Which Medigap plan?- Sewall and others?

[Tony]

Hi,

I've directed this to Sewall especially because he said he works in Medicare. But I'd be interested in any advice or experience anyone has to offer.

I've signed up for Medigap Plan A with Mutual of Omaha, but now I'm wondering if I should go with one of the more comprehensive plans, like possibly Plan F. I think I could change - no health issues that I know of.

What do you think?

Thanks in advance,

[mur44]

I would recommend that you consider either Medigap Plan 'C'
or Medigap Pan 'F'; these two plans are popular.

Plan 'A' is basic; Plan 'B' is better than 'A'; 'C' is better
than 'B' and so on. Of course, they come with higher premium.

Since you are already in Medigap, you can buy a better
plan without any problem.

Disclosure: I am a Certified Volunteer Medicare Counselor in the
state of New Jersey.

[Mel Lindauer]

After carefully considering all the options, I chose the "C" Plan, and I've never regretted that choice. For someone who travels outside the country extensively, they might want the plan with coverage for that. Otherwise, I thought the "C" plan was probably the best choice for many/(most?) folks like me.

[Sheepdog]

After carefully considering all the options, I chose the "C" Plan, and I've never regretted that choice. For someone who travels outside the country extensively, they might want the plan with coverage for that. Otherwise, I thought the "C" plan was probably the best choice for many/(most?) folks like me.

Ditto on Mel's selection.
Jim

[supergrouper]

Mel, do you use the VA for medical? I do and I've often wondered if I need a medigap plan because I have the VA. Thanks Tony

[Mel Lindauer]

Mel, do you use the VA for medical? I do and I've often wondered if I need a medigap plan because I have the VA. Thanks Tony

No, I don't use the VA, supergrouper. Many of my friends do. However, I know that the VA facilities are strained, and I feel there are other vets who might need the service more than me. I'm fortunate that I can afford to pay for my medical treatment, so I try to leave a spot for a vet who can't afford to pay for the treatment. I just feels like the right thing to do.

[sage1166]

Mel, do you use the VA for medical? I do and I've often wondered if I need a medigap plan because I have the VA. Thanks Tony

No, I don't use the VA, supergrouper. Many of my friends do. However, I know that the VA facilities are strained, and I feel there are other vets who might need the service more than me. I'm fortunate that I can afford to pay for my medical treatment, so I try to leave a spot for a vet who can't afford to pay for the treatment. I just feels like the right thing to do.

As an up-and-coming VA careerist and hospital administrator, thank you for your concern regarding the care of more needy veterans than yourself. Remember though, you've earned the privilege of coming to the VA if your current healthcare needs are not being met (and of course you qualify for VA care). Thank you again, Mel.

[Tony]

Thank you, everyone, for all this good information. As always, you have something worthwhile to say.

Best Wishes,

[Ron]

Mel, do you use the VA for medical? I do and I've often wondered if I need a medigap plan because I have the VA. Thanks Tony

No, I don't use the VA, supergrouper. Many of my friends do. However, I know that the VA facilities are strained, and I feel there are other vets who might need the service more than me. I'm fortunate that I can afford to pay for my medical treatment, so I try to leave a spot for a vet who can't afford to pay for the treatment. I just feels like the right thing to do.

Also, be aware (if you aren't already) that even though you may be a U.S. Vet, it dosen't necessarily mean you can/qualify for care. Depending on your income level, and "rating" of qualification, you may not be able to get services (easily).

Here's a link for the rating info and to determine your eligibility:

http://www.va.gov/healtheligibility/

and here's the breakdown by group:

http://www.va.gov/healtheligibility/Lib ... Groups.pdf

Even though I'm enrolled as a priority group #3, I still use my non-VA resources for medical care.

- Ron

[JDCPAEsq]

If you can stand a $2,000 deductible, Plan F comes in a high deductible version that I found very attractive. My wife and I are both in that plan for combined annual premiums totalling $1,908.53. As some may know from my other posts, I'm a great believe in self insuring and high deductibles where I feel I can absorb the loss.
John

[Mel Lindauer]

If you can stand a $2,000 deductible, Plan F comes in a high deductible version that I found very attractive. My wife and I are both in that plan for combined annual premiums totalling $1,908.53. As some may know from my other posts, I'm a great believe in self insuring and high deductibles where I feel I can absorb the loss.
John

Good point, John. Our supplemental polices cost a bit over $2000 each, and we have no deductibles, so we're out about $2000 more than you and your spouse total. So, if you and your wife didn't need medical treatment throughout the year, you'd be saving about $2000. However, for me, I don't want to even think about whether we should or shouldn't seek medical attention, if needed, so I chose the "C" coverage since I've already "prepaid" my annual medical expenses.

In the worst case scenario, you stand to pay $6000. In the best case scenario, you only pay $2000. I chose the middle ground at a known $4000.

Like many things, there's no one right answer. Folks have to choose whichever they feel works best for them.

[JDCPAEsq]

Last year was my first year on the Plan F High Deductible and, aside from the low premium, another advantage was that I never had to deal with the Medigap provider in any way. They sent out periodic statements showing the amount of the deductible remaining and that was it.

I had previously been covered under group retiree coverage from my employer and I calculated I saved over $5,000 last year after dropping that coverage. I regret ever continuing that coverage for the four years after I retired.
John

[Tony]

If you can stand a $2,000 deductible, Plan F comes in a high deductible version that I found very attractive.
John

Mutual of Omaha doesn't offer the high deductible version of Plan F in California.
I agree with you that would be the way for me to go if it were available.

John: Which insurance company is it?

[JDCPAEsq]

I'm with Bankers Life in Florida. When I subscribed, I noticed there were just a limited number of companies offering it this state. Your best source is medicare.gov which will tell you all the policies available to you in your state.
John

Edit: Since posting the above I checked California and the Website indicates that nine companies offer this plan in CA including Bankers Life, Blue Cross & Transamerica. It shows premiums ranging from $20 to $98 per month. I pay mine annually for a discount from the monthly rate.
John

[JDCPAEsq]

In the worst case scenario, you stand to pay $6000. In the best case scenario, you only pay $2000. I chose the middle ground at a known $4000.

Mel - Plan F appears to also be more comprehensive coverage, covering "Plan B Excess Charges" at 100% whereas Plan C does not cover this at all. Otherwise they are the same.
John

[Tony]

I'm with Bankers Life in Florida.

Yes, I also just saw that Bankers Life does offer the Plan F Hi Deductible in Cal. I can't remember why I didn't choose them and I don't have my notes with me right now--maybe they didn't call me back in time--I had to make a decision quickly. A friend recommended Mutual of Omaha so I went with them and I've been pleased with them in the few interactions I've had with them so far..

Plan A with Mutual of Omaha is 86/month in Cal, which is actually a little more than you're paying for your Plan F. Is there a discount also because both you and your wife are covered?

Would you recommend Bankers Life for efficiency and ease of getting through to their customer service?

Thanks!

[Mel Lindauer]

In the worst case scenario, you stand to pay $6000. In the best case scenario, you only pay $2000. I chose the middle ground at a known $4000.

Mel - Plan F appears to also be more comprehensive coverage, covering "Plan B Excess Charges" at 100% whereas Plan C does not cover this at all. Otherwise they are the same.
John

Not sure I understand what charges you're talking about, John, since I don't pay anything either.

[JDCPAEsq]

Tony - The premium was based on attained age. I am four years older than my wife and so my premium is higher and always will be. There is no discount because we are both with them. Also, all my dealings with the company have been fine, although the contact has been minimal because of the high deductible and no claims.
John

[JDCPAEsq]

In the worst case scenario, you stand to pay $6000. In the best case scenario, you only pay $2000. I chose the middle ground at a known $4000.

Mel - Plan F appears to also be more comprehensive coverage, covering "Plan B Excess Charges" at 100% whereas Plan C does not cover this at all. Otherwise they are the same.
John

Not sure I understand what charges you're talking about, John, since I don't pay anything either.

Mel - Medcare defines "Excess charges" as:

Medicare Part B excess charges (This is the difference between what a doctor or provider charges and the amount Medicare will pay up to Medicare's limiting amount)

I don't pretend to be an expert in this area, but apparently this excess is covered by Plan F and not Plan C.
John

[Mel Lindauer]

In the worst case scenario, you stand to pay $6000. In the best case scenario, you only pay $2000. I chose the middle ground at a known $4000.

Mel - Plan F appears to also be more comprehensive coverage, covering "Plan B Excess Charges" at 100% whereas Plan C does not cover this at all. Otherwise they are the same.
John

Not sure I understand what charges you're talking about, John, since I don't pay anything either.

Mel - Medcare defines "Excess charges" as:

Medicare Part B excess charges (This is the difference between what a doctor or provider charges and the amount Medicare will pay up to Medicare's limiting amount)

I don't pretend to be an expert in this area, but apparently this excess is covered by Plan F and not Plan C.
John

If the doctor is a participating doctor in Medicare, he/she agrees to accept what Medicare says is the correct amount. My Plan C insurance company pays anything not paid by Medicare up to the amount they say is the acceptable amount. Those Drs. cannot charge additional. There are some Drs. who are not participating Medicare Drs. and they can charge whatever they want.