Supplement Medicare plan questions

[Telly]

......We’ve been happy with/no issues with Mutual of Omaha for 4 years now, again I’m amazed at what’s covered and how low our out of pocket costs have been......

"what's covered" is set by CMS, and all Medigap providers must conform. It's not at an insurance companies discretion.

"how low our out of pocket costs have been" - if you mean what's left over after coverage, for you to pay, that's set by CMS's coverage actions. Again, not at any Medigap insurance companies discretion.

I'm curious... when you signed up with MoO, what was the exact name of the insurance company?
Do you know if any years previous there was no increase in premium for someone age 65 just entering Medicare, for the exact same name company as you signed up with?
Is MoO now selling Medigap plans in your state under the exact same name as the one you signed up with?

In my state, I had signed up with United World. They closed it shortly after, and OSIC, Omaha Supplemental Insurance Company, was born with "exciting competitive rates". I think they since have moved on from OSIC to another company name. All completely legal, as "everyone in your state under the same policy" is subjected to the same increases, you're not singled out. Cease writing policies under one name, start writing policies under a different name. Legal, yes. Ethical, not by me. It's a novel turn on bait and switch.

This duck said unkind words, flexed his wings, passed underwriting, and flew away. Unfortunately, harllee's DH could not, along with many others with similar health status parameters. We can be healthy today, and not tomorrow/next year/whatever.

If it looks like a duck and walks like a duck, it's a duck.
If it looks like a turd and smells like a turd, it's a turd.
I apologize for my uncouth textual use of excrement here, ER.Org's smilies collection did not have a smilie for a pile, which I would have preferred to use instead.

 

[Peter]

Does MediGAP 'G' or 'N' cover glaucoma. I do not have it but my grandmother on my dads side did and he did. He smoked. His brother did not smoke but also had glaucoma. Both had that fixed and could see perfect afterwards. I do not smoke or drink.

Yes it does.

 

[harllee]

Is it worth becoming a resident somewhere else for a year to switch it?

I guess it depends how much they jack up the premiums...

We actually considered moving to a state that would had the birthday rule to allow DH to switch to a different company but I have a mother in her 90s here in NC and I could not leave her, I am her POA and spend a lot of time with her.

 

[MBSC]

If my/DH premiums increase to the point we're not satisfied, with the IL birthday rule, we can switch to Mutual of Omaha plan N with no medical underwriting. We currently have plan G. I assume they have to offer us the same rate they're offering new customers.

Please refer back to post #40 by Youbet which describes the watered down IL Birthday Rule in detail.

1) Most Medigap enrollees are >75 when the premium becomes an issue. The IL birthday rule is not available to these enrollees due to the age 75 cap.

2) If you change before then, it must be with the same company. There is no birthday rule if MOO is using a different company at the time you want to change to Plan N. (The same applies to Aetna and Cigna which also rotate companies but have a much smaller market share). Louisiana enacted a similar 'same company' birthday rule in 2022 but recognized this flaw and has new legislation effective 8/1/23 to include affiliates of the enrollee's current insurer.

Illinois
Annual Open Enrollment lasting 45 days, beginning on an individual’s birthday, during which time a person may replace an Omaha Insurance Company Medicare supplement policy...This option is not available on closed blocks.

Source (page 10): https://blogs.mutualofomaha.com/express/files/2022/11/604504_102722_Underwriting_Guide.pdf

LA HB235 [Signed into law as LA Act 71]

Bill Summary
To amend and reenact R.S. 22:1112(A)(1), relative to the guaranteed issue of Medicare supplement policies; to authorize an individual to purchase a Medicare supplement policy offered through an affiliate of a health insurance issuer.

Source: https://www.billtrack50.com/billdetail/1612460/17934

 

[harllee]

Here in NC when DH and I got Mutual Of Omaha supplemental insurance 7 years ago the name was Mutual of Omaha. They closed the book on us when were we 70, quit selling under Mutual of Omaha and now sell under the name of Omaha Insurance. They will probably close that book in the next few years, looks like they close the book every 5 years or so.

 

[MBSC]

As I understand it the issue is not the underwriting prerequisite to change plans, it’s Mutual of Omaha punitive pricing and the enrolled have no option to change.

In several threads, it has been previously pointed out that Harllee's DH can change to a less expensive Medigap in 3 steps.

1) Enroll in an Advantage plan during AEP.

2) After a month or two, become dissatisfied with the MA and dis-enroll using the one-time only MA "trial right".

3) The enrollee is supposed to get their old Medigap plan back. But, he can't get his Medigap back because the old Omaha company is no longer accepting applications. This gives him a guaranteed-issue right to another Medigap at the preferred rate. This is not a DIY project as the stand-alone Part D enrollment has to be completed at a specific step. Most experienced brokers who sell both MA and Medigap are familiar with the process.

If you have a guaranteed issue right, an insurance company:

* Must sell you a Medigap policy
* Must cover all your pre-existing health conditions
* Can't charge you more for a Medigap policy because of past or present health problems

You have a guaranteed issue right if You dropped a Medigap policy to join a Medicare Advantage Plan for the first time, you’ve been in the plan less than a year, and you want to switch back.

You have the right to buy the Medigap policy you had before you joined the Medicare Advantage Plan, if the same insurance company you had before still sells it.

If that policy isn’t available, you can buy Medigap Plan A, B, C*, D*, F*, G*, K, or L that’s sold by an insurance company in your state.

Source: https://www.medicare.gov/health-drug-plans/medigap/ready-to-buy

Due to DH's medical condition he cannot pass underwriting and I guess is stuck with his existing policy...

There may be a way if you can find a good agent willing to work with you. The strategy is spelled out in some detail in this thread:

Medigap underwriting loophole?

This is not something new and not some hidden secret. Here is an 11 year old post on another forum where the agent could not use the trial right to get someone off MOO because they previously had an MA plan.

Male, 73, tobacco with COPD.

Has MOO plan N.

Rates increased twice this year.

Considered trial right but he had an MA plan a few years ago and has no desire to go back.

Any other way to get him out of MOO and in to another plan with another carrier?

somarco, Jul 17, 2012

 

[REWahoo]

MBSC, thanks for reminding us about about this single-use "escape clause" which enables those in situations like harlee's DH to bypass underwriting. Much appreciated.

 

[harllee]

In several threads, it has been previously pointed out that Harllee's DH can change to a less expensive Medigap in 3 steps.

1) Enroll in an Advantage plan during AEP.

2) After a month or two, become dissatisfied with the MA and dis-enroll using the one-time only MA "trial right".

3) The enrollee is supposed to get their old Medigap plan back. But, he can't get his Medigap back because the old Omaha company is no longer accepting applications. This gives him a guaranteed-issue right to another Medigap at the preferred rate. This is not a DIY project as the stand-alone Part D enrollment has to be completed at a specific step. Most experienced brokers who sell both MA and Medigap are familiar with the process.



This is not something new and not some hidden secret. Here is an 11 year old post on another forum where the agent could not use the trial right to get someone off MOO because they previously had an MA plan.

Thanks for reminding me of this. How do I find a broker in NC familiar with this process? No broker I have talked to knew about this, even Boomer Benefits did not know about it.

 

[CWradio]

Thanks for reminding me of this. How do I find a broker in NC familiar with this process? No broker I have talked to knew about this, even Boomer Benefits did not know about it.

The broker I spoke to about this said" the commision was to low for them to do"

 

[youbet]

DH tried for months to change to another company after Mutual of Omaha substantially increased his premium, applied to several other companies, even got Boomer Benefits involved, but no new company would take him. He has had psoriatic arthritis for 40 years and it is controlled by medication but could not pass underwriting. He had no other health issues. My point is to look at the company you are initially signing up with to make sure they are not known for closing the books like Mutual of Omaha does. Your state of Illinois has the birthday rule which allows you to change annually without underwriting. We do not have that here in NC

Illinois’ birthday rule law does not allow you to change providers.

 

[sengsational]

So I’m not sure why your keep bashing Mutual of Omaha for a practice that most/many underwriters in most states follow. Seems like your beef is with the rule. What am I missing?

https://www.medigap.com/faqs/medicare-birthday-rule/

The birthday rule (in those few states that have it) prevent the business practice that Mutual of Omaha (and some other insurance companies) use.

I think what might not be clear is that Mutual of Omaha chooses to "close the book", which results in a sick duck pool. Some companies, I suppose, aren't so quick or simply don't employ the business practice. I believe the business practice is disingenuous because they price very low, fill up the pool, and while people are younger and healthier, everything is fine. But when claims start coming in and the rates rise and then sales fall-off due to the higher price, they don't accept the reduced sales. Rather, they open a separate company with a low price again.

It might be possible to get a list of all active medigap policies in one's state (not just policies being currently sold), and look for companies (searching parent companies) that have multiple entries. These are companies that have been closing the book. One can expect that behavior to continue.

 

[CRLLS]

The birthday rule (in those few states that have it) prevent the business practice that Mutual of Omaha (and some other insurance companies) use.

I think what might not be clear is that Mutual of Omaha chooses to "close the book", which results in a sick duck pool. Some companies, I suppose, aren't so quick or simply don't employ the business practice. I believe the business practice is disingenuous because they price very low, fill up the pool, and while people are younger and healthier, everything is fine. But when claims start coming in and the rates rise and then sales fall-off due to the higher price, they don't accept the reduced sales. Rather, they open a separate company with a low price again.

It might be possible to get a list of all active medigap policies in one's state (not just policies being currently sold), and look for companies (searching parent companies) that have multiple entries. These are companies that have been closing the book. One can expect that behavior to continue.

Sengsational, I may be a bit naïve on this fine point. How does the birthday rule "prevent" MOO's, and possibly others' business practice of closing the book. The way I see it, the birthday rule simply provides the insured a tool to escape the sick duck pool.

 

[stedmakr]

Thanks for reminding me of this. How do I find a broker in NC familiar with this process? No broker I have talked to knew about this, even Boomer Benefits did not know about it.

Harlee, please note the link below. An internet broker who makes informative Medicare videos talks through this process. The reference to trial right exceptions is near the end of the video. The video may come up on its own.

 

[Davidhelp]

I received this email today. He mentions that:

"The prices are all the same from one agent to the next.

Anyone know if this is true as I see difference in price?

Hello -------,
You recently visited our website boomerbenefits.com, and asked for an agent to contact you with quotes.
Our agency specializes in Medicare products, and offers over 30 different insurance companies, so I can provide you with unbiased information on all your options.

Schedule a callback appointment at a time that works for you here. I am looking forward to simplifying the information to help you make an informed decision. You can also call me directly, anytime, at (682)---------

Remember that shopping for a Medicare policy is not like shopping for a car. The prices are all the same from one agent to the next.

Something that we offer that our competitors don’t is our Legendary Client Service Team. You can read about the free claims support for life that you’ll get here: https://boomerbenefits.com/client-service-team/

 

[Texas Proud]

Kinda true... but I did get different quotes from the two agencies that I contacted from some companies but not by much... maybe a dollar or two...


BUT, BB did not give AARP/UHC and did not want to get a quote for me...



These are agents, so they do not have to give quotes from everybody... just be aware of what you will get from them...

 

[Midpack]

In reply to several posts, when I enrolled in my Plan G 2019 it was with Mutual of Omaha. A year or two later I was being billed by United World Life Insurance Company, I remember being puzzled as to why at the time (2020?) but I didn't follow up. When DW enrolled to piggyback (10% discount) off my plan G in 2021, she was (and still is being) billed by Mutual of Omaha.

I pulled out my file and noticed this (below) in the Mutual of Omaha privacy statement, though I assume not all are Medigap entities?

I've heard enough that I want to look into changing providers soon since we can pass underwriting now. But I don't want to go to the effort only to find out the next provider would do the same thing harlee & her DH is faced with. It appears from posts above Aetna and United Health use the same practice...

 

[Dash man]

In reply to several posts, when I enrolled in my Plan G 2019 it was with Mutual of Omaha. A year or two later I was being billed by United World Life Insurance Company, I remember being puzzled as to why at the time (2020?) but I didn't follow up. When DW enrolled to piggyback (10% discount) off my plan G in 2021, she was (and still is being) billed by Mutual of Omaha.



I pulled out my file and noticed this (below) in the Mutual of Omaha privacy statement, though I assume not all are Medigap entities?



I've heard enough that I want to look into changing providers soon since we can pass underwriting now. But I don't want to go to the effort only to find out the next provider would do the same thing harlee & her DH is faced with. It appears from posts above Aetna and United Health use the same practice...

The Senior Savings Network appears to be a good agency, as many of his videos highlight things others ignore. Christopher Westfall is the owner of the agency.

https://seniorsavingsnetwork.org

 

[Texas Proud]

I think that AARP/UHC does not do the same as it is community rated... it is one reason I went with them...



I could be wrong but would want to see some proof...

 

[teej1985]

In reply to several posts, when I enrolled in my Plan G 2019 it was with Mutual of Omaha. A year or two later I was being billed by United World Life Insurance Company, I remember being puzzled as to why at the time (2020?) but I didn't follow up. When DW enrolled to piggyback (10% discount) off my plan G in 2021, she was (and still is being) billed by Mutual of Omaha.

I pulled out my file and noticed this (below) in the Mutual of Omaha privacy statement, though I assume not all are Medigap entities?

I've heard enough that I want to look into changing providers soon since we can pass underwriting now. But I don't want to go to the effort only to find out the next provider would do the same thing harlee & her DH is faced with. It appears from posts above Aetna and United Health use the same practice...

UHC, USAA, StateFarm, Globe, United American, BCBS are all companies that don't seem to participate in those shenaigans.

 

[Davidhelp]

I signed up for supplemental medicare today.
Here is what I got. I went thru Boomer Benefits https://boomerbenefits.com and called an agent.

Anthem Blue Cross - Part G = $141.75
Mutual of Omaha - dentist = $31.82
Wellcare Part D = $8.30
Total = $181.87
Medicare Part A & B = $164.90
Grand Total = $347.30 a month.

Part B deductible = $226.00
Drug deductible = $505.00

 

[teej1985]

I signed up for supplemental medicare today.
Here is what I got. I went thru Boomer Benefits https://boomerbenefits.com and called an agent.

Anthem Blue Cross - Part G = $141.75
Mutual of Omaha - dentist = $31.82
Wellcare Part D = $8.30
Total = $181.87
Medicare Part A & B = $164.90
Grand Total = $347.30 a month.

Part B deductible = $226.00
Drug deductible = $505.00

Interesting. Did you not find advantageous pricing from State Farm?

 

[Davidhelp]

The difference was about $4 from the state farm quote for part G.

 

[Scuba]

Thanks for starting this, OP. We are going to have to get serious about researching this soon for DH. He turns 65 in March 2024.

We already know we want to go with traditional Medicare plus supplemental insurance. It sounds like Plan G will be the best we can get since Plan F is no longer available for new Medicare enrollees? And he will also need Part D for prescriptions?

If he enrolls initially in CA and then we move out of state, likely to FL, how will we know if he has guaranteed issue rights? He had quadruple bypass surgery in 2022. Would we be better off moving before he needs to enroll?

 

[Davidhelp]

I was told if I move I am covered everywhere. Call Boomer Benefits. It costs nothing to ask questions. If you decide to go with their suggestions they will send you emails with links to sign up to various plans you decided on.

 

[Midpack]

Thanks for reminding me of this. How do I find a broker in NC familiar with this process? No broker I have talked to knew about this, even Boomer Benefits did not know about it.

That’s disappointing to hear. Maybe I’ll give Senior Savings Network a try this time. You’ve enlightened many of us here, thank you.