Bogleheads.org

You might also want to consider contacting a Medicare insurance broker. They can answer all your questions and concerns; it doesn’t cost you anything (their commission is paid by the insurance company); and it would give you someone to assist you if you have any issues with your Medigap provider in the future.

People here have been satisfied with Medicare Nationwide and Boomer Benefits.

Northern Flicker wrote: ↑Fri Mar 24, 2023 6:20 pm

Tom_T wrote: ↑Fri Mar 24, 2023 5:23 pm

ehh wrote: ↑Fri Mar 24, 2023 5:14 pm
Of course, the ability to switch without medical underwriting causes higher Plan G premiums. There are anecdotal reports on this board that Plan G in NY is expensive.

It is true. I looked at AARP Plan G in NJ. It is $162/month. I then changed the zip code to a NY zip. The price jumped to $281/month.

Keep in mind it is an age-based premium. But the total OOP cost of G-HD will rise similarly due to care needs increasing over time.

The AARP Plan G premium in New Jersey would be based on age, but Medigap premiums in New York State are not age based, they are community-rated (all ages pay the same premium), so comparing the two premiums is an apples-to-oranges comparison.

Of course, the ability to switch without medical underwriting causes higher Plan G premiums. There are anecdotal reports on this board that Plan G in NY is expensive. As expected. If I understand the situation, in NY you can just start with G HD. Then, if your health goes south, switch to plan G. Basically, you are only at risk for the higher G HD "deductible" for one year - or until you can switch to G. You can change Medigap plans and insurers at any time in New York State to any plan or insurer that you like. As far as the anecdotal reports you have heard about high rates in New York State, here are the actual current Medigap Plan G rates in New York (community rated - every age pays the same rate) and you can decide for yours...

orlandoman wrote: ↑Fri Mar 24, 2023 4:22 pm Only very limited changes can be made on Traditional Medicare, for example when the annual Part B deductible went from $203 in 2021 to $233 in 2022 to $266 in 2023.

Actually the Part B deductible decreased from $233 in 2022 to $226 in 2023.

(And, needless to say, Congress can make whatever changes they want at any time to Traditional Medicare.)

anonenigma wrote: ↑Thu Mar 23, 2023 10:33 am FYI, your medical eye care (ophthalmologist) is covered by Medicare, though not refraction, which costs perhaps $50. I've recently switched to buying my glasses at Costco, which is way less expensive than the Luxottica cartel.

You may want consider trying Zenni online. I have had great success with them.

In making your decision, hopefully you understand how a Plan G-HD works. The “high-deductible” here is a misnomer, it’s not like the high-deductible plans people have at work. With a Plan G, you just have the $226 Part B deductible. If you have Plan G-HD, since it is a Supplement to Medicare, Medicare does pay its 80% of Part B expenses first (after the $226 annual deductible). So, your coverage for Part B is: $226 annual deductible, then 20% copay (based on low Medicare-reimbursement rates) $2,700 maximum out-of-pocket The only kicker is that if you admitted to the hospital as an in-patient, you will have a $1,600 Part A deductible (which counts toward the $2,700 maximum out-of-pocket). The $2,700 figure increases with inflation (tied to C...

I feel like I'll end up spending a lot more on Medigap without really needing it, especially prescriptions. If my health remains good for the next few years, I think I could switch to Medigap if I wanted to and not have to worry about being declined. But my main concern is the "what ifs." If you sign-up for a Medicare Advantage Plan now in New Jersey and then decide in a few years that you want to switch to Original Medicare, you would then be subject to medical underwriting in order to get a Medicare Supplement Plan. Have you considered a high-deductible Plan G? As a starting point, I used a zip code in Northern New Jersey and did see a lot of policies in the $600 - $750 annual premium range at age 65 (attained age pricing) - pl...

Silk McCue wrote: ↑Wed Mar 22, 2023 8:01 am If you already give substantially to church/charity from your income you could consider setting up a Donor Advised Fund to support multiple future years of giving and will be able to reduce your overall tax burden this year.

We funded a DAF just prior to retiring two years ago to support our giving until we bridge to using QCDs (Qualified Charitable Distributions) from our IRAs once the first of us reaches 70.5.

Cheers

This is a potentially good way to handle the situation.

JoMoney wrote: ↑Tue Mar 21, 2023 9:41 pm The companies that are my Vanguard mutual funds, seem to use an institutional money market fund, in particular the "Vanguard Market Liquidity Fund"
https://institutional.vanguard.com/inve ... /fund/1142

Vanguard would not do business with us, because they didn’t like how we moved money around daily (so called “hot money”) to wherever we could get a better yield that day.

After leaving enough at the bank for that day’s needs, we would jump between time deposits, money market funds, and commercial paper with the excess cash. Whatever had the best rate at the moment is where the funds would be invested (as long as the investment had been approved by our credit people).

Late in the day it would often be money market funds, if time deposits rates fell in the afternoon.

Treasury bills were usually viewed as a last resort, due to their lower yield. Investing in Treasury bills was considered a failure.

(We tried not to think about earning an extra 3 or 5 basis points on a $1 billion is actually only $300,000 or $500,000 extra a year, because that is not a lot of money for a major corporation.)

HomeStretch wrote: ↑Tue Mar 21, 2023 11:43 am

vanguarded wrote: ↑Tue Mar 21, 2023 11:34 am So medigap is no longer available for someone hitting 65 in August 2023? Does this mean they only really have to use those medicare advantage plans now? Was advised a few years ago to look at medigap and steer clear of the all in one advantage plans...

No, Medigap is still available. This thread is about just a couple of the Medigap plans that were closed to new enrollees which is not uncommon.

Just Medigap Plans C, F, and F-high deductible were closed to people first eligible for Medicare on January 1, 2020 or later.

Most Bogleheads have now been signing up for Medigap Plans G, G-high deductible, or N.

KyleAAA wrote: ↑Mon Mar 20, 2023 11:47 pm Remember that FDIC insurance coverage is per account, per owner. You can have $250k in a high yield savings account and $250k in a CD both at Ally and be 100% covered by FDIC insurance. You can also divy accounts between you and your spouse to achieve the same result. It's very easy to have more than $250k insured at a single bank.

This is incorrect.

In this situation, a single person would have $250k of FDIC-insurance. The fact that the funds are in two different bank products is irrelevant.

Per the FDIC:

“Deposits are insured up to at least $250,000 per depositor, per FDIC-insured bank, per ownership category.”

https://www.fdic.gov/resources/deposit-insurance/faq/

bighatnohorse wrote: ↑Mon Mar 20, 2023 10:35 am Keep it in the bank so mom feels safe about it - but open another savings account at the same bank.
Each account is insured to $250K including savings and checking. Often a bank will have additional type(s) of savings accounts.
Or do as others suggest and move some to a better insured rate elsewhere.

I

Incorrect. Just opening another savings or checking account at the same bank under your mother’s name (the same name as the existing account) will not increase the $250,000 FDIC limit.

You’re covered for a joint account up to $500,000.

I bought the book and read it. Two specific things I would like to have seen included: ( 1) What happens to the balance of a donor advised fund when the donor/trustee dies? (2) What are the ins-and-outs of a charitable donation that results in a tax write-off and an annuity -- e.g. donor gives an appreciated vacation home -- basis unknown -- to suitable charity (perhaps a university), receives an immediate tax write-off, and thereafter receives $X per month for life. More generally, I understand that the book is not meant to be comprehensive. But surely there are more uses for "more than you need" beyond simply giving it away one way or another, which seems to me to be the book's focus. I hope this helps, as Mike seems to be open...

The Medicare website is a bit of a mess on this one. (I had the exact same question as you have when I was signing up.)

I would enroll in Parts A and B immediately, to be effective May 1, so you have time to straighten out any possible bureaucratic issues.

As soon as you have your Medicare number (which hopefully should only take a few weeks), you can enroll in a Medigap plan, to be effective May 1, as well as a Part D plan.

You should then be able to have everything in place on May 1.

SteadyOne wrote: ↑Fri Mar 17, 2023 8:53 am Another reason might be that they have to show that there are government bond investments that benefit ordinary people. Those who just want safe instruments to save safe from inflation. This is how IBonds came to be as well

+1

Very timely thread as I’m in the midst of this process now. So even if there was a very serious illness with costs running into six figures the annual out of pocket is $2,700? I ask, as I had an initial conversation with a SHIP counselor and we seemed to gravitate towards N with a comparison to G. My sense was this was due to N or G providing additional protections related to costly procedures and or illness but maybe this was all related to the $2,700 deductible. This could be a mistake on my part as my head was spinning. I'm not an expert on anything related to Medicare but have read this: Medigap Plan G covers Medicare Part B excess charges, while Plan N doesn’t. If a health care provider is legally permitted to charge more than Medicar...

So, the so-called deductible $2700 for HD-G is not a deductible, but just a misnamed OOP (out-of-pocket maximum). The actual deductible is $226 (deductible for Part B). Did I get it right? Thank you. Exactly! If you have Plan G-HD, you’re coverage for Part B is: $226 annual deductible, then 20% copay (based on low Medicare-reimbursement rates) $2,700 maximum out-of-pocket The only kicker is that if you admitted to the hospital as an in-patient, you will have a $1,600 Part A deductible (which counts toward the $2,700 maximum out-of-pocket). The $2,700 figure increases with inflation (tied to CPI-U). This is built-in cost sharing and results in HD premiums either having no annual increase or a minimal annual increase. Up until the last few y...

MrJedi wrote: ↑Sun Mar 12, 2023 7:11 pm You need to provide a much bigger picture to get a good answer. Either one could be right but we can't tell without any numbers.

+1

All you need is group health plan coverage through an employer in order to avoid the Part B late enrollment penalty. Notice that the form used to verify health plan coverage with an employer, Form L564, makes no reference to “creditable coverage”, just that your employer needs to verify group health plan coverage. The phrase “creditable coverage” only applies to Part D. The Medicare website states: “Notice of Creditable Coverage What is it? You'll get this notice each year if you have drug coverage from an employer/union or other group health plan. This notice will let you know whether or not your drug coverage is ‘creditable.’” https://www.medicare.gov/basics/forms-publications-mailings/mailings/costs-and-coverage/notice-of-creditable-cove...

So, the so-called deductible $2700 for HD-G is not a deductible, but just a misnamed OOP (out-of-pocket maximum). The actual deductible is $226 (deductible for Part B). Did I get it right? Thank you. Exactly! If you have Plan G-HD, you’re coverage for Part B is: $226 annual deductible, then 20% copay (based on low Medicare-reimbursement rates) $2,700 maximum out-of-pocket The only kicker is that if you admitted to the hospital as an in-patient, you will have a $1,600 Part A deductible (which counts toward the $2,700 maximum out-of-pocket). The $2,700 figure increases with inflation (tied to CPI-U). This is built-in cost sharing and results in HD premiums either having no annual increase or a minimal annual increase. Up until the last few y...

ForestWolf wrote: ↑Sun Mar 12, 2023 7:34 am Do appreciate replies to this topic.

cashmoney, Westfall was also actually encouraging viewers of this video who already had G plans to get a different plan SOON to avoid major rate increases and of course to use his company. So in essence, more commissions for him.

My main personal concern is selecting a plan ( have narrowed them down to G, G*(high deductible), and N) that will guard against catastrophic charges. I do, thankfully, have a health savings account to help.

(I do not live in a state that allows changing a plan without underwriting.)

Plan G, Plan G-HD, and Plan N would all guard against catastrophic charges.

As stated previously, the Medicare website has a definitive answer. By the way, there is no issue with “creditable” insurance here. That only applies to Part D (prescription) coverage. You do not have to sign-up for Medicare Parts A and B at age 65 if you are working for an employer with less than 20 employees, unless required by the employer’s health plan: Under “Working Past 65” Medicare.gov states: “You (or your spouse) are: - Still working at a job that has fewer than 20 employees - Have health insurance from that job You can wait until you (or your spouse) stop working (or lose your health insurance, if that happens first) to sign up for Part B (Medical Insurance), and you won’t pay a late enrollment penalty. - Ask the employer that pr...

Simply if the annual premium plus the deductible for the plan G-HD are higher than the annual premium for a standard plan G then the standard plan G makes sense Are you assuming that this person hits their deductible every single year? That would be highly unlikely in the vast majority of cases. At 65? With medical costs as high as they are now I find it very likely. We don’t expect or want things to happen but they do at any given time. Even common diagnostic procedures such as a colonoscopy or an endoscopy can be quite costly. Add lab work and office visits to this and it’s not hard to get to $2700. (A friend of mine once joked that the reason we retire is so that we have time to go to all of our doctors appointments). You do understand ...

You do not have to sign-up for Medicare Parts A and B at age 65 if you are working for an employer with less than 20 employees, unless required by the employer’s health plan: Under “Working Past 65” Medicare.gov states: “You (or your spouse) are: - Still working at a job that has fewer than 20 employees - Have health insurance from that job You can wait until you (or your spouse) stop working (or lose your health insurance, if that happens first) to sign up for Part B (Medical Insurance), and you won’t pay a late enrollment penalty. - Ask the employer that provides your health insurance if you need to sign up for Part A and Part B when you turn 65. If you don’t sign up for Part A and Part B, your job-based insurance might not cover the cost...

Leesbro63 wrote: ↑Sat Mar 11, 2023 4:13 pm

ModifiedDuration wrote: ↑Sat Mar 11, 2023 3:44 pm Since you are on a health plan with just one other person (an employer with less than 20 employees), if you do not sign-up for Part B at age 65 you will end up with lifetime penalties when you eventually do sign-up.

You’d have to determine if paying the Part B lifetime penalty is worth it to avoid IRMAA until you hit 68 and retire.

Are you sure this is definitively true? If so, this answers my question. I’ll need to go on Medicare, with Part B, at 65, because the penalty will make my overall cost more expensive over the long run.

Again, is this definitely a fact?

1,000 apologies!

You are good with not signing up for Part B until you retire, unless your employer (health plan) requires you to sign-up for Part B.

Since you are on a health plan with just one other person (an employer with less than 20 employees), if you do not sign-up for Part B at age 65 you will end up with lifetime penalties when you eventually do sign-up. You’d have to determine if paying the Part B lifetime penalty is worth it to avoid IRMAA until you hit 68 and retire. As far as the cost of the most comprehensive Medicare Supplement (Plan G), the monthly premium would depend on where you live, at what age you sign-up, and the pricing methodology used by the insurance company. Many Bogleheads have the Plan G-high deductible. The “high deductible” is not what you are used to, as Medicare still pays its share on each bill and the “high deductible” only applies to what Medicare doe...

If you are interested in G-HD, you might want to consider United American.

High-deductible plans are their “bed and butter” and they usually have low, stable rates for their HD plans.

As far as brokers go, people here have had good experience with Medicare Nationwide and with Boomer Benefits.

Medicare Nationwide is a big proponent of G-HD.

krisSA wrote: ↑Tue Feb 28, 2023 8:22 pm Can we do QCDs from 529 account without getting tax penalties?

No, only from IRAs and you must be at least 70-1/2yrars old.

Robert20 wrote: ↑Mon Feb 27, 2023 7:01 am

Boglelicious123 wrote: ↑Sun Feb 26, 2023 11:12 pm

Robert20 wrote: ↑Sun Feb 26, 2023 2:51 pm Typically over 15-20years period, how much fees paid in 529 plan?

For my 529 it uses Vanguard target date funds so the fees are small. My initial main reason for even thinking the IUL might make sense is if the 529 takes away the chance for financial aid, while the IUL does not. Even in a standard several thousand $$$ scholarship/year that different could be big

explanation is fine.. What is the $ amount? (approximately)?

For example, Michigan’s 529 plan with an equity index option, which tracks the Russell 3000 Index, has a total annual fee of 9.5 basis points ($9.50 a year for $10,000 invested):

https://www.misaves.com/media/np5pvg3x/ ... iption.pdf

Your mother should file for a spousal benefit now as she should receive 50% of your father’s PIA which should be higher than $12k per year. Perhaps. It depends on when mother started her own benefits. For example, if she started at 62, she will never get 50% of father's benefits. +1 Also, her spousal benefit would be based off of her spouse’s Primary Insurance Amount (PIA). If he is getting a higher amount than his PIA, due to delayed retirement credits, that would not impact her spousal benefit. Then why do people suggest they higher earner wait until 70 ? Thought the whole point was so that either surviving spouse could get the largest benefit. Why not have high earner take at FRA if that is all their spouse will get after passing away ?...

ddurrett896 wrote: ↑Wed Feb 22, 2023 9:22 am John Goodman said it best

https://www.youtube.com/watch?v=xdfeXqHFmPI

JL Collins said it better:

https://youtu.be/eikbQPldhPY

If you are on plan G, what would it to to premiums if others in your actuarial pool are going to the ER for a strep throat because it is all paid for anyway? I'll be starting Medicare later this year. I'm planning on choosing G or HD-G. I've been reading that (a) you only get one medical physical; that's during your first year on Medicare. After that it's a wellness visit. I'm used to having one annual physical with a comprehensive blood panel to ensure that everything is okay. Is that not available on medicare? Does the gov't deem an annual physical as unnecessary / excessive? Seems wrong to me... Or is it just a game and PCPs will still do physicals and comprehensive bloodwork and just code it appropriately in the manner that Medicare wa...

Does your employer have less than 20 employees?

That’s an important factor.

The difference in deductible between Plan G and Plan G-HD is $2,474, since the $226 Part B deductible is included in the Plan G-HD deductible of $2,700 (and you have to pay the $226 Part B deductible with Plan G).

Your thought process is correct, though, as it appears the premium savings in your zip code basically covers the possible additional exposure with Plan G-HD (and you can switch to Plan G whenever you like in New York).

Plan N is sometimes purported to be actuarially more cost effective than Plan G. One downside is that Plan N does not cover excess charges by providers who do not accept Medicare assignment. If it became common for providers not to accept it, the Plan N copay plus excess charge would exceed Plan G-HD coinsurance, though plan N coverage aligns with plan G for all other costs. Good point. If someone lives in one of the 8 states that do not allow Excess Charges, then that is not an issue (you just have the up to $20 co-pay for office visits for Plan N): Connecticut, Massachusetts, Minnesota, New York, Ohio, Pennsylvania, Rhode Island, and Vermont Curious, if you know, are those states the same as the states that allow for switching from Medic...

First, according to the New York State website, there is no part of New York where the lowest price Plan G is as high as $332. Same for the Plan G-HD at $74 - there are lower cost options no matter where you live in New York.

https://www.dfs.ny.gov/consumers/health ... ons/plan_g

https://www.dfs.ny.gov/consumers/health ... lan_g-plus

Second, you are aware that in New York State you can switch Medigap plans and insurers anyone you want with no medical underwriting, correct?

This would tend to lead someone to a Plan G-HD to start and then switch to a Plan G at a later date.

Northern Flicker wrote: ↑Sat Feb 18, 2023 4:39 pm Plan N is sometimes purported to be actuarially more cost effective than Plan G. One downside is that Plan N does not cover excess charges by providers who do not accept Medicare assignment. If it became common for providers not to accept it, the Plan N copay plus excess charge would exceed Plan G-HD coinsurance, though plan N coverage aligns with plan G for all other costs.

Good point. If someone lives in one of the 8 states that do not allow Excess Charges, then that is not an issue (you just have the up to $20 co-pay for office visits for Plan N):

Connecticut, Massachusetts, Minnesota, New York, Ohio, Pennsylvania, Rhode Island, and Vermont

If anyone is interested, Medicare Nationwide specializes in the HD plans. They are big proponents of it. When I was looking to sign up, I had one of the owners on the phone for almost an hour with my questions. When I apologized for taking up so much of his time for such a small commission (which, if I remember correctly, is 15% of the first year’s premium and then a lower amount going forward), he said, “Don’t worry about the commission.” He said that they basically end up with the clients until they pass away and they get a ton of referrals. I just got an email from the other owner, telling me to contact him if I have any questions or if I need to talk about anything. I’ve gotten great service from them. By the way, the brokers get a lot ...

Northern Flicker wrote: ↑Sat Feb 18, 2023 2:03 pm One other wrinkle for some: Medigap premiums are not HSA-eligible but expenses paid to meet the G-HD deductible are. The G-HD plan will enable more costs to be HSA-eligible.

This is an excellent point, particularly relevant for those with high HSA balances going into retirement.

No need to think about the Part A deductible as a separate issue. G-HD simply caps your Part A out of pocket plus your Part B out of pocket for a calendar year. The 2023 cap is about $2,700. The cap grows each year with the CPI. Doesn't matter whether your out of pocket is from Part A deductible, Part A coinsurance, Part B deductible, or Part B coinsurance. You pay the first $2,700 out of pocket. Then your G-HD covers you for the rest of the calendar year. Does G-HD cap you at $2926 ($2700 + part B premium of $226) or $2700 (part B premium is part of the deductible/OOP Max)? The Part B deductible of $226 is part of the $2,700 high-deductible plan annual deductible. My Plan G-HD policy has specific language on this point. Also, Boomer Benef...

Does the high deductible Plan G-HD require one to pay the Medicare Part A deductible? It depends on your Part B out of pocket for the year prior to your Part A charges. For example, if you racked up $2,700 in Part B out of pocket during January thru June and then were hospitalized in July, your Plan G-HD will pay the Part A deductible. On the other hand, if the July hospitalization was your first health care interaction for the calendar year, Plan G-HD won't pay the Part A deductible. Doesn't the standard Plan G with it higher premiums pay the Medicare Part A deductible? Yes. Thanks. So folks that are calculating the premium delta between G and G-HD are not taking into account the Part A deductible benefit of standard Plan G in their calcu...

These posts highlight one inherent downside of Medigap. You have to be careful and do your best to pick a plan because you might get "stuck" in it. Medigap plans can turn into high rate increases year after year which can lead to a plan death spiral. Those who can pass underwriting will switch to a different Medigap plan but those who can't will be stuck. Then your only option is to keep paying the huge rate increases or you can drop your plan for Medicare Advantage. It's best to do your homework at the beginning to try and choose the best plan at the time. However, as noted, it's very difficult to predict what will happen, especially over many years. If someone is concerned about a possible “death spiral” of premium increases fo...

First, I would check United American for their Plan G-HD rates. HD plans are their “bread and butter” and they usually have very low rates over time. Mine started at $37 a month at age 65 and then maxes out at $77 a month at ages 81 and above. Using Plan F-HD as a proxy (since it has been around so long), United American has not increased their HD premiums in my state in over 15 years (during that time period they have had several price decreases, resulting in a cumulative decrease of over 40% in HD premiums). What I then did was prepare a spreadsheet with various assumptions on how much my out-of-pocket expenses would be each year and different assumptions on how often I would hit the Plan G-HD maximum out-of-pocket. I did this comparing U...

Where I live, Humana Medigap Plans include Silver Sneakers, but the monthly premium cost was so much higher than other insurers that it just wasn’t worth it for me.

There are two Medicare brokers that many Bogleheads have used and recommend, Boomer Benefits and Medicare Nationwide. Unlike the agent mentioned above, they both correctly explain how High-Deductible Medigap plans work: Boomer Benefits: “Here’s what you need to know about the High Deductible Plan G: - Original Medicare will still pay its 80% portion - You will pay the other 20% until you satisfy the $2,700 (in 2023) deductible - After the out-of-pocket deductible is met, the plan will pay the same benefits as regular Plan G - The plan does not cover the Part B deductible (just like Plan G) - The annual Part B deductible that you will pay counts toward the total out-of-pocket deductible” https://boomerbenefits.com/medicare-supplemental-insur...

That agent is incorrect. As the previous poster said, this is a Medicare SUPPLEMENT policy, meant to supplement what Medicare does not cover. Medicare still covers what it covers and then Supplement plans (such as High-Deductible plans) fill in the gaps. In addition, needless to say, the many Bogleheads who have had high-deductible Medigap plans for years regularly receive all the statements regarding any medical charges they have incurred and understand how the HD plans work. However, just to be crystal clear, the exact wording from my G-HD policy makes it clear that the agent is incorrect: “The benefits provided by this policy, which are designed to cover cost sharing amounts under Medicare, will change automatically to coincide with any ...

Farmerberg wrote: ↑Thu Feb 16, 2023 8:28 am

ModifiedDuration wrote: ↑Thu Feb 16, 2023 8:25 am It is also important for you to know the pricing methodology used for the plans you are looking at:

Attained age
Issue age
Community based

The wiki has a lot of good information:

https://www.bogleheads.org/wiki/Medicare

Yes, I am aware of those differences. Thanks much for that though.

Ok, just mentioning that because where I live almost all plans are attained-age.

The difference between Plan G and Plan G-HD was about $115 a month at age 65 ($1,300 a year), but increased to almost $200 a month (about $2,200 or $2,300 a year) by the mid-80s.

That information helped me make my Medigap plan decision.