Medigap Advice Please

[joesxm3]

I will be turning 65 soon and signing up for Medicare. I think that I will want to get a Medigap paln and have started to look at the different types. I would appreciate any advice or tips.

At first glance, I think I would like the Type G Medigap and maybe with a high deductible.

I am single and am estimating that I have a 25% chance of needing a medium level surgical procedure in the next 10 years. Since I live by myself, I am thinking that I would need to go to a skilled nursing facility if I had to recover from some sort of procedure, so the SNF coverage seems like something I would want to have.

I see that there are types of pricing. It seems I would want a policy with "community pricing" so that I don't get stuck with increasing costs due to age. Does that seem right?

I currently do not have any prescription medicine costs. If I don't take a Medicare D plan now, can I add one in a future year without getting socked with some sort of penalty like the one for not taking Medicare B?

I do have dental costs, cleanings and typically a cavity or two per year and I wear eye glasses and have been told that I will eventually need cataract surgery. A quick search seems to show that Medicare will cover cataract surgery. At this point I am thinking to self pay for dental and vision.

Any reason to prefer a Medicare Advantage to Medigap?

Aside from price, should I be concerned about the company that underwrites the policy? In my area I see that the big names offer type A, but the type G companies were ones I have not seen that often.

Thanks in advance for any advice.

Joe

 

[PaunchyPirate]

I will be turning 65 soon and signing up for Medicare. I think that I will want to get a Medigap paln and have started to look at the different types. I would appreciate any advice or tips.

At first glance, I think I would like the Type G Medigap and maybe with a high deductible.

I am single and am estimating that I have a 25% chance of needing a medium level surgical procedure in the next 10 years. Since I live by myself, I am thinking that I would need to go to a skilled nursing facility if I had to recover from some sort of procedure, so the SNF coverage seems like something I would want to have.

I see that there are types of pricing. It seems I would want a policy with "community pricing" so that I don't get stuck with increasing costs due to age. Does that seem right?

I currently do not have any prescription medicine costs. If I don't take a Medicare D plan now, can I add one in a future year without getting socked with some sort of penalty like the one for not taking Medicare B?

I do have dental costs, cleanings and typically a cavity or two per year and I wear eye glasses and have been told that I will eventually need cataract surgery. A quick search seems to show that Medicare will cover cataract surgery. At this point I am thinking to self pay for dental and vision.

Any reason to prefer a Medicare Advantage to Medigap?

Aside from price, should I be concerned about the company that underwrites the policy? In my area I see that the big names offer type A, but the type G companies were ones I have not seen that often.

Thanks in advance for any advice.

Joe

Research the Part D aspect more. I’m quite certain I have read multiple times that if you don’t sign up for one now, there will be significant penalty later on to sign up. Most people in this situation pick the lowest cost plan they find. You can change to a better plan at the next open enrollment period should you start taking prescriptions.

 

[Midpack]

Do yourself a favor and contact Boomer Benefits and they can explain all your options. They don’t hard sell in my experience, but they earn your business and get paid that way - so they bend over backwards to get you options you’re happy with. It doesn’t cost you anything. https://boomerbenefits.com/ I spent months researching Medicare and all the options and rules, then contacted Boomer Benefits and realized I could have just let them do the work for me for free! I knew enough to know what they recommended was as good or better than I would have come up with on my own.

And you really don’t save money delaying Part D, you just pay higher premiums when you do sign up - for the rest of your life. If you’ll ever need a Rx plan, you may as well get on board sooner rather than later. My Part D plan is much less expensive than Medicare, my Plan G supplement or even our dental plan, and it has saved me money anyway. It’s so cheap I pay my Part D premium annually instead of fussing with 12 tiny monthly premiums. Of course there are (much) more expensive Part D plans for customers who take lots of expensive drugs, but I didn’t need or want that. https://www.medicareinteractive.org...dicare,month for as long as you have Medicare.

 

[pb4uski]

+1 on Boomer Benefits... they are wonderful and gave us good advice.

We chose a Medigap Plan G because we snowbird and travel and wanted the flexibility to go to any doc anywhere. We probably would save with a Medicare Advantage plan but we didn't want the limitations... my understanding is that it is sort of like a HMO in that there are gatekeepers. Our Medigap is reasonable $200/mo for me and $174 for DW... and then we also get a 7% additional household discount.

Get Part D now... its cheap... I pay $7/mo and DW pays $14.

 

[Telly]

I will be turning 65 soon and signing up for Medicare. I think that I will want to get a Medigap paln and have started to look at the different types. I would appreciate any advice or tips.

At first glance, I think I would like the Type G Medigap and maybe with a high deductible.

Just to keep the terminology straight, it's Plan G, not type G

Your only reasonable choices are Plan G or G High Deductible, or Plan N. Think carefully about whether a high-deductible plan is a good idea, because of future underwriting. If you choose G HD, and later you have increasing medical problems (!) and want to switch to regular Plan G, you would have to successfully pass health underwriting to do so. And the chances are very good then that you would fail it. You would have to stay on Plan G with that company forever, or depart to a Medicare Advantage (MA) plan instead, never to return to Original Medicare. I suggest planning for the long term. You are healthy, until you're not. And it can be sudden.

I see that there are types of pricing. It seems I would want a policy with "community pricing" so that I don't get stuck with increasing costs due to age. Does that seem right?

I think in most cases, it turns out to be six of one, half dozen of the other. A true Community Pricing model has to account for increasing health costs with age, so with an all-age same price setup, for the age 65 entrants, the cost will be high compared to at-age pricing methods at 65. The way AARP/UHC handles this is by giving a 36% discount at age 65 to be competitive with age-based. Each year you lose 3 percentage points off of that discount. So age does matter anyway.

I currently do not have any prescription medicine costs. If I don't take a Medicare D plan now, can I add one in a future year without getting socked with some sort of penalty like the one for not taking Medicare B?

As others have pointed out, at least get a Part D as a place holder!

A quick search seems to show that Medicare will cover cataract surgery. At this point I am thinking to self pay for dental and vision.

That's what I am doing. Cataract surgery and first contacts/glasses lenses after surgery were well covered. For eyes, the medical part of examinations are covered, not the refraction. My yearly Ophthalmology bill is covered, except for the refractions part, if I choose to have that done. I pay dental out of pocket, biggest single expense for me was a crown, around $1,200 for a gold one. No big deal to me, I'm not needing a crown every year. I was self-insuring for Dental for many years before turning 65 anyway. Most dental insurance that I have seen is to me, laughable, with its small amounts covered per year, vs. exclusions, vs premiums.

Any reason to prefer a Medicare Advantage to Medigap?

That's a big question, and you will find many each way. I saw no benefit to me to go the MA route.

Aside from price, should I be concerned about the company that underwrites the policy? In my area I see that the big names offer type A, but the type G companies were ones I have not seen that often.

Theoretically, they should offer the exact same coverage. Are you looking at the Medicare website to locate Medigap plans in your area? There should be quite a few!


EDIT - I typed up a whole bit about watching out when dealing with brokers about the "book game", but for some reason it was all lost when I posted it now. So in a nutshell - Salesmen are still salesmen! There can and are behind the scenes incentives from some insurance companies to have brokers get X$ if they sign up Y number of people in Z amount of time. Ongoing incentives.

 

[Dash man]

I also recommend contacting Boomer Benefits and they don’t charge you. They do have many videos on YouTube to help you learn about Medicare, so take some time and watch them. There is a penalty for delaying Part D, so don’t make that mistake.
I start Medicare in August, so I’ll be signing up for Part A and Part B tomorrow. We will be using Via Benefits to sign up for our MediGap and part D plans, because my former employer requires us to use them to receive some HRA benefits.

 

[ShokWaveRider]

AARP Part G never looked back. Works Great, last as long time.

 

[Telly]

If I could go back in a time machine to my approaching age 65, I would have changed which broker I went with. I would have avoided the one I picked, oft recommended later on here. Instead, I would have checked out Senior Savings Network, Chris Westfall's brokerage. As an Engineer, I find that Westfall is detail-oriented, knows the pitfalls, knows the insurance company BS, and tells it like it is. He speaks my language. No salesman's buttery slather.

Among many other good youtube videos he's put out, here is one that in 27 minutes is an excellent primer on Medicare, pitfalls, Medicare's recent bias towards divesting themselves of direct Medicare recipients and why, etc. The whole video is great, but if you don't like long vids, at least see starting about minute 18... he sounded just like me when I received that crappy purposely obfuscating letter from Medicare last year! (I hope that the change in CMS leadership will tone this down now, but it's an uphill battle with insurance companies feeding on the schools of tasty fish).

But alas, I picked another broker company back then, and got toasted with their recommendation of Medigap provider. At the time, I was unaware of the provider running the "book game", and their ever-ongoing incentives to brokers to feed new people in. I found that out with my own investigating, after my rates suddenly took a big increase, and saw how they do it all over the country, state by state, over and over, it's their MO. The broker never mentioned that... wonder why... (that's a rhetorical question!).

Luckily for me, my health was good enough to pass underwriting, and I changed not only ins. co., but took the opportunity to change plans too, going from G to N. I ramrodded that change through with the original broker. They wanted to "shop me around" their other ins. co's they represent. I do not want to be "shopped around" each time a ins. co plays games, as I will one day, maybe tomorrow, who knows, not pass underwriting, and be stuck! I want a ins. co. that is reasonable, that I can stay with without worrying about the future. As best as can be done with ins. cos.

 

[kevink]

This may save you a lot of time watching videos and doing online research (at least it did for me):

https://retireearlyhomepage.com/medicare2020.html

 

[anethum]

Someone on this forum (sorry, I don't recall who) recommended the book "Get What's Yours for Medicare: Maximize Your Coverage, Minimize Your Costs", by Phillip Moeller. I got it out of the library and read it before I signed up 2 years ago. It was very informative.

I used Boomer Benefits to sign up for Plan G two years ago. I felt that the particular agent assigned to me was pushing me to select Mutual of Omaha instead of AARP UHC. I even told her that. She claimed that I would probably get larger increases in the future from UHC than from Mutual of Omaha. She also neglected to tell me about one small discount I could get from UHC. She was otherwise pleasant to deal with and answered my questions well. Long story short, I went with Mutual of Omaha and was hit with a 10% increase on my 1 year anniversary last year. I contacted Boomer Benefits again, got a different agent who was excellent, and I switched to AARP UHC plan G. I am in good health and passed underwriting.

As for that Christopher Westfall guy, he was mentioned in another thread two ago and there was a video link. In that video, I felt he was deliberately misleading people regarding "Guarantee Issue" in order to get them to switch from plans F & G to plan N (and presumably get new commissions).

So do your research. In addition to that book I cited, the "Medigap Plans to Rule Out?" sticky thread in this forum also has some excellent information. And if you have concerns about an agent you're working with, request a new agent or change to a different signup company. I should have done that myself when I had qualms about my first agent at Boomer Benefits.

 

[ncbill]

Did anyone skip paying for a Medigap plan based on David Belk's advice?

https://truecostofhealthcare.org/

Part D case study:

https://truecostofhealthcare.org/part-d-case-study/

 

[REWahoo]

^ No, I have a Medigap policy for the same reason I carry home insurance. In both cases I hope the insurance company keeps my money.

 

[MichaelB]

^ No, I have a Medigap policy for the same reason I carry home insurance. In both cases I hope the insurance company keeps my money.

+1

 

[audreyh1]

If someone wants to skip Medigap - just imagine being diagnosed with cancer and facing the unlimited 20% copays...

It happened to someone I knew after dropping supplemental insurance a couple of years earlier.

 

[Bamaman]

Advantage is being pushed heavily in marketing, but I question any plan that's being advertised so heavily. Sounds good on paper, but they pay the primary physican $X a month no matter how many times he has to see you. There is a huge hospital chain to the north of me that refuses to take Advantage, and they have 1700 physicians employed in their system. Their doctors don't accept it either. I'm not so sure that Advantage doctors ae absolutely top of the line often.

My wife has numerous problems and has had too many surgeries. I'm Type II diabetic too, and 20% deductibles on pump supplies are high. I switched from Plan G to Plan F--the most expensive and inclusive plan.

The Plan G high deductible might suit you well if you want to have control over what hospitals and what doctors you'll see.

Plan D programs can be very inexpensive or expensive--depending on the deductibles. Most people today have something like a $425 deductible, and if they take generic meds they never even get over the deductible in a year. I'm on the cheapest monthly cost Plan D, but my wife (taking 14 meds) is on a much more expensive plan.

 

[Another Reader]

With Long Covid, I have been making good use of both Part B and the AARP/UHC Plan F. Not interested in saving a few bucks for a lesser supplement company. Who knows what problems I would have if I had signed up for an Advantage plan? My strong suggestion is to pick the best plan available to you and pay the incremental price difference.

 

[Midpack]

^ No, I have a Medigap policy for the same reason I carry home insurance. In both cases I hope the insurance company keeps my money.

+2.

Furthermore, when I hear people complain about senior healthcare costs and % premium increases, I have to wonder how they compare to the actual cost of healthcare and what non-senior healthcare insurance actually costs, or full bore ACA?

I know from personal experience some who had MegaCorp or public sector plans don’t realize how heavily subsidized they usually are, employee contributions are a small part of the cost. With my former MegaCorp employees paid about 15% - and thought that was outrageously expensive! Clueless…

I guess I still haven’t gotten over how low my Medicare+Plan G+Part D costs are compared to what we’ve been paying for DW between her early 2019 retirement and when she goes on Medicare later this year. The increases I’ve seen have been more than reasonable. It’s a screaming bargain IME. Healthcare in the US is VERY expensive…

On Boomer Benefits, they offered me over a dozen options for secondary and several for Part D and dental. Sure they want to make a sale and earn a commission like any broker, but they didn’t seem to steer me into any one policy. They well earned their commission IMO.

 

[Ian S]

Did anyone skip paying for a Medigap plan based on David Belk's advice?
Part D case study:

https://truecostofhealthcare.org/part-d-case-study/

I looked at his claim that Part D insurance plans were a scam and think he cherry-picked the case as well as ignored the fact that a person can change Part D plans annually. He also neglected to mention the penalty imposed for going without a Part D plan and opting to get one later.

I take three generic prescription meds on a daily basis and all three are covered by my el cheapo Part D plan with no copay by me. If I had to get them through GoodRX, that cost alone would be more than 4X my Part D premium!

 

[Dash man]

DW and I just applied for Medicare Parts A & B this morning. We have appointments in June to speak with Via Benefits agent to set up our Medigap plans. Based on what I've read on this forum, I'm thinking the AARP/UHC Plan G. I'll have to compare the high deductible version to see if it might be better. Plan D will be tough with all the prescriptions I'm on.

 

[Ian S]

DW and I just applied for Medicare Parts A & B this morning. We have appointments in June to speak with Via Benefits agent to set up our Medigap plans. Based on what I've read on this forum, I'm thinking the AARP/UHC Plan G. I'll have to compare the high deductible version to see if it might be better. Plan D will be tough with all the prescriptions I'm on.

I'm happy with my AARP/UHC Plan G supplement(non-HD version). Every doctor and medical facility I've used is quite familiar with it.

For Part D, the government Medicare website has a calculator that allows you to input your prescriptions to see what your costs will be with the plans in your area. Also, remember that the Part D plans' premiums and what they cover can change pretty dramatically from year to year so revisiting your Part D choice is likely something you'll be doing on an annual basis each December.

 

[audreyh1]

We decided after all our non-Medicare HDHP plans that we were done with high deductible plans!!

The paperwork and charge reconciling just gets more and more annoying. Mainly having to pay up front. Supposedly easier on Medicare with a high deductible Medigap plan as they usually bill after the fact, but we just didn’t want to deal with tracking billing as we got older.

The constant question: have you met your deductible this year? If it’s only $201 or whatever, we don’t care so much.

Whatever Medigap plan you choose, you might be stuck with it forever. It can be quite difficult to change depending on your location or health.

 

[Dash man]

I'm happy with my AARP/UHC Plan G supplement(non-HD version). Every doctor and medical facility I've used is quite familiar with it.

For Part D, the government Medicare website has a calculator that allows you to input your prescriptions to see what your costs will be with the plans in your area. Also, remember that the Part D plans' premiums and what they cover can change pretty dramatically from year to year so revisiting your Part D choice is likely something you'll be doing on an annual basis each December.

Yes, I’ve looked at the Plan D offerings on the website. There’s a wide range of prices! For this year, I think the Walmart/Humana plans works for me. But I’ll check again before I commit. I have several doctors appointments between now and then, so my prescriptions may change.

 

[audreyh1]

With Humana, be prepared for the jump in price the following year.

DH switched to the Aetna $7 plan during open enrollment when Humana increased prices significantly on their prior $13 plan. He takes no drugs.

 

[ncbill]

I looked at his claim that Part D insurance plans were a scam and think he cherry-picked the case as well as ignored the fact that a person can change Part D plans annually. He also neglected to mention the penalty imposed for going without a Part D plan and opting to get one later.

I take three generic prescription meds on a daily basis and all three are covered by my el cheapo Part D plan with no copay by me. If I had to get them through GoodRX, that cost alone would be more than 4X my Part D premium!

So basically a new enrolls not already on meds should just pick the cheapest Part D plan & switch later depending on whether or not the new plan saves them money versus just paying out of pocket?

 

[Ian S]

With Humana, be prepared for the jump in price the following year.

DH switched to the Aetna $7 plan during open enrollment when Humana increased prices significantly on their prior $13 plan. He takes no drugs.

That's what I did too. It's gotta be kind of a loss-leader for Aetna where they draw you in with a low price and hope you'll stick with it when they raise the price next year. It covers my three drugs with no co-pay so they can't be making money off me this year!