Medigap Questions

[joesxm3]

I am about to sign up for medicare and have narrowed it down to Medigap G or Medigap G High Deductible. I read most of the sticky on Medicare and have watched the Boomer Benefits 6 day videos.

In the sticky some comments were made about normal Medigap G having less hassles compared to to the high deductible and that it may be worth the higher cost. Any thoughts.

I have not contacted the companies, but the .gov page estimated the high deductible being $75/mo (plus the $200 or so max deductible), they estimated the normal as $175 to $650.

The main thing I worry about is that the companies offering high deductible in my state are not that many

Colonial Penn
Humana
Omaha Insurance Co
United American Ins Co.

There are more names that I recognize in the normal plans:

AARP-UNH, which several in the sticky seemed to like
Anthem BC/BS, which I have my ACA with
CIGNA
Colonial Pe3nn
Combined Insurance Company of America
Humana
Omaha
Transamerica (direct)

Any of these to run away from?

Any that you really like?

Some mention "household". What does that mean?

Any actual experience with Boomer Benefits? I wonder if they, or any agent, will steer you to the company that gives them the largest commission.

I am assuming that the only difference between normal and high deductible is the deductible. Is that the case? Could there be things in the fine print to worry about?

Are these standardized, or could there be fine print items between companies?

Thanks in advance for any advice.

Joe

 

[pb4uski]

We have Plan G and pay the $203 Part B deductible.

From what I'm reading the Plan G HD is similar except that you pay the first $2,573 ($203 Part B deductible + $2,370 Plan G deductible).

So let's say that the Plan G is $200/month and the Plan G HD is $75/month... you save $1,500 in premium but are exposed to $2,370 in additional deductible.

So far in 2021, the HD would have been a good deal for me (negligible medical costs) but really bad for DW (very significant medical costs and we have only paid the $203 Plan B deductible).

YMMV. Pick your poison.

 

[Katsmeow]

Yes, these plans are standardized. Plans with the same letter all provide the same coverage. I personally have Plan G without the high deductible. My plan is with AARP-United Healthcare. It is a household plan in that both DH and I have our supplement with them. There is a 5% premium discount as a result.

Why not go the high deductible? Two reasons.

First, the hassle factor. Generally the first medical thing I do in a year consumes the deductible. After that I don't have to pay attention to deductibles for the rest of the year. For this year if I had had a high deductible plan it would have meant paying parts of deductibles to various people and it just would have been a real pain during a stressful time. So nice not to have to deal with it.

Second, for most people I think the high deductible ultimately becomes uneconomical if they live long enough. For many of us when we get to 65 we are used to having had good health and not spending much on doctor's visits, etc. We think a high deductible plan will save money. And for awhile that is true for many. But as you get older people did to develop more chronic conditions and have other health issues. Even though I consider my self an overall healthy person I am so glad I didn't have a high deductible plan this year.

 

[CardsFan]

We also have plan G with the $203 deductible. With a history of skin cancer and quarterly visits to the dermatologist, including biopsies and subsequent surgeries, I would blow thru the higher deducible in 4-5 months. So a no brainer for me. Could be a wash for DW.

Keep in mind you might not be able to change from the HD plan to the low Deductible plan at a later date. Underwriting may be required. So about $150 each for peace of mind: Priceless.

 

[teej1985]

We have Plan G and pay the $203 Part B deductible.

From what I'm reading the Plan G HD is similar except that you pay the first $2,573 ($203 Part B deductible + $2,370 Plan G deductible).

So let's say that the Plan G is $200/month and the Plan G HD is $75/month... you save $1,500 in premium but are exposed to $2,370 in additional deductible.

So far in 2021, the HD would have been a good deal for me (negligible medical costs) but really bad for DW (very significant medical costs and we have only paid the $203 Plan B deductible).

YMMV. Pick your poison.

The Plan G Deductible is not stacked on top of the Part A and Part B deductibles. You pay whatever the HD deductible is period. So you pay the $203 or whatever deductible plus the 20% that Medicare odes not pay, it's not like a normal HDHP where the plan pays nothing until you pay the deductible.


If one has a large HSA, the HD plan is probably better because medical expenses qualify for tax free HSA distributions, but medigap premiums do not.



Also you are less likely to get hit with rate increases on the HD plan since it's generally a self-selecting healthier pool.

One can also compare the costs for G Vs HD G as one ages, there will become a point where the difference deductible is less than the difference in premiums, and at that point, I don't know why one wouldn't downgrade if they are spending more in additional premium to avoid less deductible.

 

[finnski1]

I am about to sign up for medicare and have narrowed it down to Medigap G or Medigap G High Deductible. I read most of the sticky on Medicare and have watched the Boomer Benefits 6 day videos.

In the sticky some comments were made about normal Medigap G having less hassles compared to to the high deductible and that it may be worth the higher cost. Any thoughts.

I have not contacted the companies, but the .gov page estimated the high deductible being $75/mo (plus the $200 or so max deductible), they estimated the normal as $175 to $650.

The main thing I worry about is that the companies offering high deductible in my state are not that many

Colonial Penn
Humana
Omaha Insurance Co
United American Ins Co.

There are more names that I recognize in the normal plans:

AARP-UNH, which several in the sticky seemed to like
Anthem BC/BS, which I have my ACA with
CIGNA
Colonial Pe3nn
Combined Insurance Company of America
Humana
Omaha
Transamerica (direct)

Any of these to run away from?

Any that you really like?

Some mention "household". What does that mean?

Any actual experience with Boomer Benefits? I wonder if they, or any agent, will steer you to the company that gives them the largest commission.

I am assuming that the only difference between normal and high deductible is the deductible. Is that the case? Could there be things in the fine print to worry about?

Are these standardized, or could there be fine print items between companies?

Thanks in advance for any advice.

Joe

I'm 62 but the DW turned 65 Last November. I went thru the plans and we decided on Plan G. Her costs for the first year are only $136/month with Anthem BCBS here in NH. We assume we may hit the deductible so avoided the HD plan. She usually has enough issues/procedures to justify the higher premium vs. the higher deductible version.

 

[pb4uski]

The Plan G Deductible is not stacked on top of the Part A and Part B deductibles. You pay whatever the HD deductible is period. So you pay the $203 or whatever deductible plus the 20% that Medicare odes not pay, it's not like a normal HDHP where the plan pays nothing until you pay the deductible. ...

Yes, perhaps I worded it poorly, here is how boomerbenefits described it:

As with any new plan, there are looming of questions of how a High Deductible Plan G will stack up against the High Deductible Plan F. Here’s what you need to know about the High Deductible Plan G:

1. Original Medicare will still pay its 80% portion
2. You will pay the other 20% until you satisfy the $2,370 deductible
3. After the out-of-pocket deductible is met, the plan will pay the same benefits as regular Plan G
4. The plan does not cover the Part B deductible (just like Plan G)
5. The annual Part B deductible that you will pay counts toward the total out-of-pocket deductible

So it looks like you pay the first $203 since the plan doesn't cover the Plan G deductible and then 20% of the next $10.700 of claims. $203 +20% x $10,700 = $2,370 total deductible. Still not interested.

https://boomerbenefits.com/medicare...De2Ccm2UWxaV83J1Mb8ZjwLB_aS_dhX4aAn9mEALw_wcB

 

[harllee]

On your list of companies, I wonder if the Omaha company you mention is Mutual of Omaha. DH and I had a regular G supplement with Mutual Of Omaha. After 3 years Mutual of Omaha increased their premiums substantially (30% on one year). So I moved to the G supplement with AARP UHC, much cheaper. DH has a preexisting condition and is stuck with Mutual of Omaha, he is paying about twice what I am with AARP UHC. We used Boomer Benefits to help us moved from Mutual Of Omaha but they were not able to find a company that DH could move to due to his preexisting condition.

 

[SheitlQueen]

I used Boomer Benefits to get my Plan G and Part D. Their agents are paid the same commission no matter who you go through, so there is no benefit to them to recommend one company over the other. They were very helpful to me and I recommended them to my BIL who used them and also highly recommends them. I went with G through AARP/UHC. They include a gym membership and Boomer reviewed the history of their annual increases and how they do increases. I've been very happy with them. Boomers just called me to see if I was still happy with everything or did I want to look at any other options. I asked them about the Phillips cpap recall and did they have any info with Medicare. The lady I spoke to said she would have someone try to call me and sure enough within 15 minutes my phone rang. I was driving so I missed the call but they have tried several times to reach me as well as emailed me. I need to get back to them but I appreciate their quick response.

 

[Marita40]

I always project “worse case scenario” and in that case the HD plan was more expensive than the regular plan(we don’t have G here in MN but an equivalent). I am currently in the process of signing up for it. All in all, with Part D added in and my higher salary in 2019 ratcheting up the cost, Medicare is a higher monthly expense than I had thought. Still, with a chronic health issue, I want excellent coverage.

 

[Telly]

.....Any actual experience with Boomer Benefits? I wonder if they, or any agent, will steer you to the company that gives them the largest commission.

Oh joe, what a skeptic you are!

I came real close to pulling the plug on BB. In other threads, I outlined Mutual of Omaha and some of the other names they cycle their policies through as they play "The book game". When I was turning 65, BB's top recommendation was MoO. I went with it, I did not know then about the book game, and that MoO runs a big agent special commission system behind the scenes. BB strongly talked down AARP/UHC at the time, the agent said "we really don't do anything with them". Well, after a bit of time, MoO closed the book on me, and then rates were going up fast.

I did more research on my own, and decided to go through medical underwriting and try to switch to AARP/UHC. I called BB, and told them that I was very unhappy with the result of their recommendation, and I wanted to switch. I had made up my mind that if they did not get on board with my request, I would drop them. I got a run around for a bit, that they wanted to "shop around" for me "to find a better 'deal'". No thanks. I already got "dealed" once! And if you think of it, the whole "shopping around for a better deal" if your rates go up is flawed. The only way it works is if you can pass medical underwriting of the insurance company to switch to. Yeah, and as we get older, how long will THAT last? And for those with medical conditions already at age 65, it's a non-starter beyond the initial age 65 guaranty period. The concept seems Pollyanna to me. Makes good press to customers who don't think too deeply, I guess.

The BB agent relented and went with my choice, just seconds short of me pulling the plug.

Don't let your guard down. It, like many/most, is a business driven by sales and commissions. Caveat emptor.

 

[Telly]

joe, since you are looking at both Plan G and Plan G-HD, why not also look at Plan N? Plan N has lower rates than G, looks like it tends to have lower rate increases than G, and does not have the big deductible issue of G-HD.

 

[Cat-tirement]

MIL has plan G through Omaha Insurance (yes, affiliated with Mutual of) for about 4 years. There was about a 15% increase when she turned 86. Don’ t know about their customer service as there have never been any problems.

 

[RetMD21]

Oh joe, what a skeptic you are!

I came real close to pulling the plug on BB. In other threads, I outlined Mutual of Omaha and some of the other names they cycle their policies through as they play "The book game".......

Don't let your guard down. It, like many/most, is a business driven by sales and commissions. Caveat emptor.

Is there any reason not to just go directly with AARP/UHC? I am not sure what value BB or others add. I did have issues with providers claiming that they didn't get their 20% from my mother's employer sponsored traditional medicare supplement. At one point I even went to the insurer web site and downloaded transactions to disprove their position. Would a broker help with that?

 

[Telly]

Is there any reason not to just go directly with AARP/UHC? I am not sure what value BB or others add. I did have issues with providers claiming that they didn't get their 20% from my mother's employer sponsored traditional medicare supplement. At one point I even went to the insurer web site and downloaded transactions to disprove their position. Would a broker help with that?

Some of the brokers say that they will help you with problems such as billing problems. BB says they do, though the only problem I have had in using Medicare I went after myself... Dermatologist has a third-party billing company which seems to be run as a distributed collection of loosely-coupled incompetents. I read them over the phone what Medicare had already paid them, same with what AARP/UHC had paid them. After me hounding the billing company every two weeks over the phone, they finally relented and went with my numbers, which were correct.
Another internet broker is Chris Westfall's Senior Savings Network in South Carolina.

 

[pb4uski]

We have Plan G and pay the $203 Part B deductible. ...

So far in 2021, the HD would have been a good deal for me (negligible medical costs) but really bad for DW (very significant medical costs and we have only paid the $203 Plan B deductible).

YMMV. Pick your poison.

Just received DW's Medigap claim summary for 1/6/21 to 4/8/21.... providers billed $14,724... we only paid $203.

 

[audreyh1]

Oh joe, what a skeptic you are!

I came real close to pulling the plug on BB. In other threads, I outlined Mutual of Omaha and some of the other names they cycle their policies through as they play "The book game". When I was turning 65, BB's top recommendation was MoO. I went with it, I did not know then about the book game, and that MoO runs a big agent special commission system behind the scenes. BB strongly talked down AARP/UHC at the time, the agent said "we really don't do anything with them". Well, after a bit of time, MoO closed the book on me, and then rates were going up fast.

I did more research on my own, and decided to go through medical underwriting and try to switch to AARP/UHC. I called BB, and told them that I was very unhappy with the result of their recommendation, and I wanted to switch. I had made up my mind that if they did not get on board with my request, I would drop them. I got a run around for a bit, that they wanted to "shop around" for me "to find a better 'deal'". No thanks. I already got "dealed" once! And if you think of it, the whole "shopping around for a better deal" if your rates go up is flawed. The only way it works is if you can pass medical underwriting of the insurance company to switch to. Yeah, and as we get older, how long will THAT last? And for those with medical conditions already at age 65, it's a non-starter beyond the initial age 65 guaranty period. The concept seems Pollyanna to me. Makes good press to customers who don't think too deeply, I guess.

The BB agent relented and went with my choice, just seconds short of me pulling the plug.

Don't let your guard down. It, like many/most, is a business driven by sales and commissions. Caveat emptor.

Pretty much your story got to us in time. And we researched the pricing and the increases likely with AARP/UHC and totally didn’t want to experience an MoO runaround. And told BB we wanted UHC even though they pointed out cheaper options.

I appreciate your reporting on this issue. It really helped us!

 

[teej1985]

Just received DW's Medigap claim summary for 1/6/21 to 4/8/21.... providers billed $14,724... we only paid $203.

Who cares what they billed? What did the Medigap actually pay?

If you were billed 14,274, I'm guessing it was a lot less.

 

[Bamaman]

Which plan to choose often correlates to how healthy we are. And what's your future estimates of your cost of healthcare.

My wife and I have been on Plan F with AARP/United Healthcare. My wife's had 7 major surgical procedures done in 3 years, and our payouts have been minimal.

I'm diabetic, and my very expensive insulin pump was up for replacement under Plan B. Supplies run just over $2K a year, and insulin vials were costing $2500 a quarter. I was paying 20%.

We knew my wife was having foot surgery, and Medicare was going to pay $2500 for an electric wheel chair.

We switched from Plan G to Plan F because there are no deductibles on Plan B. Then Trump negotiated with the insulin companies to put insulin vials on Plan D for $105 max. per quarter--a big savings over $505.

My wife fainted Wednesday, and we took her to the emergency room. They've done every heart related test known to man, and it ended up being an arrhythmia issue. And we'll never pay a deductible or even see a bill. There's no telling how much the visit cost.

So you can see in our case, Plan F is the one for us.

 

[grasshopper]

Between medigap F an G if the cost per year for F is more than the $203(2021) deductible then G is the better deal.

Every year it's a little iffy.

 

[audreyh1]

Just received DW's Medigap claim summary for 1/6/21 to 4/8/21.... providers billed $14,724... we only paid $203.

Who cares what they billed? What did the Medigap actually pay?

If you were billed 14,274, I'm guessing it was a lot less.

Yeah, the initial bill is meaningless. It’s always outrageous. Then there is what Medicare says is the cost.

You paid your deductible for the year. Your plans paid the rest.

 

[audreyh1]

That whole insulin racket was outrageous. Probably still is even with the price negotiated down to what it used to be for Medicare patients.

It’s even possible to reduce US insulin demand. A lot of type 2 diabetics are able to reduce or even stop their insulin use via diet. But it’s still not a common treatment. The UK is having more obvious success with this approach.

Type 1 diabetics however, are always going to need some.
https://www.businessinsider.com/ins...tion-drug-so-expensive-pharma-industry-2019-1

 

[CRLLS]

Which plan to choose often correlates to how healthy we are. And what's your future estimates of your cost of healthcare.

My wife and I have been on Plan F with AARP/United Healthcare. My wife's had 7 major surgical procedures done in 3 years, and our payouts have been minimal.

I'm diabetic, and my very expensive insulin pump was up for replacement under Plan B. Supplies run just over $2K a year, and insulin vials were costing $2500 a quarter. I was paying 20%.

We knew my wife was having foot surgery, and Medicare was going to pay $2500 for an electric wheel chair.

We switched from Plan G to Plan F because there are no deductibles on Plan B. Then Trump negotiated with the insulin companies to put insulin vials on Plan D for $105 max. per quarter--a big savings over $505.

My wife fainted Wednesday, and we took her to the emergency room. They've done every heart related test known to man, and it ended up being an arrhythmia issue. And we'll never pay a deductible or even see a bill. There's no telling how much the visit cost.

So you can see in our case, Plan F is the one for us.

It is not quite as easy as figuring out what your medical needs are now, in most cases one must bet on on what your medical needs will be in the future. In the name of blow that dough, this seems to me to be a poor place to be gambling on Medigap plans. Go for the best you can afford. Your Plan F was that plan when you entered.

Between medigap F an G if the cost per year for F is more than the $203(2021) deductible then G is the better deal.

Every year it's a little iffy.

A couple years back, we switched from F-HD under BCBS to G under AARP-UHC. Yes, we had to go thru medical underwriting. Last year I had my gallbladder removed at a rack rate of over $70k. I also had Back problems and 4 months of PT. Boy am I glad that I was on Plan G. Between Medicare's reduced price per procedure and the AARP-UHC I paid the Medicare deductible of $198 and that was it.

One thing to consider is, unlike a traditional insurance we got thru our employer, under Medicare, the deductibles are per person, not per family. When we got our F-HD plan we planned on each of us meeting our deductibles every other year. assuming deductible of ~2k per person per year, the upcharge from F-HD to F in premiums exceeded that amount so it was budgeted into our plans. When Medicare closed Plan F to new applicants, the writing was on the wall. No fresh blood into the plan means much higher annual increases in the future, so we switched while our health was still fairly good.

Repeat, Plan F is no longer open to new applicants. Plan G is today's "Gold Standard" plan.

 

[finnski1]

Between medigap F an G if the cost per year for F is more than the $203(2021) deductible then G is the better deal.

Every year it's a little iffy.

If you're new to medicare after Jan1 2020, such as DW who turned 65 in Nov 2020, you aren't even eligible for Plan F.

 

[grasshopper]

If you're new to medicare after Jan1 2020, such as DW who turned 65 in Nov 2020, you aren't even eligible for Plan F.

My comment was for a comment that there is no deductible with F. True but I am sure the deductible is just built into the higher price of the F policy premium.

I switched from F to G 3 years back, when BCBS said they would switch me with no underwriting.