Help With Medicare Supplement Choices

chisue

My Plan F - High Deductible with BCBS renews in April. I've had it since 2014. I will use my entire deductible in 2020, along with the new premium of $89/month, so I'll be out almost $3400 before ihe policy starts picking up the (very little) that Medicare hasn't paid since I began requiring monthly treatment for Multiple Myeloma at the end of 2018. I've been astounded at how much Medicare pays for my care -- and how little that will leave for the plan to fund past my $2340 deductible. .


Any idea if I could switch to a less costly plan?


I thought that I could not be denied Plan F once I had it, but does that do me any good?

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C Marlin

Have you compared coverage and rates on the medicare.gov site, the rates vary around the country? I have the Plan F HD also, it was the least expensive plan for me, I've never met my deductible.

Knowing you have a preexisting condition does complicate you changing.

I know people on earlyretirement like boomerbenefits, you might check with them also.



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chisue

Thanks for your speedy reply. I tried the Medicare site but only got a lengthy list of companies that offer supplement plans -- not a nice comparison like you get for Part D plans in your area. Is there a specific place to LOOK that I'm not seeing?

We're older than Boomers; I'm about to leave my 'seventies'.

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C Marlin

boomerbenefits is the name of a medicare insurance broker. You can get the same info for plan G or N on the medicare.gov. But in your situation you should contact a broker for the best way to proceed if you want to change your plan. Here is a link with a brief comparison of plans. boomerbenefits

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ravencajun Zone 8b TX

We used an agent. Definitely helpful. It's free so it certainly can't hurt.

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morz8

I too have used a broker. Both before medicare when we bought insurance polices - and I bought one for our tech, and later with medicare. He found a renters policy appropriate for my mother when she sold her home too, at about 25% the annual premium her State Farm agent presented to me.

If you will tell him/her ahead of time what you need, the appropriate policies can be put in front of you to compare at your appointment.

I have a different agent through which I insure my car and house.

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Elmer J Fudd

"We used an agent. Definitely helpful. It's free so it certainly can't hurt."

Insurance agents/brokers are paid a commission based on the policy premiums their sale produces. Unless there's some special rule imposed by the Medicare agency itself, you can be sure the premium a customer pays includes an amount to cover the agent's commission. To my way of thinking, that's not free. It's just not billed separately.

Even in cases where the insurance company requires the use of an agent or broker and won't sell directly.


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Lars

Ask your primary care doctor for a recommendation. Mine recommended SCAN, which I think is only available in southern California, but it is very inexpensive and I think my deductible is about $250. After that, SCAN pays for everything, and my monthly bill is about $35. It is similar to HMO, and so I have to go to UCLA doctors, but there are hundreds of those in my area. You should probably have something similar in your area.

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sushipup1

Lars, Scan is indeed an HMO, a not-for-profit Medicare Advantage plan. Similar plans are available in many parts of the country.

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laceyvail 6A, WV

Those of you with Medicare Advantage or considering it, should look at this:

https://justcareusa.org/ten-ways-medicare-advantage-plans-differ-from-traditional-medicare/

The site has other useful information on Medicare Advantage plans and other health issues.

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C Marlin

The stated premium is the same if you go direct or buy through an agent? In that sense you are not paying an agent's commision, but of course, everyone is paying the commission in the stated premium. All medicare insurance plans are mandated federally but regulated in each state, so it is difficult to discuss an insurance company or premium as many plans are available in one zip code but not another and premiums vary greatly. This is why I suggested going to a broker to know what is available in your local area.

I also wanted a plan that included Silver Sneakers.

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chisue

Elmer is right. There is no 'free lunch' whenever a middleman is involved. You will also only hear about the providers who compensate your middleman. He may even push the ones that pay him the most. That's one reason I'm posting here.

DH's former employer pays a company to handle their health care benefits and advise on Medicare questions. However, when I querried them about my Part D insurance plan choice last fall, they 'had no information' about a company I found on Medicare.gov I presumed that they don't get a commission from that one.

Yesterday I asked them my Medigap question. When I brought up my need for ongoing chemo, the advisor pretty much said that I would not pass underwirting questions asked by another company.

I STILL DON'T KNOW THIS:

I had thought that my Plan F was a guarantee that I could not later be denied Plan F. Is this true, and if so, until what date?

Is there a less costly Plan F (HD or not) available to me from BCBS or another insurer? (I know that Medicare has set the maximum deductible at $2340.)

Should I consider another Plan (G, N, whatever), and would I face underwriting?

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mollycats

I think you have to keep plan F continuously. Once you drop it you can't get it back.

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sushipup1

You can go down from an F plan without underwriting, but never up to F from a lesser plan without the underwriting. G would be the next best plan. F will no longer be available to new subscribers soon, since regulations changed to not allow a plan to cover the Part B deductible.

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salonva

Very knowledgeable people on this forum. Today I went to a presentation by my medicare advantage company. To begin with, you probably all know this but it bears repeating, when looking at plans, you need to indicate your county as neighboring counties don't all have the same plan. (at least in Pennsylvania).

I know nothing is black and white, but I thought the article about the advantage plans that @laceyvail 6A, WV linked was kind of questionable. There might be a lot of valid points in the article ( I am far from an expert for sure!!) but it seemed to have an agenda-- very much.


I also wondered about the agents and brokers that charge no fee... as @Elmer J Fudd and @chisue explained- I guess it goes to the point of no such thing as a free lunch.

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chisue

sushipup1 -- I was hoping you would reply. Thank you.

So... unless *I* choose to drop it, I am eligible to buy Plan F as long as it's offered by anyone, not only from my current BCBS? Could I choose Plan F without the HD? Is the Plan F premium 'standard' or could they hike mine because they'd be paying all my bills, including the $2340 I'm paying with the HD policy? I'm a 'known cost risk' through the BCBS records from 2019.

OR...I *could* take a different plan without underwriting? Why would anyone leave Plan F voluntarily? Lower premiums for Plan G? (Plan N doesn't sound like a good fit after reading about extra costs for ancillary care beyone the co-pays.)

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sushipup1

I do not know about moving from the HD plan to the regular plan. In fact, I don't know if there are special rules about the HD plans in the first place.

The F plans will be going up more int he future because they are will be phased out because of the Part B deductible. That means a shrinking pool of participants which means higher premiums. Which leaves the G plan as the best alternative.

Some of your questions may be answered by your local Medicare Advisors, called different things n different states, Make an appointment thru your local county office of Senior Services.

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chisue

Thanks, sushipup1. It helps to get my questions refined before contacting Medicare. I've also gotten incomplete info from 'official advisors'.

I would probably wait to leave Plan F (HD or not) for a Plan G until, as you point out, Plan F premiums rise for lack of participants.

All that plan upheaval over just Part B coverage! A *nit* requiring new administration 'reform'?

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sushipup1

What I suggested is not contacting Medicare. It is part of the Older Americans Act and is meant to assist people with questions just like yours. You are not contacting Medicare, this agency will help you. Besides, Medigap insurance isn't part of Medicare anyway, it's private insurance to supplement Medicare.

https://www2.illinois.gov/aging/ship/Pages/default.aspx

The law now says that the insurance cannot cover the Part B deductible. Don't know why or how that change came about.

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chisue

Thanks. I did send an email to SHIP in my state (Illinois). It didn't bounce back, so that's a good sign. LOL

All I know about the shift regarding Part B is that it is most likely another way for a certain current administration to kill what the prior one accomplished. I'd guess the change also benefits the insurance industry -- limiting benefits and permitting denials?

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sushipup1

Part B deductible in 2020 is $198. I suspect the change in supplemental is an insurance industry standard, but that's just a guess.

From https://www.medicare.gov/supplements-other-insurance/how-to-compare-medigap-policies

Starting
January 1, 2020, Medigap plans sold to new people with Medicare won’t
be allowed to cover the Part B deductible. Because of this, Plans C and F
will no longer be available to people new to Medicare starting on
January 1, 2020. If you already have either of these 2 plans (or the
high deductible version of Plan F) or are covered by one of these plans
before January 1, 2020, you’ll be able to keep your plan. If you were
eligible for Medicare before January 1, 2020, but not yet enrolled, you
may be able to buy one of these plans.

Comparison of F and G

https://boomerbenefits.com/medicare-supplemental-insurance/medicare-supplement-plans/medicare-plan-f/

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chisue

It pays to keep pushing. Today, after being told it was impossible, I successfully enrolled in a BCBS of Illinois Standard Plan F Medicare Supplement. When documentation arrives I will cancel my prior policy.

My DH's health benefits company told me I couldn't cancel my BCBS Plan F-HD and get this no-deductible Plan F without underwriting. It turned out that *they* wouldn't do it. (Supposedly the benefits company isn't allowed by BCBS to arrange this. I have my doubts about that, but it should no longer concern me. We will use the health benefits stipend differently.)

I would have given up had I not gotten (overnight!) email help from SHIP-Illinois. They confirmed that BCBS-Illinois guarantees coverage to policy holders changing plans, *without requiring* new underwriting.

This will save me only $280 a year, but I will no longer have to parse medical bills to be sure I'm being charged correctly. What Medicare doesn't pay, my policy will pay. Let them challenge any incorrect billing!

I owe thanks to everyone on the KT -- especially sushipup! and C Marlin -- for aiding my quest.



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sushipup1

Sounds great! I am so happy that SHIP came thru for you, It's a great resource, available all over the country (altho called different names in other states), and free!

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maddie260

I highly recommend going thru a SHIP program to sort out the different medicare plans. In CA, it's called HICAP. I learned more from those people in two hours than from anyone else, or from any booklet. It helps to have a baseline knowledge. They have NO stake (financial) in what you choose, so I think they are the best people. DH was driving me nuts with plan x, y, z and, finally, I called the insurance people I worked with and they said to call HICAP- best decision EVER! Every state has to have such a program. We just became eligible, and they are the best!

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sushipup1

HICAP/SHIP/APPRISE/etc and other Medicare counseling programs are part of the Older Americans Act of 1965, federally funded. Available through the local offices of senior services in local health departments, and totally free.

I am honored to be a part of the local Area Agency on Aging Advisory counsel here and where I lived in California as well. We are charged with helping the local public agencies identify the needs of the senior community and producing a 4 year plan to meet those needs. Programs covered under the OAA include nursing home Ombudsman, senior legal services, elder abuse services, communal meals, home-delivered meals, supportive and in-home services, outreach and Medicare counseling, all provided with no needs testing (free to all.)

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chisue

Thank you for all you do, sushipup1 -- with the OAA and here, too!

I was a longtime volunteer board member with my community's Visiting Nurse Assn. I was sorry to see the VNA be frozen out when hospital conglomerates realized they could profit from similar services. I'm heartened to hear about the OAA, as I feel there are entirely too few *truly community-based* services.

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raee_gw zone 5b-6a Ohio

I use the Ohio version of SHIP (OSHIP here) when I was deciding on Medicare supplement vs Advantage, and also found it very useful.

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