Approaching Medicare: Boomer Benefits or Fidelity or ??

[Retired2021]

DW starts on Aug. 1st. I start on Jan. 1st. Since there is a 12 month trial period rule that allows you to switch plans within the 1st 12 months guaranteed issue without medical underwriting, we are going to start her on the HumanaChoice advantage plan to see how it goes for her and to save a few months of premiums. She is in good health and is on no meds.

During open enrollment, I'm going to start with a G plan because you can always switch to an equal or lessor plan without medical underwriting on your birthday in our state (and in the 1st 12 months). You cannot go from a GHD plan to a G plan without underwriting.

I understand that annual premium increases for the G plan will be greater than all other available plans, so i at some point the premiums squeeze me out, I have the option to drop to a lessor plan. Did a 20 year premium run rate with a 6.5% annual increase and the premiums for wife and I at age 80 will be higher than our property taxes.

Adios Obamacare...

 

[sengsational]

In Post 1 I said:

My state (VA) has the birthday rule, so I'm not concerned with getting stuck with an insurer who closes the book and jacks up rates.

Correct?

Ah, my bad. No sick duck pools in VA.

That means you buy on price and customer service.

All the offerings are probably "attained age" pricing, so the older you get, the more they'll charge, but that's the case everywhere anyway.

 

[audreyh1]

I signed up directly. A few years earlier DH used Boomer Benefits and pushed Mutual of Omaha hard, blowing off their frequent practice of closing the books. They reluctantly signed him up with UHC/AARP. I suspect they got a bigger commission from MoA.

They are certainly worth a try for OP since he can use the new birthday rule to change Medigap insurers. You can always get a quote or two.

 

[dickoncapecod]

Since age 65 I have had the misfortune of consuming over $600k in "list price" medical care. Two large surgeries with weeks in hospital, visiting nurse care, follow ups, imaging and imaging and imaging of every type. The GOOD fortune: I had/have Medicare A&B and the standard no-frills AARP Gap Coverage and I have not paid a penny. Strong belief: you do not need cheap sneakers or a gym membership or cut rate eye/hearing care ---- YOU NEED COVERAGE.
PS. For every "extra" you are "given" in other supplement plans, something MUST be taken away ---- usually through network and/or geographic restrictions. Nightmare: you have a heart attack or accident and are unconscious----' ambulance takes you to an "out of network" emergency room/hospital where you are treated by out of network docs. You wake up a few days later with a meter running in six figures, 20+% of which is on you.
Regards, Dick

 

[junkanoo]

Yeah, I started medicare a few days ago - never in my wildest dreams did I think I'd be excited about turning 65. But here we are...

Cheers

My wife turns 65 this fall. The savings to get on Medicare are so significant, I've joked about throwing a party.

 

[Midpack]

If you are in the market for Plan A / Plan B, and if your broker doesn't describe the tactic many companies employ called "closing the book", then your broker is not looking out for your long-term results. Probably more interested in their own commission.

Boomer Benefits did not offer any commentary on the likelihood that the company that they were suggesting would close the book, even as I prompted them to go in that direction. They were pushing Mutual of Omaha on me. They have one of the worst records for pricing low to suck people in, then, as soon as a few claims start coming in, raise the price by a large margin. That causes people who can pass underwriting to leave, creating a "sick duck pool" where costs skyrocket.

If Fidelity is getting commission, they also may not mention closing the book. I'd be interested in seeing how they navigate this.

This is the most important reply you’ll get.

Boomer Benefits is very good at finding low rates for customers, and they save customers from having to learn about Medicare supplements - something most people benefit from.

What they don’t bother to inform customers about at all is closing the book practices that most insurers employ to offer low initial rates. In all fairness, most customers probably can’t see beyond what’s the cheapest premium today, so I can understand why they don’t. It’s not Boomer Benefits fault, nor is it the fault of the providers who do it - they can’t compete otherwise with the majority of customers who won’t bother to understand.

If I had it all to do over again I’d go with AARP/UHC instead of Mutual of Omaha. At the time MoO was much cheaper, now I know why. That said, AARP/UHC isn’t cheap, senior medical expenses are high, no getting around that.

 

[big-papa]

This is the most important reply you’ll get.

Boomer Benefits is very good at finding low rates for customers, and they save customers from having to learn about Medicare supplements - something most people benefit from.

What they don’t bother to inform customers about at all is closing the book practices that most insurers employ to offer low initial rates. In all fairness, most customers probably can’t see beyond what’s the cheapest premium today, so I can understand why they don’t. It’s not Boomer Benefits fault, nor is it the fault of the providers who do it - they can’t compete otherwise with the majority of customers who won’t bother to understand.

If I had it all to do over again I’d go with AARP/UHC instead of Mutual of Omaha. At the time MoO was much cheaper, now I know why. That said, AARP/UHC isn’t cheap, senior medical expenses are high, no getting around that.

It's also important to know that AARP/UHC isn't immune from book closing/deadpooling either. My wife started medicare a little over a year ago and AARP/UHC had 2 Plan G offerings. One was just a standard Plan G and the other came with "extras" (gym memberships, etc.). The standard plan was a little cheaper, which is what my wife went with. We found out late last year that the plan my wife had was going closed-book and had notified our state insurance commission accordingly.

In January, my wife called AARP/UHC to change plans to the one with "extras". A little more expensive, but we wanted to stick with this Plan G provider. She passed underwriting easily and the switch happened almost instantly. I started medicare a few days ago and went with the same plan.

Ultimately the data was there, if I had looked for it. The original plan my wife was on was available in many states but for one reason or another didn't have that many enrollees. That should have been a sign.

This was discussed on bogleheads earlier in the year here: https://www.bogleheads.org/forum/viewtopic.php?t=466935

Cheers

 

[bobandsherry]

I'm about in the same boat as you, will be starting Jan 1st of the new year. I had looked at Boomers Benefit, saw what Fidelity offered, also saw several other "Medicare decision assistance" (aka insurance broker) companies including local. What I have yet to comprehend, what benefits has someone found using one of these brokers? Medicare.gov seems to have all the details on what companies are available, along with prices. Sign-up seems easy. The sign-up window is clearly defined. So what else do they help with?

After my research, I looked earlier this year for prices in Florida, I'm leaning towards a Plan G HD. As I looked at the lowest price Plan G, it was $221/mo with Cigna. Plan N was $164, and I thought that was what I would lock-in on. But then I looked at prices with GHD and found $58/mo with AARP/UHC. The difference is a savings of nearly $2K/yr.

I do have some additional "risk" with the higher deductible, but it's $711 difference, worst case.

• Plan G: $2,652 (annual premium) + $283 (Part B deductible) = $2,935 total guaranteed/max cost.
• Plan GHD: $696 (annual premium) + $2,950 (max deductible) = $3,646 total max cost.

To hit that "worst case" I'd have to have roughly $13,600/yr in in actual allowed gross covered medical bills each year as break-even.

From my own research, I don't believe a Medicare Advantage plan is for me. It saves on the premium, but has limitations/restrictions that I can't justify in my mind, and it has even a higher out of pocket deductible.

 

[big-papa]

I What I have yet to comprehend, what benefits has someone found using one of these brokers?

First, I did not use a broker. Like you, my wife and I did our own research and decided our path on our own. I have a good friend who has used Boomer Benefits and has been happy with the results.

There's a school of thought that, for example, since Plan G is Plan G is Plan G, that the only consideration should be price

But there are several other considerations as well
- Customer Service.
- Historic rate increases. While not perfectly correlated to future rate increases, it's still important to get as much history about this as you can when making a decision. While much of this is available on the internet, it can be difficult to find and extract. A good broker will provide this for you.
- History of closing books/deadpooling plans. If a provider has made a frequent habit out of doing this, that's a red flag. It's a dangerous game of musical chairs where at some unknown point in the future, when you may have chronic ailments or medical history that may prevent you from passing underwriting, preventing you from moving out to a cheaper plan. The healthier individuals who can leave the plan do so and you're stuck in a spiral of increasing rates because the pool is increasingly more risky for the insurer. Again, a good broker can provide this information.
- How many subscribers a particular plan might have in your state and nationwide, as well as how old the plan might be. We didn't consider this when my wife first went on medicare and in less than a year, the provider dead-pooled her plan. Fortunately my wife was healthy and switching to a different plan from the provider, with a much larger number of subscribers was easy for her. Again, this is something that a good broker can provide, though it also is available on the internet.

Whether any of this is important also depends on the state you live in and their rules about how easy it might be to switch providers without underwriting.

Cheers

 

[sengsational]

I do have some additional "risk" with the higher deductible, but it's $711 difference, worst case.

I don't think having a broker or not would make a difference on the "reconciliation simplicity" aspect of HD vs not, but it's something to consider.

I wish they had offered the HD-G when I came of age. And I'm glad they didn't offer the HD-G when I came of age

It would be really nice to pay a lot less for Medigap. But it's also nice to hit a low deductible after my first visit or two, and know that any bill that comes after that is wrong.

Because I'm inclined to understand the details, I actually have an elaborate system where I download and parse the Medicare data, download and parse the Medigap data, and match them up. I've found the most interesting thing is what I call zero reimbursement line items. Somebody (you or the provider) needs to eat those or appeal those.

The other interesting thing is when the provider "forgets" to run a service through Medicare at all, at which point their billing system just lumps the charge master rate onto your legit amount, and unless you dig, you'll have no idea you were just ripped off. This latter thing can't really happen with the low deductible, but probably happens all the time with the HD.

 

[bobandsherry]

There's a school of thought that, for example, since Plan G is Plan G is Plan G, that the only consideration should be price

But there are several other considerations as well
- Customer Service.
- Historic rate increases. While not perfectly correlated to future rate increases, it's still important to get as much history about this as you can when making a decision. While much of this is available on the internet, it can be difficult to find and extract. A good broker will provide this for you.

I hear you on that, and why I am only considering the major players. For my area, CIGNA and AARP/UHC are some of the better rates offered and both appear to be well respected.

- History of closing books/deadpooling plans. If a provider has made a frequent habit out of doing this, that's a red flag. It's a dangerous game of musical chairs where at some unknown point in the future, when you may have chronic ailments or medical history that may prevent you from passing underwriting, preventing you from moving out to a cheaper plan. The healthier individuals who can leave the plan do so and you're stuck in a spiral of increasing rates because the pool is increasingly more risky for the insurer. Again, a good broker can provide this information.
- How many subscribers a particular plan might have in your state and nationwide, as well as how old the plan might be. We didn't consider this when my wife first went on medicare and in less than a year, the provider dead-pooled her plan. Fortunately my wife was healthy and switching to a different plan from the provider, with a much larger number of subscribers was easy for her. Again, this is something that a good broker can provide, though it also is available on the internet.

I had looked for info on price increases, and it has been hit or miss. Maybe a broker might help in this regard, and also for size of their pool of policyholders in a plan/area.

 

[bobandsherry]

I wish they had offered the HD-G when I came of age. And I'm glad they didn't offer the HD-G when I came of age

It would be really nice to pay a lot less for Medigap. But it's also nice to hit a low deductible after my first visit or two, and know that any bill that comes after that is wrong.

I'm sure for some, not needing to worry about bills past the initial deductible is worth paying more. For me, coming off nearly 10 years on an ACA Bronze plan, a much higher deductible, and which many people don't like because of that. Medicare is going to be welcome relief either way.

I tend to look at the psychology the opposite way. Paying a small co-pay out of pocket for a doctor visit once or twice a year doesn't bother me at all when I know I kept nearly two grand of premium savings in my own bank account. And I know I'll naturally use more healthcare as we age, but risking a maximum of $711 to guarantee a $1,950 premium savings is a trade-off I’ll take any day. Plus, looking long-term, a 5% annual rate hike on a $221 premium widens the pricing gap a lot faster than a 5% hike on a $58 premium. I have an HSA account that will have some money still available once I go on Medicare. I can't use that money to pay premiums, but I can use the HSA funds to pay for the additional out of pocket expenses.

There's no telling exactly how much the GHD deductible itself will tick up over the years, but based on a decade of tracking our actual ACA out-of-pocket numbers, I've never come close to crossing that line. With most decisions in life, we make a best guess, hold our nose, wish of the best and plan for the worst.

 

[CRLLS]

Since my "plan" goes out to age 100, I wasn't interested in short term comparisons in price. I never contacted Boomer or anyone else. I foolishly chose what I was familiar with and that was BCBS plan F-HD. When Plan F was being closed to new customers the handwriting was on the wall. I had the opportunity to change plans and due to our health, we could pass underwriting if we changed insurers. I carefully analyzed the options, excluding Advantage plans. I went with the best available "plan" knowing the chance of one or two major health issues could easily wipe out any savings from a lower coverage plan. Once that was decided, it was down to choosing the insurer. My state has a list of every insurer and their prices at various ages. By using a breakeven point as in the faulty SS calculations, I chose AARP/UHC. They were not the cheapest out of the gate, but the state's data indicated that when we get to ~80 the others would "likely" pass up the AARP premiums. While nothing is guaranteed, I think I did the right choice for the long term.

Medicare choices are just like stock picking. One does their best at picking the plan and provider that appears to be a winner in the long term. Then we hope the future goes according to plan. LBYM and investing has benefited us over the years. If things get a bit costly, we can tolerate some increases. Trying to save 5 or 10% on supplement costs is not a big hit in our plan.

 

[ksr]

I have an HSA account that will have some money still available once I go on Medicare. I can't use that money to pay premiums, but I can use the HSA funds to pay for the additional out of pocket expenses.

HSA funds can be used for Medicare premiums, but not for supplemental plan premiums.

 

[dickoncapecod]

A lot of folks who post in the investment threads here would never dream of buying single-B rated bonds because there is an increased risk of damaging default/bankruptcy. However, when their own net worth/quality of retired life is the thing at risk, they are drawn to lower cost or "bells and whistles" health insurance that is well below "AAA"/bulletproof. Unless folks' retirement health coverage "B vs AAA" premium differentials are actually financially constrained, IMO buying the AAA/bulletproof coverage ON YOUR NET WORTH is clearly the best bet.
Regards, Dick

 

[Texas Proud]

Throwing in agreeing with many...

I do not want to determine if what they are billing me is correct etc... a low deductible and then 100% NOT MY BILL is what I want and what I pay the higher premiums for... a friend of mine's parents have the F where they pay NOTHING... so they even know it is wrong when they first to to DRs...

As for brokers... a lot of people will not do the necessary work to know what is the best option for them... it is easy to get a broker to say 'buy this' and do it... I tried the brokers after knowing 95% of where I wanted to go to see if they added any value... I found out they do not for me...

 

[Go Bolts]

Many people overlook the High Deductible Plan G when it comes to Medicare Supplement. You can save a lot of money choosing this option and yes, you will have some out of pocket expenses to pay during the year. Some people don't mind paying a lot more in premiums with Regular Plan G, because they like not having to worry about paying providers after their Part B Deductible is met. Each to their own.

I can highly recommend Pamela at https://www.decodingmedicare.com/ as a very knowledgeable and helpful broker. She also has a Facebook Group "Navigating Medicare the Easy Way."

 

[Retired2021]

A lot of folks who post in the investment threads here would never dream of buying single-B rated bonds because there is an increased risk of damaging default/bankruptcy. However, when their own net worth/quality of retired life is the thing at risk, they are drawn to lower cost or "bells and whistles" health insurance that is well below "AAA"/bulletproof. Unless folks' retirement health coverage "B vs AAA" premium differentials are actually financially constrained, IMO buying the AAA/bulletproof coverage ON YOUR NET WORTH is clearly the best bet.
Regards, Dick

DW HumanaChoice Advantage Plan has a Maxium Out of Pocket (MOOP) of $3,100 in network and $6,200 out of network. DW is a home body and rarely travels out of network.

 

[Dtail]

We used BB for fiancee and me. We were happy with the process for Medigap.
However, we both signed up for Part D with Wellcare Script, which is a plan they do not offer.

 

[2retireearly]

Why in the world would anyone forgo Part B or is what would be covered by Part B be covered by your Federal plan so part B would be redundant? Not sure about Federal plan but I think most corporate retire plans require that you are enrolled in Part B.

And they should be very well educated on penalties for not having it, if it is required. I think it is not required if you have a plan through your large company. But, if for some reason they don't deem it sufficient, you are penalized every year, for life, for the years you didn't have it. I am sure the OP knows this and it acting accordingly.

 

[Joylush]

I wasn’t impressed with Boomer Benefits. They are insurance sales people first and foremost. But they don’t even the G-HD plan which is such a great value and suitable for many people. Why? Because they don’t sell it- premiums too low to make it worth their time.

 

[jazz4cash]

Why in the world would anyone forgo Part B or is what would be covered by Part B be covered by your Federal plan so part B would be redundant? Not sure about Federal plan but I think most corporate retire plans require that you are enrolled in Part B.

I am glad you asked because this was not the plan until 2 weeks ago. I am still thinking it all through.

The FEHB Plan becomes secondary coverage when you have Part B but the premium does not change. Many folks say to switch to a cheaper plan that supplements MC but that is not a clear choice. If the MC premium is more than the OOP max it seems reasonable to forego Part B. Further, we have some IRMAA risk and most years we don't get anywhere near OOP max. Make sense?

 

[hesperus]

I think doing your research on YouTube in advance answers most questions or prepares you to ask them.

Consultant we used we found due to a lot of great training videos on YouTube.

The particular consultant matters less in my opinion.

Doing some video research beforehand is a great strategy. It gives you the right vocabulary and helps you figure out exactly what questions to ask when you finally talk to a professional.