UHC/AARP vs UHC Medigap

[FiveDriver]

Plan N has an up to $20 copay for office visits, but not lab work, imaging and such.
Excess charges are rare and easy to avoid, but even if you get one, it’s usually only a few dollars. 96% of doctors don’t charge excess charges, and seven states, including PA where I live, don’t permit excess charges. All you have to do is ask if the doctor accepts Medicare assignment to avoid them completely.

This entire thread contains some valuable information....I'd almost say it's worthy of a sticky.

Yesterday in the US Mail, came a nice informative package from South Carolina Blue Cross. It has a decision tree in flow-chart form, asking questions like --

"Are you willing to pay a percentage of hospital bills for a lower premium?"
A Yes response leads to Plan G-HD, No Response leads down a different path.

"Would you be willing to pay $20 copay for lower premium?"
Yes Response leads to Plan N. No leads to Plan G.

Followed by a Table with what each Plan pays.

Not saying we'll sign-up with SC Blue Cross, but this flow chart is about as much info in one place that I've ever seen. The lowest cost provider based on my phone calls would be UHC/AARP. I will check out United American Co, on Monday for their quotes.

Still not sure about the actual savings on Monthly Premiums when using High Deductible Plans. Or if it's easy to switch out of HD at some point down the road.
Nor do I have a clear answer on what is the catch with a Medicare Advantage Plan. I've been on MA for 8 years with near Zero Dollar cost.

 

[Texas Proud]

I just called UHC, I will be starting in Jan of 2023, and I Live in Florida. There is no discount for multi plans in household.

Kinda surprising as I got a 10% discount for having another AARP person in the house... and NOT on the plan...


If both of us were on the plan it was a 15% discount..


I had mentioned before that calling UHC does not give the cheapest cost for the same plan... they were like $18 more per month that what I got on their website...

 

[MBSC]

I just called UHC, I will be starting in Jan of 2023, and I Live in Florida. There is no discount for multi plans in household.

Kinda surprising as I got a 10% discount for having another AARP person in the house... and NOT on the plan...

If both of us were on the plan it was a 15% discount.

Medigap policies are subject to both state and federal regulations. The Florida Dept of Insurance has different regulations pertaining to household/multi-policy discounts than most other states.

 

[perrytime]

My concern over excess charges revolves around the possibility of serious accident/disease that lands me in hospital and lengthy followup visits to specialists. So picking a doc without excess charges isn't possible in emergency situations, and with bills ( doctor and hospital) that could climb to hundreds of thousands of $, I would think that I might have doctor bills of $100,000. I think that could mean excess of charges well over $10,000. Spending $40 a month more to avoid that was my thinking.

If that's not how it works, I would be glad to hear that. Plan N would be back on my list of consideration.
thanks

 

[Dash man]

My concern over excess charges revolves around the possibility of serious accident/disease that lands me in hospital and lengthy followup visits to specialists. So picking a doc without excess charges isn't possible in emergency situations, and with bills ( doctor and hospital) that could climb to hundreds of thousands of $, I would think that I might have doctor bills of $100,000. I think that could mean excess of charges well over $10,000. Spending $40 a month more to avoid that was my thinking.



If that's not how it works, I would be glad to hear that. Plan N would be back on my list of consideration.

thanks

Do whatever you’re comfortable with. Inpatient hospital charges are covered by Part A, so wouldn’t be an issue. Part B charges could be.
Providers that don’t accept Medicare assignment are paid 95% of what those who do accept Medicare assignment. The 15% is added to the 95%, so it works out to about 9.6% more. Only about 4% of providers don’t accept Medicare assignment, and it’s a lot more administrative work to get paid, plus the hassle of collections for those who don’t pay.
I’m in a state that doesn’t allow excess charges, plus I’m concerned about the premium increases over time. So Plan N is a no brainer for me.

Found this on Medicare.gov:
“Medicare won’t pay for items or services you get from provider that opts out, except in emergencies.”

 

[Trooper]

This is a really good thread, and based on it I'm now considering a Plan N vs G.

Question: Can I down the road switch from a Plan N to a G, or would be considered an increase in coverage, thus requiring underwriting?

 

[Dash man]

This is a really good thread, and based on it I'm now considering a Plan N vs G.

Question: Can I down the road switch from a Plan N to a G, or would be considered an increase in coverage, thus requiring underwriting?

You may have to pass underwriting, depending on your state. I can’t imagine it would be difficult if you stayed with the same company since they’ve already taken on the risk. Changing companies could be more difficult. I suggest you ask your supplement provider.

 

[Trooper]

I suggest you ask your supplement provider.

Thanks Dash man. I do not yet have a provider; I turn 65 in February.

 

[Texas Proud]

This is a really good thread, and based on it I'm now considering a Plan N vs G.

Question: Can I down the road switch from a Plan N to a G, or would be considered an increase in coverage, thus requiring underwriting?

I was thinking the same thing... and thought the same as Dash man.. I would think that the same company would allow it... but you never know..


I still think the rate between the two will continue to widen where plan G is not something you would want to go to anyhow...

 

[Trooper]

I still think the rate between the two will continue to widen where plan G is not something you would want to go to anyhow...

Do you mean the cost differential between plans G and N will get larger over time? I guess that could happen. My thought around switching from N to G down the road was that as I aged and needed more care, the likelihood of finding providers that didn't accept Medicare assignment would be greater.

 

[baskin]

Advantage vs Supplemental Medicare plans

If you're healthy and not going to get sick often or seriously ill (like transplant) and perhaps suddenly and luckily die in your sleep, Advantage is the way to go. The other big consideration is, what can you afford. My Supplemental Plan at my age is now $330 a month, but I can afford it. A dear friend is not as well off and could not afford a Supplemental so in her case Advantage is the way to go-she really doesn't have a choice.


I can say that after 10+ years, I have yet to see a single medical bill which is great. I take the blood thinner warfarin and home test every two weeks. I don't see a co pay but if I was on an Advantage Plan?


To be real, insurance companies are all blood suckers. Do you really think the Advantage companies can give you the same quality medical care for that much less than a Supplemental Plan?

 

[baskin]

Please double check recent news, but I believe Mayo Clinic in Arizona and Florida have now stopped working with Advantage Plans except in emergencies. Isolated case or a view into the future? https://www.medpagetoday.com/special-reports/exclusives/101320

 

[Texas Proud]

Do you mean the cost differential between plans G and N will get larger over time? I guess that could happen. My thought around switching from N to G down the road was that as I aged and needed more care, the likelihood of finding providers that didn't accept Medicare assignment would be greater.

Yes.... with not many years of info it looks like plan G has a higher % rate increase each year.. that means the cost of G will be more and more the longer you are on it...


Even if the % was the same the gap will increase some... will it matter to you?




I doubt it will be a problem with assignment.. from what I read very few charge it... the insurance agent said it was mental health that she saw it the most... and it if gets way out of whack I bet they would change it...

 

[Trooper]

Plan N has an up to $20 copay for office visits, but not lab tests, imaging and so on.

How does Plan N handle chiropractic visits? I'm on a maintenance plan with my chiropractor, i.e. I go in for an adjustment once a month. Under Plan N would I be billed a $20 copay each time?

 

[Dash man]

How does Plan N handle chiropractic visits? I'm on a maintenance plan with my chiropractor, i.e. I go in for an adjustment once a month. Under Plan N would I be billed a $20 copay each time?

Probably, but it depends on the codes your chiropractor uses. Check with his/her billing office.

 

[Texas Proud]

How does Plan N handle chiropractic visits? I'm on a maintenance plan with my chiropractor, i.e. I go in for an adjustment once a month. Under Plan N would I be billed a $20 copay each time?

An interesting question... but I saw some video that said chiropractic visits were not covered by medicare so...



Interesting to find out.

 

[Dash man]

An interesting question... but I saw some video that said chiropractic visits were not covered by medicare so...



Interesting to find out.

Does this help?

https://www.medicare.gov/coverage/chiropractic-services

 

[Buckeye]

To those of you who have a UHC Medigap policy: have you had any issues getting your bills paid? We have BCBS and have been happy with it, but UHC is quite a bit cheaper for me. My husband is 6 years older, and his UHC rate is actually higher than his current BCBS amount, so I am considering moving just my coverage. We currently have plan F, and may keep that or go to Plan G if possible.

My husband has had an AARP UHC Medigap policy since 2014. He is a low consumer of healthcare but he did get his hip replaced in 2021. Everything has been paid perfectly since 2014. He currently has Plan N.

 

[MBSC]

How does Plan N handle chiropractic visits? I'm on a maintenance plan with my chiropractor, i.e. I go in for an adjustment once a month. Under Plan N would I be billed a $20 copay each time?

Here are the office visit codes subject to the Plan N copay. Check your current EOBs for these codes or the term "E/M - Evaluation and Management".

https://www.cms.gov/Medicare/Health-Plans/Medigap/downloads/Plan_N_Guidance2.pdf

In a typical visit, Medicare only covers Chiropractic manipulative treatment codes 98940-98943, which are exempt from the copay. The Chiropractor would need to perform a “separately identifiable service" before Medicare would also cover an office visit. This would be something like reviewing a new patient's history or established patients with "new conditions, new injuries, aggravation or exacerbation of existing injuries."

This also applies to physical therapy visits.

 

[Buckeye]

How does Plan N handle chiropractic visits? I'm on a maintenance plan with my chiropractor, i.e. I go in for an adjustment once a month. Under Plan N would I be billed a $20 copay each time?

They have historically been covered for DH (with a Plan N copay which is up to $20) but I guess the new chiro who bought the practice of our old chiro hasn't figured out how to bill yet because we have not see a Medicare claim for his 3 visits over 2 months ago.

 

[perrytime]

I just called the number on UNH website, and the agent clearly stated that when I get plan G, a discount is applied, and that discount decreases, so I will see 2 increases, one due to inflation/cost, the other due to discount going away, and it applies to Florida.
The agent said the discount would not start decreasing for 3 or 4 years.
That does contradict what was posted here. I am always concerned the agents I talk to are accurate in answers. So maybe I will try again in a few days. Maybe UHC can claim the discount just goes away, and it is not an age based increase?
Can anyone here, in Florida, with 3 or 4 years of UHC plan G premiums comment?


the above is a follow up to the earlier post -

Originally Posted by perrytime View Post
...My understanding is UHC considers real rate much higher than what you pay first year, something like a 35% discount is given that goes away with age, that increase, and normal rate increases due to inflation/etc may mean UHC rates will go up faster than others.
Medigap policies written in FL are "issue-age" so they have inflation increases but not annual age increases. The UHC disappearing discount is only used in states that allow attained-age plans in order to compete with their low initial rates, so it doesn't exist in Florida. The ~$188 quote is "the rate" and will increase for inflation.

 

[MBSC]

I just called the number on UNH website, and the agent clearly stated that when I get plan G, a discount is applied, and that discount decreases, so I will see 2 increases, one due to inflation/cost, the other due to discount going away, and it applies to Florida.
The agent said the discount would not start decreasing for 3 or 4 years.
That does contradict what was posted here. I am always concerned the agents I talk to are accurate in answers.

Here are two screen shots from UHC.com. One shows a $2 ACH discount for a Florida zip code. The other a South Carolina zip code showing the premium cut in half due to the decreasing discount.

 

[perrytime]

very interesting, certainly supports info posted here.

 

[Texas Proud]

I just called the number on UNH website, and the agent clearly stated that when I get plan G, a discount is applied, and that discount decreases, so I will see 2 increases, one due to inflation/cost, the other due to discount going away, and it applies to Florida.
The agent said the discount would not start decreasing for 3 or 4 years.
That does contradict what was posted here. I am always concerned the agents I talk to are accurate in answers. So maybe I will try again in a few days. Maybe UHC can claim the discount just goes away, and it is not an age based increase?
Can anyone here, in Florida, with 3 or 4 years of UHC plan G premiums comment?


the above is a follow up to the earlier post -

Originally Posted by perrytime View Post
...My understanding is UHC considers real rate much higher than what you pay first year, something like a 35% discount is given that goes away with age, that increase, and normal rate increases due to inflation/etc may mean UHC rates will go up faster than others.
Medigap policies written in FL are "issue-age" so they have inflation increases but not annual age increases. The UHC disappearing discount is only used in states that allow attained-age plans in order to compete with their low initial rates, so it doesn't exist in Florida. The ~$188 quote is "the rate" and will increase for inflation.

Go on their website and see what the rate is.... mine was $10 to $15 a month less than the agent gave me over the phone...


My discount was either 40% or 45%.... cannot find the letter quickly and do not want to spend my time... it was set for 2 or 3 years and then started to go away at 2% for awhile and then 3%....


The stated rate was over $200... like $230 ish...