Medigap Plan G vs Plan F?

[brownie]

I will be turning 65 in June and have been researching Medigap policies. I'm so glad I discovered this forum - it has been very helpful . But I don't think my questions have been addressed yet.

Since premium information is not available at the government Medicare site, I talked to a broker called United Medicare Advisors. Although I thought I was interested in Plan F, she encouraged me to consider Plan G which covers EVERYTHING Plan F covers EXCEPT the Part B deductible ($147 for 2013). Her point was that the lower premium for Plan G usually offsets the out-of-pocket deductible, or can even result in additional savings (i.e., if the annual premium difference between Plans G&F is equal to or greater than the Part B deductible, there is no cost or possible savings to the consumer). If the consumer doesn't go to the doctor at all for reasons subject to the deductible (only for preventive care), the entire difference in premium is saved. Because of my overall good health and because I prefer to keep money in my pocket if the risk is reasonable, I am intrigued by Plan G. The $147 is certainly a lot lower risk than I have been carrying all these years ($2500-$7500 deductibles!). When I challenged her on the probable increase in the Part B deductible each year and therefore my increased exposure, she said since the insurance companies will have to pick up that increase in Plan F, they will undoubtedly factor that into their annual rate increase for Plan F (plus whatever other rationale they want to come up with in addition to age to increase the rate each year).

Does anyone have any comments about Plan G vs. Plan F?
The lowest rates she had for Plans G and F were from CSI (Central States Indemnity of Omaha). Does anyone have experience with this company? Our current broker doesn't deal with CSI and so has no information.
I have had Anthem BC/BS for my regular insurance for many years, yet she had negative comments about them as a Medigap provider. Does anyone have experience with them for Medigap?
I hesitate to change to an unknown broker with an unknown company. Does anyone have any comments about CSI and/or United Medicare Advisors?

Thanks for your time.

[samjuno]

Just signed up for Plan G for all the reasons you mentioned.
Went w/ cheapest company (in my state) for that Plan (GPM) which is administered by MofO. Don't know if
that's good or bad since this is my first year w/ them.



-sam

[apk]

I think Kaiser Health just did a study on Medigap policies. One of its conclusions was that the monthly premium for the same plan varied dramatically from company to company. Calling a slew of companies is time-consuming. Also, in many cases you are asked for your name, address, and phone number. An agent will eventually call you back.

Recently I went through this process for my wife. With some companies, I did not have to give my name, etc. I was able to immediately speak with an agent and the agent was low-key, i.e., he/she did not try to sell me a plan. He/she responded to my question about the monthly premium by giving me the premium cost.

Here are several companies along with their toll-free numbers:

Aetna - 1-888-436-9678.
Humana - 1-800-872-7294.
Medico - 1-800-228-6080.
State Mutual - 1-855-764-4000.
USAA - 1-800-845-8026.

In all, I found 14 insurance companies that were able to give me quotes immediately. The five above have been randomly (but not alphabetically) selected. All these companies sell Plan F, which is what I was interested in. They may or may not sell Plan G.

[BruDude]

Plan G is usually the better choice for the reasons stated by your agent. Most of the time the Plan G premiums are at least $147/year lower than the Plan F premiums, at least in my state.

[ResNullius]

No offense intended, but I don't see that there's a whole lot of difference.

[jimkinny]

I just enrolled in Medicare and bought a Medigap policy. I first bought a plan G, mainly because it was sold by BCBS and the BCBS price was the same as or better than other insurers. It was significantly less costly than plan F and basically had the same benefits.

I had second thoughts and within the 6 month window (3 months =/- age 65years) enrolled in a plan F high deductible and cancelled the BCBS policy.

Plan F HD has a deductible of $2070 per year.

Jim

[midareff]

I turned 65 last December and enrolled in Medicare and AARP United Plan F. No deductibles at all and no copays.

[LillieRoss]

I chose F - the price difference pretty much equaled the deductible. I wanted a plan that would cover the physicians I was already using. Even though the Medicare websites seem to present many many companies to chose from, when it came down to actually getting details I found that there were restrictions, provider networks, plan memberships, ... and many insurance providers weren't actually selling products in my geographic area (central California). At the end I had three companies to choose from, and two had poor customer reviews. I ended up choosing AARP and United Healthcare and have stayed with them.

It's all so overly complicated!

Sylvia

[mur44]

If you are from New York or Connecticut, consider a Medicare Advantage plan
as you will have continuous guarantee issue to buy a Medigap plan at any time.

Else, consider Medigap Plans 'C, 'F', High Deductible 'F' or 'N'.
Plans "C', 'F' and 'N' are popular Medigap plans.
Go with the cheapest insurance company plan as long as customer service
is acceptable.

Your county SHIP (State Health Insurance assistance Program) counselor
can provide valuable tidbits. You can find your SHIP telephone number on the
back of Medicare and You handbook or Medicare.gov. SHIP counselors
provide unbiased advice.


Disclosure: I am a Certified Volunteer Medicare Counselor from NJ

[jimkinny]

If you are from New York or Connecticut, consider a Medicare Advantage plan
as you will have continuous guarantee issue to buy a Medigap plan at any time.

Else, consider Medigap Plans 'C, 'F', High Deductible 'F' or 'N'.
Plans "C', 'F' and 'N' are popular Medigap plans.
Go with the cheapest insurance company plan as long as customer service
is acceptable.

Your county SHIP (State Health Insurance assistance Program) counselor
can provide valuable tidbits. You can find your SHIP telephone number on the
back of Medicare and You handbook or Medicare.gov. SHIP counselors
provide unbiased advice.


Disclosure: I am a Certified Volunteer Medicare Counselor from NJ

Yes, contact your state's SHIIP. My state's SHIIP office sent me a booklet that had a list of all Medigap providers in the state, what Medigap plans they offered and the premiums. This was a valuable tool and made the work a lot easier. Maybe your state's SHIIP office does this also. This booklet did not have any of the Medicare Advantage plans, just traditional Medigap insurers.

BTW, I contacted a local salesperson about Plan F HD. He initially told me that a high deductible plan F did not exist. Perhaps the premium and commission is lower or as the salesman later told me, if he sells a plan with deductibles, people forget and call him with complaints when they get a bill so he was simply not aware of the HD plan because he never sold it.

jim

[obgraham]

The benefits should be consistent for a given plan (F,G,A,etc) from company to company, but the customer service definitely will not be. And the selection of doctors available might vary a lot. That's why simply choosing the cheapest might not be your best choice.

Look carefully at the available providers -- hospitals, doctors, and pharmacies (for drug plans). After you've determined which will suit your needs, then you can shop price.

The brokers love to go with the cheapest. I've heard many tales of unhappiness with that choice.

And bve very careful before choosing a Medicare Advantage plan.

[apk]

Correct me if I am wrong, but if you are choosing a Medigap policy, then you can use any doctor you want. The limit on doctors only applies if you are choosing a Medicare Advantage plan. With Medigap, the only potential limit on doctor choice is if the doctor you want does not accept Medicare as payment in full. Then, you would have to pay the difference between what Medicare pays (including your Medigap policy) and what the doctor charges. Some Medigap policies also cover the excess cost.

[btenny]

My wife and I both choose Medigap Plan F High Deductable from Anthem Blue Cross/Blue Shield. It is very cheap, $37.24 per month ($453 per year) when you auto deduct. It allows me to use any doctors I want in any location as long as they take Medicare. It pays 100% after the $2K deductable. It covers excess charges if they apply. It covers foreign travel. So I get good insurance for small annual costs that covers any big medical bill. It is great.

Why would you want to spend $1550+ per year EVERY year on a Medigap Plan F or Plan G? Do the math and some forecasting on what you spend every year on doctors and medical tests and hospital visits? I am pretty sure there is no way will you spend anywhere near the extra $1100 you will be giving to the insurance companies. In order to spend this much you will need to spend $5K or more at medicare rates EVERY YEAR on just Doctors office calls and lab tests. This means you would have to have some sort of major big problem requiring multiple CT scans and out patient surgery every year. Look at some bills sometime. I think you will find this just does not happen. So the High Deductable plan is much better IMO.

Bill

[TheGreyingDuke]

I also went with high deductible F, I can handle the $2100 deductible, and like that once I hit that number, I am 100% covered (for covered services.)

Contacting your SHIP is OK, but here n VT they did not have rates, for that I went to our Banking and Insurance Department and they had the rates online

[SpringMan]

Blue Cross Legacy Plan C costs $122.86 per month ($1474.32 per year), no deductibles, seems like a better deal for us. Does not include Part D drug benefit. We have First Health Value Plan for drugs, $31.70 per month, no deductibles. We are in MI, each state has different pricing.

[samjuno]

Local SHIP counselor told us in Medicare class that some medigap companies either won't accept you or allow you to "upgrade" your plan (ex. move from a N plan to a F plan) if you change your mind later. Think that refers to changes once your "Guaranteed Enrollment Period" is past. Also, unless you change in the first year, going from an Advantage plan to regular medicare with medigap can be problematic (underwriting or nonacceptance issues).

I decided to get the best coverage the first year and will probably go with Kaiser later on when finances get tighter.

-sam

[rixer]

I'm also shopping for medigap insurance as I'll turn 65 this summer. I hadn't thought about it so when my agent suggested plan F, HD I was a little hesitant. The more I think about it, the more interested I'm becoming. It covers all the expenses plan F does after 2100 deductable. In the meantime medicare pays 80% of most things so you're still not hit with a big bill and if you suddenly need major healthcare, it'll cover all expenses once you reach your ded. Best reason, it's only around $37 bucks a month and the worst you'll be out is $1000 more than with regular plan F if you need lot's of care.

Why shouldn't I choose plan F, HD? Talk me out of it.

[mur44]

rixer,

If your health care needs are modest, Medigap F, HD is a good option.


Disclosure: I am a Certified Volunteer Medicare Counselor from NJ

[midareff]

I turned 65 last December and enrolled in Medicare and AARP United Plan F. No deductibles at all and no copays.

I also seem to remember that the list of available hospitals was much smaller.

[TheGreyingDuke]

Correct me if I am wrong, but if you are choosing a Medigap policy, then you can use any doctor you want. The limit on doctors only applies if you are choosing a Medicare Advantage plan. With Medigap, the only potential limit on doctor choice is if the doctor you want does not accept Medicare as payment in full. Then, you would have to pay the difference between what Medicare pays (including your Medigap policy) and what the doctor charges. Some Medigap policies also cover the excess cost.

No Mediagp plan imposes restrictions on doctors/hospitals you can access,no matter the company selling it or the specific plan

[penumbra]

Plan F is more generally available, and offered by more companies, compared to F hi-D. I use USAA, which doesn't offer the hi-D option. I researched it, but wasn't happy with the few providers for my area.
That being said, in my first 4 years on Medicare, USAA paid out $7000, 3000, 7000 and 8000 (so far). And I've always been a healthy, low utilizer. You never know. Don't count on always being healthy. Everybody gets something, sometime. Some go on for a while.

[rixer]

Plan F is more generally available, and offered by more companies, compared to F hi-D. I use USAA, which doesn't offer the hi-D option. I researched it, but wasn't happy with the few providers for my area.
That being said, in my first 4 years on Medicare, USAA paid out $7000, 3000, 7000 and 8000 (so far). And I've always been a healthy, low utilizer. You never know. Don't count on always being healthy. Everybody gets something, sometime. Some go on for a while.

That's very true penumbra, you never know. The way I figured it, it's about a thousand a year cheaper if you just have a couple of dr appts and lab tests going with plan f, hd. it's a max thousand more if you have more issues. It's a crap shoot because we never know what the future has in store. With plan f, hd,it covers everything plan f does. medicare part b pays 80%, you pay 20% until you hit 2100.Then it pays everything so you're still able to get the best care when something comes up. I wasn't open to it at first but it makes more sense to me especially when you look at the price of planf, hd. At about $37 per month, it looks better all the time.

[LAbob]

If you change from Plan F to Plan F-HD, is there a problem down the road in switching back to Plan F during an open enrollment period if you, at that point, find you have high medical expenses?

[TheGreyingDuke]

If you change from Plan F to Plan F-HD, is there a problem down the road in switching back to Plan F during an open enrollment period if you, at that point, find you have high medical expenses?

Any switches after the six-month open enrollment period will subject you to medical underwriting, and you can be refused. If your insurance company leaves your region's market or if you move to a region where your original carrier does not offer service, you are guaranteed coverage; what would happen if you had High Deductible F and no one else offered such a plan in these events is not clear to me.

Oh and open enrollment is ONLY during that six month window surrounding your 65th birthday, although there are some exceptions and some states have mandated greater flexibilities.

[fandango]

I was advised by 3 different insurance agents to go with Plan F, and I did. I went with BC/BS of Georgia (which is really Anthem out of Los Angeles) because of their enormous network.
Just about any doctor that you would want to see is in their network because they have 70% of the market in Georgia.

I go into the doctor's office and leave without co-pays or deductibles. No paperwork hassles.

My mother-in-law (85 years old) also has plan F and had a heart catheterization. When we left the hospital, we checked her out, and she owed absolutely nothing.

[TheGreyingDuke]

There seems to be some ongoing confusion about "networks" and Medigap plans. There are no Mediagp networks, you go to any Medicare provider, Medicare pays their share, the Medigap plan, whatever company's name is on it, pays the rest.

Now if you are talking about Medicare Advantage plans, that is a different story.

[BruDude]

I was advised by 3 different insurance agents to go with Plan F, and I did. I went with BC/BS of Georgia (which is really Anthem out of Los Angeles) because of their enormous network.
Just about any doctor that you would want to see is in their network because they have 70% of the market in Georgia.

I go into the doctor's office and leave without co-pays or deductibles. No paperwork hassles.

My mother-in-law (85 years old) also has plan F and had a heart catheterization. When we left the hospital, we checked her out, and she owed absolutely nothing.

If Plan F is more than $147/year more than Plan G, then it makes no sense to take Plan F in any scenario. The only difference between G and F is that G does not pay the Medicare Part B deductible and F does. Ex: Plan F is $125/month and Plan G is $100/month, annual difference = $300. Why would anyone want to pay an extra $300 to insure against a loss of $147? People do it all the time though because "Plan F is the best"