Private Healthcare Markets and Medigap Plans Question

[Katiek]

My Megacorp moved retiree health insurance to one of the large private healthcare markets. They'll give you a certain amount of money to purchase your plans on the marketplace once you qualify for Medicare.


I'm not yet retired or eligible for medicare, but I have a general question regarding medigap plans. Megacorp will give some subsidy for purchasing medigap plans on the private marketplace, but what happens if I start with one of their plans to get the subsidy, but it later turns out that even with a subsidy the price is more than a generally available plan?


If I decided to switch at that point, it appears there is no "guarantee issue" and there could be medical underwriting by the new company. So if I start with a medigap plan on a private marketplace, am I pretty much locked into that plan?


Does anyone have experience with these plans on a private marketplace and how they compare to plans generally available through AARP or just generally available?


Thanks in advance for any advice or experience people may have on this issue.

 

[Another Reader]

Most companies use Via Benefits. They offer many of the same plans as are available in the general marketplace. Pricing is similar. Rules for medical underwriting vary by state as do the plans and their prices. Prices can vary locally as well.

I have the AARP UHC Plan F supplement. The price is similar to that for purchasing through an agent.

There are a couple of good threads on shopping plans here. If you are locked into Via Benefits, you won't be able to use Boomer Benefits or Senior Savings Network, two of the largest customer-oriented insurance agencies specializing in Medicare supplement plans. Senior Savings Network has some good videos about Medicare supplements that are worth watching.

 

[Katiek]

Thank you for the response. I believe it is Via Benefits, and the subsidy from MegaCorp is a fixed amount (not a per year amount) and it's not that much. So if there was a big benefit to buying on the open market, sacrificing the subsidy isn't that big of a sacrifice (especially if I use some of it to buy insurance pre-Medicare).



But it sounds like any concern about guaranteed issue would be the same with any marketplace or any plan that raises its rates disproportionately.

 

[MichaelB]

Here’s a discussion on Via Benefits from late last year. http://www.early-retirement.org/forums/f38/via-benefits-formerly-one-exchange-94967.html

 

[Katsmeow]

I use ViaBenefits. You need to check exactly what you can use your subsidy for. In my case, it could be used for 4 things:

1. Medicare Supplement bought through Via Benefits.
2. Prescription Drug Plan bought through Via Benefits.
3. Medicare Part B premium
4. Vision/dental plan bought through Via Benefits.

What you can spend your money on at ViaBenefits may vary though so you need to check.

I ended up buying a prescription plan from them and paying my Part B premium with them.

I was not impressed with most of their supplements. They did offer AARP UHC at the same price I could get directly from UHC. I was getting a household discount though and I was worried about them screwing it up so I thought it was safer to just get reimbursed for Part B premiums from them.

Another Reader said "They offer many of the same plans as are available in the general marketplace. Pricing is similar." With the exception of AARP UHC that was not my experience. They plans from the same companies as in the general marketplace. But the pricing was not the same. For example, for one plan, they were charging much more than the pricing for that company in the general marketplace. What appeared to be the issue was that the plan number being sold by Via Benefits had higher premiums than the same supplement sold elsewhere by the same carrier. Here is a link to discussion on my dealings with Via Benefits. Some of the posts unearth this pricing issue:

http://www.early-retirement.org/forums/f38/which-medigap-plan-insurer-texas-95604.html

Look specifically at posts 8 and 14. It really looks like ViaBenefits was using plans that were more costly. Specifically they had a plan from Humana that was way more expensive than the Humana you could buy on the open market. ViaBenefits was selling one under a different (higher) rate plan.

All of which is why I used my supplement for the prescription plan and the Part B premiums.

 

[Katiek]

Thank you for the links and for sharing your experiences. I'm still working. so for the moment, I'm just trying to gather info for planning purposes, but you never know when you may need to implement plans sooner than you expected.

 

[Another Reader]

I use ViaBenefits. You need to check exactly what you can use your subsidy for. In my case, it could be used for 4 things:

1. Medicare Supplement bought through Via Benefits.
2. Prescription Drug Plan bought through Via Benefits.
3. Medicare Part B premium
4. Vision/dental plan bought through Via Benefits.

What you can spend your money on at ViaBenefits may vary though so you need to check.

I ended up buying a prescription plan from them and paying my Part B premium with them.

I was not impressed with most of their supplements. They did offer AARP UHC at the same price I could get directly from UHC. I was getting a household discount though and I was worried about them screwing it up so I thought it was safer to just get reimbursed for Part B premiums from them.

Another Reader said "They offer many of the same plans as are available in the general marketplace. Pricing is similar." With the exception of AARP UHC that was not my experience. They plans from the same companies as in the general marketplace. But the pricing was not the same. For example, for one plan, they were charging much more than the pricing for that company in the general marketplace. What appeared to be the issue was that the plan number being sold by Via Benefits had higher premiums than the same supplement sold elsewhere by the same carrier. Here is a link to discussion on my dealings with Via Benefits. Some of the posts unearth this pricing issue:

http://www.early-retirement.org/forums/f38/which-medigap-plan-insurer-texas-95604.html

Look specifically at posts 8 and 14. It really looks like ViaBenefits was using plans that were more costly. Specifically they had a plan from Humana that was way more expensive than the Humana you could buy on the open market. ViaBenefits was selling one under a different (higher) rate plan.

All of which is why I used my supplement for the prescription plan and the Part B premiums.

That's interesting. I compared the four plans that interested me and the differences were zero to $2.00 a month between ViaBenefits and the plans sold by independent agents. I'm in California, so it's possible the regulatory environment is different.

 

[kaneohe]

My Megacorp did the same yours did. In the beginning I compared AARP UHC
Plan F w/ AARP UHC directly and thru Extend Health (now VIA) and the prices were identical so I let VIA handle it. For us it seemed to simplify reimbursements which became automatic for the plans handled by them.....
the supplement and the Rx plan. For Medicare B it is quasi-automatic.......we have to file a request annually showing the new Medicare charge.

Interestingly changes in the supplement/Rx plans seemed to be handled differently. I changed Rx plans from one Humana plan to another on my own.
Reimbursement which used to be automatic then ceased. Since the subsidy was not huge, the Medicare and supplement ate up the subsidy so I never did the manual reimbursement request for the Rx plan monthly.

However when I changed from AARP UHC Plan F to AARP UHC Plan G on my own, the reimbursements kept coming so somehow continuity was maintained by AARP UHC /VIA without any action from me.

The subsidy turned out (probably planned) to be a good deal for Megacorp.
Initially it was more than we were getting when Megacorp handled the insurance themselves so we were happy. Over the yrs as rates have gone up (and subsidy remained fixed) Megacorp has benefited.

 

[Katsmeow]

That's interesting. I compared the four plans that interested me and the differences were zero to $2.00 a month between ViaBenefits and the plans sold by independent agents. I'm in California, so it's possible the regulatory environment is different.

That could well be the case.