $50/mo for each of us.

 

[Katsmeow]

The difference between Plan N and Plan G. for me is $25 a month. A cheap price to pay for no copays or other Plan N vs G deficiencies. A whopping $300 a year. Will that really make a difference to anyone here?

I personally have Plan G so it is worth it to me.

But, on the $300 a year. It isn't that any one expense makes a difference. But, if you add up all the "will $X a year really make a difference" into one collective number then it could indeed make a difference as part of that collective number.

 

[pirsquared]

Thanks for all the replies! DH went with AARP/UHC Plan G and we feel good about that.

 

[Rianne]

Adding one more question: I applied for SS and Medicare (got Medigap G). Online at the end of the applications, it says something about providing a birth certificate and other documents. Do you mail those in? There were no instructions. I received my medicare card already.

 

[MichaelB]

Adding one more question: I applied for SS and Medicare (got Medigap G). Online at the end of the applications, it says something about providing a birth certificate and other documents. Do you mail those in? There were no instructions. I received my medicare card already.

If you already have your Medicare card you’ve been approved and are good, so no need for those documents. Those are “may ask”, and if they want copies they’ll let you know.

 

[Rianne]

If you already have your Medicare card you’ve been approved and are good, so no need for those documents.

Ok, thanks. What about SS? I won't start that until Sept. with medicare.

 

[MichaelB]

Ok, thanks. What about SS? I won't start that until Sept. with medicare.

Did you apply for SS and Medicare together? The SSA approves the Medicare application, so they would have verified your identify for both at the same time.

When my brother applied for SS they asked for his birth certificate, which was difficult to get, but during the interview didn’t look at any documents other than his driver license. When DW applied for Medicare they asked for her marriage certificate, naturalization document, and US passport, all in addition to the driver license, and when she applied for SS they asked for her marriage certificate and passport a second time - and it was the same individual both times.

If they want a specific document they’ll ask for it.

 

[Pluperfect]

The AARP/UHC plan is community rated, while the Priority Health is attained age. This is another pro for AARP/UHC.

The AARP/UHC plan is community rated, but each person's premium has a discount based on their age. with a bigger discount the younger they are. Which seems to me isn't different from an attained-age plan--with both, the premium is higher for an older person than for a younger person.

Is there a difference I'm not seeing? I think there must be, because they bother to have these two different categories (in addition to age-at-issue), but that might be expecting rationality in Medicare, which I'm finding in short supply the more I look into it.