Search found 1407 matches

by ModifiedDuration
Sun Mar 24, 2024 4:16 pm
Forum: Personal Finance (Not Investing)
Topic: Medicare: Getting Part A and D only
Replies: 89
Views: 4992

Re: Medicare: Getting Part A and D only

and as I noted above he has the optionality of six months retroactive Part B in his back pocket all along. Yes. I avoided mentioning this aspect because it felt too close to politics and an invitation for argument, but since it is mentioned I'll add that AFAIK Part B can be started and stopped without limit It does indeed seem that you can turn Part B on and off ad lib, but I was actually wrong about the 6 month retroactivity for Part B, as TallGuy subsequently pointed out. Still there are no pre-existing condition exclusions and as long as you have funds in HSA or elsewhere to cover the initial expenses, then Part B could kick in to cover long months of followup expenses. I just couldn’t imagine putting myself in a position where I have t...
by ModifiedDuration
Sun Mar 24, 2024 3:46 pm
Forum: Personal Finance (Not Investing)
Topic: Medicare: Getting Part A and D only
Replies: 89
Views: 4992

Re: Medicare: Getting Part A and D only

If you need outpatient surgery (hip replacement, knee replacement, etc.) you’re either not going to have the surgery or pay for it out-of-pocket? If you need chemotherapy you’re either going to not get it or pay for it out-of-pocket? Please understand, I have insight into those scenarios that you almost certainly do not, and I am a lot more capable than most in navigating the healthcare landscape. E.g., I am familiar with the financial peculiarities of inpatient Vs OP care, and international care. I know my actuarial risks of most cancers, and which ones I would not treat irrespective of cost. I also am familiar with the marginal benefits of the latest and greatest medicines compared to the much less expensive treatments of a few years ago...
by ModifiedDuration
Sun Mar 24, 2024 2:40 pm
Forum: Personal Finance (Not Investing)
Topic: Medicare: Getting Part A and D only
Replies: 89
Views: 4992

Re: Medicare: Getting Part A and D only

Sconie wrote: Sun Mar 24, 2024 2:23 pm Well, the thing about insurance is that when you need it, you REALLY need it. Buying coverage is not necessarily about getting the best return or minimizing one's cost, but rather, about making sure that you have coverage for events which otherwise could/would prove to be financially cataclysmic. It's that simple. Don't over-think it.
That would appear to lead one to Plan G-HD, with its $2,800 annual out-of-pocket maximum.

If the purpose of insurance is to protect one from low probability / high cost events, than Plan G-HD provides that catastrophe coverage.
by ModifiedDuration
Sun Mar 24, 2024 2:10 pm
Forum: Personal Finance (Not Investing)
Topic: Medicare: Getting Part A and D only
Replies: 89
Views: 4992

Re: Medicare: Getting Part A and D only

I have Part A and the cheapest Part D I could find at $1.5 a month. This is my first year on Medicare As you'll read, I'm unusual enough that the details really matter here, but I offer my example for things to consider * I am a physician in Internal Medicine * I buy medicines internationally, sometimes generics locally if they are dirt cheap. I choose the medicine and the dose. E.g., I have idiopathic (salt conserving) hypertension. I limit my salt intake to about 500 mg a day, and I buy lisinopril/hctz for $2 a month. I keep track of my blood pressure, and know that it is well-controlled. I buy blood tests periodically as warranted for medication follow-up and preventive care. * I have a well funded HSA * I have a lifelong uber-healthy l...
by ModifiedDuration
Sun Mar 24, 2024 12:44 pm
Forum: Personal Finance (Not Investing)
Topic: Medicare: Getting Part A and D only
Replies: 89
Views: 4992

Re: Medicare: Getting Part A and D only

Courtesy of the American taxpayer, Medicare Part B is being offered to you at 25% of its true cost (unless you are subject to IRMAA).

It’s a bargain and, in true Bogleheads fashion, how could anyone pass that up?
by ModifiedDuration
Sat Mar 23, 2024 2:39 pm
Forum: Personal Finance (Not Investing)
Topic: Medigappers: which plan do you have and why
Replies: 89
Views: 5055

Re: Medigappers: which plan do you have and why

An insurance broker who specializes in medicare policies told someone I know that United American offers many (or all) of their G-HD customers an 1-time opportunity to upgrade to a G plan after 2 years on their G-HD plan. I don't know if that is true for all customers or all states or even if true at all, but it is interesting etc. Even if they do their regular g plans in my area are over $300 per month so it would make no sense at all. Yes, United American does offer holders of G-HD policies a one-time opportunity to switch to Plan G without underwriting at the two year mark. In my zip code the rate for their Plan G is slightly over $200 a month, which is a little high but not outrageous. The G plan premium partly covers having the G plan...
by ModifiedDuration
Sat Mar 23, 2024 3:19 am
Forum: Personal Finance (Not Investing)
Topic: Medigappers: which plan do you have and why
Replies: 89
Views: 5055

Re: Medigappers: which plan do you have and why

placeholder wrote: Sat Mar 23, 2024 12:45 am
Northern Flicker wrote: Sat Mar 23, 2024 12:11 am An insurance broker who specializes in medicare policies told someone I know that United American offers many (or all) of their G-HD customers an 1-time opportunity to upgrade to a G plan after 2 years on their G-HD plan.

I don't know if that is true for all customers or all states or even if true at all, but it is interesting etc.
Even if they do their regular g plans in my area are over $300 per month so it would make no sense at all.
Yes, United American does offer holders of G-HD policies a one-time opportunity to switch to Plan G without underwriting at the two year mark.

In my zip code the rate for their Plan G is slightly over $200 a month, which is a little high but not outrageous.
by ModifiedDuration
Fri Mar 22, 2024 8:59 pm
Forum: Personal Finance (Not Investing)
Topic: Medigappers: which plan do you have and why
Replies: 89
Views: 5055

Re: Medigappers: which plan do you have and why

billaster wrote: Fri Mar 22, 2024 8:35 pm
Vinny_in_NJ wrote: Fri Mar 22, 2024 5:51 pm UHC in NJ is community rated as well. They have a large discount the dwindles each year, for 2024 they revamped the amount and how it dwindles at least in my zip code.
I'm curious how that "discount" works. Does that mean you get a big discount for your first year of enrollment that decreases each year. That sounds a lot like shadow age rating. Community rating means that everyone pays the same rate.
You are correct. By taking a little bit of the discount away each year, the UHC policy is actually an attained-age policy that is just called community-rated.
by ModifiedDuration
Fri Mar 22, 2024 4:19 pm
Forum: Personal Finance (Not Investing)
Topic: Medigappers: which plan do you have and why
Replies: 89
Views: 5055

Re: Medigappers: which plan do you have and why

That is why the NY plans are more expensive. I just priced out United Healthcare plans, for fun, for a 65-year-old male. The only detail I changed in the two example was the zip code. New Jersey: Plan G is $165, Plan N is $112 New York: Plan G is $306, Plan N is $165 One big difference is that all New York plans are community rated -- everyone pays the same rate regardless of age or health condition. In New Jersey medigap plans may be attained age rated. Try comparing an 85 year old using the same plans listed above with the same rating systems. Yes, it's a different story. New Jersey: G = $334, N = $257 New York: G = $306, N = $240 Or one could go with Emblem Health’s G-HD in New York for $68 a month. $238 a month savings over UHC’s Plan ...
by ModifiedDuration
Thu Mar 21, 2024 12:01 pm
Forum: Personal Finance (Not Investing)
Topic: Medigappers: which plan do you have and why
Replies: 89
Views: 5055

Re: Medigappers: which plan do you have and why

Since the Medigap insurer doesn’t make any decisions regarding approving medical care and just takes what Medicare has approved and then pays their portion, you very, very rarely hear about problems with Medigap insurers.

The more common problems that people have are with service providers coding charges incorrectly and Medicare then rejecting the charges.

Many people have reported never or very rarely having to contact their Medigap insurer. I have just contacted my Medigap insurer once with a minor billing question.

I wouldn’t worry about having Humana as a Medigap insurer.
by ModifiedDuration
Thu Mar 21, 2024 9:01 am
Forum: Personal Finance (Not Investing)
Topic: Medigappers: which plan do you have and why
Replies: 89
Views: 5055

Re: Medigappers: which plan do you have and why

From reading the discussion, the rational choice for us (1-2 years away) would be G-HD. The main drawback I see is the hassle of needing to pay (a small fraction) of every single charge (until the deductible). Whereas with G, you don’t really see the bill at all. How much weight to put on this convenience factor is not clear? But, it might push me towards plan G. I'd add: In doing the math, one should also consider the state they live in and whether or not they can change Plans in the future without going through medical underwriting. One might choose G-HD during open enrollment and then find they're stuck with it when they'd like to change to G. They may be prevented from changing plans in the future if they no longer pass medical underwr...
by ModifiedDuration
Thu Mar 21, 2024 8:04 am
Forum: Personal Finance (Not Investing)
Topic: Medigappers: which plan do you have and why
Replies: 89
Views: 5055

Re: Medigappers: which plan do you have and why

From reading the discussion, the rational choice for us (1-2 years away) would be G-HD. The main drawback I see is the hassle of needing to pay (a small fraction) of every single charge (until the deductible). Whereas with G, you don’t really see the bill at all. How much weight to put on this convenience factor is not clear? But, it might push me towards plan G. Some of the G-HD providers have interest bearing savings accounts that can automatically pay your coinsurance so that there is no bill to pay after a claim is processed. Interesting! That’s very good to know as it’d address my main concern. Thank you for sharing! The big player in the high-deductible arena, United American, offers its Reserve Fund Annuity that will pay deductibles...
by ModifiedDuration
Thu Mar 21, 2024 8:01 am
Forum: Personal Finance (Not Investing)
Topic: Medigappers: which plan do you have and why
Replies: 89
Views: 5055

Re: Medigappers: which plan do you have and why

From reading the discussion, the rational choice for us (1-2 years away) would be G-HD. The main drawback I see is the hassle of needing to pay (a small fraction) of every single charge (until the deductible). Whereas with G, you don’t really see the bill at all. How much weight to put on this convenience factor is not clear? But, it might push me towards plan G. I'd add: In doing the math, one should also consider the state they live in and whether or not they can change Plans in the future without going through medical underwriting. One might choose G-HD during open enrollment and then find they're stuck with it when they'd like to change to G. They may be prevented from changing plans in the future if they no longer pass medical underwr...
by ModifiedDuration
Thu Mar 21, 2024 6:54 am
Forum: Personal Finance (Not Investing)
Topic: How would you estimate Medicare costs for us?
Replies: 11
Views: 1074

Re: How would you estimate Medicare costs for us?

My actual Medicare-related costs have been much lower than the $1,000 a month being discussed - about $250 a month (or $3,000 a year): $175 - Part B monthly premium $1 - Part D monthly premium $43 - Plan G-HD monthly premium $20 - Part B deductible ($240/12) $10 - 20% of actual Part B expenses (on average) $5 - Monthly prescription cost $254 Per Month Dental and vision would be on top of that, probably about $50 a month (or $600 a year). The big surprise to me has been how low the Medicare-approved rates are. For example, last year I went to two specialists. They each billed about $200 for the office visit, the Medicare-approved amount was $95, so I paid 20% of that or $19. All my blood work and vaccines have been 100% covered. A colonoscop...
by ModifiedDuration
Thu Mar 21, 2024 6:28 am
Forum: Personal Finance (Not Investing)
Topic: Medigappers: which plan do you have and why
Replies: 89
Views: 5055

Re: Medigappers: which plan do you have and why

From reading the discussion, the rational choice for us (1-2 years away) would be G-HD. The main drawback I see is the hassle of needing to pay (a small fraction) of every single charge (until the deductible). Whereas with G, you don’t really see the bill at all. How much weight to put on this convenience factor is not clear? But, it might push me towards plan G. Some of the G-HD providers have interest bearing savings accounts that can automatically pay your coinsurance so that there is no bill to pay after a claim is processed. Interesting! That’s very good to know as it’d address my main concern. Thank you for sharing! The big player in the high-deductible arena, United American, offers its Reserve Fund Annuity that will pay deductibles...
by ModifiedDuration
Mon Mar 18, 2024 7:49 pm
Forum: Personal Finance (Not Investing)
Topic: Medigappers: which plan do you have and why
Replies: 89
Views: 5055

Re: Medicare: 64 Year Old Eyeing 2025 Medicare

tj wrote: Mon Mar 18, 2024 6:40 pm Evidently UHC is going to start offering HD G plans:

https://www.carevalue.com/blog/high-ded ... ment-plans
Thanks! That’s certainly an interesting development.
by ModifiedDuration
Thu Mar 07, 2024 1:10 pm
Forum: Personal Consumer Issues
Topic: AARP/UHC Medigap policies
Replies: 40
Views: 3339

Re: AARP/UHC Medigap policies

In October when the open enrollment period comes around that is the time to look into changing Part D plans. Apparently, I haven't done it yet, if you put your drugs into the Medicare website they will auto populate when looking for new Part D companies. Once open enrollment is posted the drug insurer can't change the formulary that they will cover until the following year. That won't help with anything that happens during the year but it may help a little going forward. I'm on Xarelto and I get it for $10 for 3 months supply on my employer's health care plan, it'll be much more expensive once on Medicare. Also, my Doc told me about Mark Cuban's Pharmacy ... take a look there for drug pricing. I've been looking around due to the Xarelto an...
by ModifiedDuration
Thu Mar 07, 2024 12:46 pm
Forum: Personal Consumer Issues
Topic: AARP/UHC Medigap policies
Replies: 40
Views: 3339

Re: AARP/UHC Medigap policies

My wife and I have been on AARP/UHC Plan N since joining Medicare 7 years ago. The coverage has been great and the price has risen every year, but only by about $5. We pay $147 (wife) and $151 (me) a month. The main difference between Plan N and Plan G is that Plan N providers are allowed to bill you for "extra charges" which is 15% of the Medicare approved cost, not 15% of the retail cost of the procedure or visit. There are also office visit charges, $20 per office visit for Plan N, but none after the Part B deductible is reached on Plan . The Part B deductible is $240 per member in 2024. We live in a state where switching Medigap plans requires underwriting, which we have been told by consultants, neither of us would pass. If ...
by ModifiedDuration
Wed Mar 06, 2024 7:00 pm
Forum: Personal Consumer Issues
Topic: AARP/UHC Medigap policies
Replies: 40
Views: 3339

Re: AARP/UHC Medigap policies

Excess Charges are not an issue to be concerned about. About 97% of physicians are participating Medicare providers, which means they accept the Medicare-approved amount as full payment. About 2% of physicians are non-participating Medicare providers, which means they can bill a 15% Excess Charge above the Medicare-approved rates. About 1% of physicians have opted out of the Medicare system entirely. For some reason, the largest specialty of this 1% that have opted out are psychiatrists. Excess Charges are rather uncommon. Aetna stated a few years ago that over 99.0% of the bills they processed did not have Excess Charges and, of the ones that did, the average charge was less than $20. Medigap Plans F and G cover Excess Charges, Plan N doe...
by ModifiedDuration
Wed Mar 06, 2024 1:55 pm
Forum: Personal Consumer Issues
Topic: AARP/UHC Medigap policies
Replies: 40
Views: 3339

Re: AARP/UHC Medigap policies

Excess Charges are not an issue to be concerned about. About 97% of physicians are participating Medicare providers, which means they accept the Medicare-approved amount as full payment. About 2% of physicians are non-participating Medicare providers, which means they can bill a 15% Excess Charge above the Medicare-approved rates. About 1% of physicians have opted out of the Medicare system entirely. For some reason, the largest specialty of this 1% that have opted out are psychiatrists. Excess Charges are rather uncommon. Aetna stated a few years ago that over 99.0% of the bills they processed did not have Excess Charges and, of the ones that did, the average charge was less than $20. Medigap Plans F and G cover Excess Charges, Plan N does...
by ModifiedDuration
Wed Mar 06, 2024 11:52 am
Forum: Personal Consumer Issues
Topic: AARP/UHC Medigap policies
Replies: 40
Views: 3339

Re: AARP/UHC Medigap policies

AUH2O wrote: Wed Mar 06, 2024 11:40 am Also be prepared for changes in Part D plans in 2025. The lower out of pocket limit and lower prices on certain brand name drugs will likely be passed on to consumers in some form.
The lower cost of the brand name drugs (Eliquis,
Jardiance, Xarelto, Januvia, etc.) does not occur until 2026 and should result in lower Part D prescription costs as this will be a negotiation to lower the cost of these drugs at the expense of Big Pharma.

The impact of the $2,000 out-of-pocket cap in 2025 on Part D premiums is a different matter.
by ModifiedDuration
Tue Mar 05, 2024 4:13 pm
Forum: Personal Finance (Not Investing)
Topic: Medicare: 64 Year Old Eyeing 2025 Medicare
Replies: 164
Views: 11832

Re: Medicare: 64 Year Old Eyeing 2025 Medicare

I hope that you understand that the Plan G-HD deductible isn’t really a deductible at all, but is really a maximum out-of-pocket.

Medicare still pays its 80% upfront for Part B expenses.

Due to the high rates in New York City and the large spread between G and G-HD premiums, it makes sense to very seriously look at the G-HD Plan in New York City.

That $233 a month spread you mention between G and G-HD is $2,796 a year, which exceeds the $2,560 maximum out-of-pocket difference between the two plans.

In other words, in a worse-case scenario you are $236 a year ahead with G-HD. In a best case scenario, you would be over $2,000 a year ahead with G-HD.
by ModifiedDuration
Sun Mar 03, 2024 4:39 pm
Forum: Personal Finance (Not Investing)
Topic: Medicare: 64 Year Old Eyeing 2025 Medicare
Replies: 164
Views: 11832

Re: Medicare: 64 Year Old Eyeing 2025 Medicare

tj wrote: Sun Mar 03, 2024 3:49 pm I'm surprised your HD plan includes Silver Sneakers.

For New York City, it only shows 4 results for F HD and G HD: Emblem Health, Globe Life, Bankers Life, and Humana.
It’s probably Humana, as they frequently include Silver Sneakers.
by ModifiedDuration
Sun Mar 03, 2024 11:09 am
Forum: Personal Finance (Not Investing)
Topic: Medicare: 64 Year Old Eyeing 2025 Medicare
Replies: 164
Views: 11832

Re: Medicare: 64 Year Old Eyeing 2025 Medicare

I’m in the same boat as the author starting to research my options and this thread has been very helpful. Two things I’m wondering how others have dealt with: - The pricing between companies of a plan varies widely. How have you researched this to determine which ones to avoid and which one to choose? - If during the year you are prescribed an expensive drug that has limited coverage in your Plan D, other than using GoodRx… I assume you have no choice but to wait for enrollment to change your Plan D? My dad has the $0.50/mo plan and is on some drug that is considered experimental for his autoimmune issue. He says he "got a waiver approved". I have no idea what that means, but he says he hasn't got a bill. Yes, you can file with y...
by ModifiedDuration
Fri Mar 01, 2024 12:06 pm
Forum: Personal Finance (Not Investing)
Topic: Medicare: 64 Year Old Eyeing 2025 Medicare
Replies: 164
Views: 11832

Re: Medicare: 64 Year Old Eyeing 2025 Medicare

Ok, I pulled out my G-HD policy.

Under Definitions, it says:

“ANNUAL HIGH DEDUCTIBLE means the amount of your out-of-pocket expenses…….Out-of-pocket expenses for this deductible include expenses for the Medicare Part B deductible.”
by ModifiedDuration
Fri Mar 01, 2024 11:41 am
Forum: Personal Finance (Not Investing)
Topic: Medicare: 64 Year Old Eyeing 2025 Medicare
Replies: 164
Views: 11832

Re: Medicare: 64 Year Old Eyeing 2025 Medicare

The deductible for medigap G HD is $2,800, after the standard $240 deductible. If you're above the deductible, the higher deductible costs you $233/month when on G HD. For my location the monthly cost difference between the lowest cost G and G HD is $228 (302-74). Not a very big spread, so you can't go that far wrong choosing one or the other. The choice would seem to depend on your anticipated medical expenses (and of course the pricing in your location). No, not after. The $240 deductible is included in the $2800. Are you sure? This certainly seems to say $2800 after you pay $240 part B deductible: https://i.imgur.com/jHlBG5w.jpeg The $240 is part of the $2,800 maximum out-of-pocket for Plan G-HD. It specifically states so in the standar...
by ModifiedDuration
Fri Mar 01, 2024 11:31 am
Forum: Personal Finance (Not Investing)
Topic: Medicare: 64 Year Old Eyeing 2025 Medicare
Replies: 164
Views: 11832

Re: Medicare: 64 Year Old Eyeing 2025 Medicare

The deductible for medigap G HD is $2,800, after the standard $240 deductible. If you're above the deductible, the higher deductible costs you $233/month when on G HD. For my location the monthly cost difference between the lowest cost G and G HD is $228 (302-74). Not a very big spread, so you can't go that far wrong choosing one or the other. The choice would seem to depend on your anticipated medical expenses (and of course the pricing in your location). No, not after. The $240 deductible is included in the $2800. Are you sure? This certainly seems to say $2800 after you pay $240 part B deductible: https://i.imgur.com/jHlBG5w.jpeg The $240 is part of the $2,800 maximum out-of-pocket for Plan G-HD. It specifically states so in the standar...
by ModifiedDuration
Fri Mar 01, 2024 11:27 am
Forum: Personal Finance (Not Investing)
Topic: Medicare: 64 Year Old Eyeing 2025 Medicare
Replies: 164
Views: 11832

Re: Medicare: 64 Year Old Eyeing 2025 Medicare

The deductible for medigap G HD is $2,800, after the standard $240 deductible. If you're above the deductible, the higher deductible costs you $233/month when on G HD. For my location the monthly cost difference between the lowest cost G and G HD is $228 (302-74). Not a very big spread, so you can't go that far wrong choosing one or the other. The choice would seem to depend on your anticipated medical expenses (and of course the pricing in your location). The deductible for Plan G-HD is really not a deductible at all. Plan G-HD is a supplement to Original Medicare, so Medicare pays its 80% up front. For Part B expenses (physician services and outpatient services), with a G-HD you are just paying a 20% copay until you reach the $2,800 “ded...
by ModifiedDuration
Fri Mar 01, 2024 10:44 am
Forum: Personal Finance (Not Investing)
Topic: Medicare: 64 Year Old Eyeing 2025 Medicare
Replies: 164
Views: 11832

Re: Medicare: 64 Year Old Eyeing 2025 Medicare

I spent a fair bit of time looking into options but figured out pretty early on that Medicare Advantage was not for me. The G plans rose to the top and in the end it was a simple decision. My Anthem plan is about $150 a month and my prescription plan is $70 a month. I will shop prescription plans next year as the cost doubled but I was too busy at the time to look at other options and I don't have any regular meds. The big hole is vision and dental. After looking into options and wanting to keep my current dentist and eye doctor, I decided to just pay cash and buy my glasses from an online discount seller. After having bought individual health insurance, Medicare is much appreciated. Everyone should check their Part D policy each and every...
by ModifiedDuration
Fri Mar 01, 2024 10:39 am
Forum: Personal Finance (Not Investing)
Topic: Medicare: 64 Year Old Eyeing 2025 Medicare
Replies: 164
Views: 11832

Re: Medicare: 64 Year Old Eyeing 2025 Medicare

tj wrote: Fri Mar 01, 2024 10:35 am The problem with brokers like Boomer Benefits is that they can push bad companies like Mutual of Omaha.If you just blindly trust one of these brokers, you could end up screwed down the road. It's less important in states that have the birthday or similar rule.
You are absolutely correct. One of the companies that Boomer Benefits represents (and signs people up for) is Mutual of Omaha.

People have to do their homework.
by ModifiedDuration
Fri Mar 01, 2024 10:31 am
Forum: Personal Finance (Not Investing)
Topic: Medicare: 64 Year Old Eyeing 2025 Medicare
Replies: 164
Views: 11832

Re: Medicare: 64 Year Old Eyeing 2025 Medicare

Boomer Benefits is not a big fan of high deductible plans (presumably because of the low commission). I’m surprised they didn’t try and talk you out of a high deductible plan, they usually do.

Also, Boomer Benefits doesn’t represent the big player in the high deductible arena, United American. United American usually has the lowest premium for a high deductible plan.
by ModifiedDuration
Fri Mar 01, 2024 10:24 am
Forum: Personal Finance (Not Investing)
Topic: Iowans Medicare Plan G AARP or
Replies: 1
Views: 608

Re: Iowans Medicare Plan G AARP or

65 this month and have the A&B, also successfully had my IRMA reduced🙏. Any thoughts recommendations on Plan G or high deductible providers. Thinking of going with AARP, Plan G at $117 per month. Also have my wife’s 3 year insurance w United, she’s 62. Appreciate the feedback or pushback, it’s simple right🥴 United American is the big player in the high deductible arena. They are known for low, stable premiums. I see that they have a premium of $35 a month for a 65 year old male in a random zip code in Des Moines. Their parent, Globe Life, has $33 a month with a direct to consumer policy (no agent). They would be fine too. I see AARP/UHC at $130 at that zip code for Plan G. Interestingly, at age 85, Globe Life is only $59, United Americ...
by ModifiedDuration
Fri Mar 01, 2024 7:27 am
Forum: Personal Finance (Not Investing)
Topic: Medicare: 64 Year Old Eyeing 2025 Medicare
Replies: 164
Views: 11832

Re: Medicare: 64 Year Old Eyeing 2025 Medicare

It's no secret that I'm in Pennsylvania. The 2 year with no underwriting option would probably be the way to go for me. I can test drive it without penalty if I decide I'm better of with a "regular' Plan G. Thank you again for the info here. Pennsylvania is one of the states that does not have lenient rules for switching Medigap plans, so medical underwriting is usually required. United American does have low, stable premiums in Pennsylvania for high-deductible plans. Their rates are attained-age, so they go up a few dollars a year and then level off at ages 81 and beyond. I’m not sure how competitive their Plan G rates are though. I’m assuming that you know you can look up Medigap rates by zip code here: https://www.medicare.gov/medi...
by ModifiedDuration
Fri Mar 01, 2024 7:07 am
Forum: Personal Finance (Not Investing)
Topic: Medicare: 64 Year Old Eyeing 2025 Medicare
Replies: 164
Views: 11832

Re: Medicare: 64 Year Old Eyeing 2025 Medicare

https://www.medicare.gov/procedure-price-lookup/cost/70553/ I pay $43 a month for Plan G-HD. Best I could do in my area would be about $125 a month more for Plan G. That’s $1,500 a year extra. To exceed that with Plan G-HD, I would either have to be hospitalized or have about $7,500 in physician services and outpatient services at the low Medicare-approved rates. Since with both G and G-HD I have to pay the annual $240 Part B deductible, what matters is how much I exceed the $240 deductible. Some years I don’t even hit the $240 annual deductible (and just pocket the entire $1,500 premium savings), some years I am slightly over and have to pay an additional $100 or so out-of-pocket (it’s hard to rack up a big bill when you’re paying $19 an ...
by ModifiedDuration
Fri Mar 01, 2024 6:21 am
Forum: Personal Finance (Not Investing)
Topic: Medicare: 64 Year Old Eyeing 2025 Medicare
Replies: 164
Views: 11832

Re: Medicare: 64 Year Old Eyeing 2025 Medicare

I'm also using traditional: Medicare part b: $174.70 Plan g hd united american: $48.00 Part d silverscript: $9.90 with all prescriptions at $0 The past two years I have yet to exceed the part b deductible. How much is your high deductible? My costs are in-line with placeholder: Medicare Part B: $174.70 Plan G-HD with United American: $43.00 Part D: $0.50 with WellCare Value Script (one prescription at no cost, one at $5 a month) The high-deductible Plan is mis-named. It’s really a maximum out-of-pocket. This is how it works for Part B expenses (physician services and outpatient services): $240 deductible, then 20% copay based on the low Medicare-approved rates with $2,800 maximum out-of-pocket The only kicker is that if you are admitted to...
by ModifiedDuration
Fri Mar 01, 2024 5:56 am
Forum: Personal Finance (Not Investing)
Topic: Medicare: 64 Year Old Eyeing 2025 Medicare
Replies: 164
Views: 11832

Re: Medicare: 64 Year Old Eyeing 2025 Medicare

I'm also using traditional: Medicare part b: $174.70 Plan g hd united american: $48.00 Part d silverscript: $9.90 with all prescriptions at $0 The past two years I have yet to exceed the part b deductible. How much is your high deductible? My costs are in-line with placeholder: Medicare Part B: $174.70 Plan G-HD with United American: $43.00 Part D: $0.50 with WellCare Value Script (one prescription at no cost, one at $5 a month) The high-deductible Plan is mis-named. It’s really a maximum out-of-pocket. This is how it works for Part B expenses (physician services and outpatient services): $240 deductible, then 20% copay based on the low Medicare-approved rates with $2,800 maximum out-of-pocket The only kicker is that if you are admitted to...
by ModifiedDuration
Fri Mar 01, 2024 5:32 am
Forum: Personal Finance (Not Investing)
Topic: Medicare: 64 Year Old Eyeing 2025 Medicare
Replies: 164
Views: 11832

Re: Medicare: 64 Year Old Eyeing 2025 Medicare

Some of the prior discussion on Part D prescription coverage is incorrect.

In 2024, for prescriptions covered by your Plan’s formulary, once your out-of-pocket and the manufacturers’ discounts you receive total $8,000 you enter Catastrophic Coverage and have zero copay.

Your actual out-of-pocket maximum is usually about $3,300 (with the manufacturers’ discounts you receive getting you to the $8,000 figure) and then you have zero copay.

Next year, with the $2,000 cap on out-of-pocket, it will be interesting to see what premiums will be like (with this year’s WellCare Value Script, with its $0.00 to $0.50 monthly premium, depending on the state, being just a fond memory).
by ModifiedDuration
Sun Feb 11, 2024 12:12 pm
Forum: Personal Finance (Not Investing)
Topic: Medicare Medigap Insurers
Replies: 21
Views: 2796

Re: Medicare Medigap Insurers

I have UA Plan G HD for two years now. I am quite satisfied. I also use their savings plan (technically Reserve Fund Annuity) which automatically pays the deductibles for you to provide a seamless experience. It pays 3% interest which isn’t a bad deal since you don’t have the hassle of dealing with the deductibles. Several friends have this same plan and are also satisfied. Could you please share your experience using the reserve fund annuity? I see it as a valuable automation especially as one ages. Do they issue a 1099 for the interest earned? Is it easy to designate a beneficiary for the unused funds upon death? We have well funded HSAs - we hope to annually withdraw the incurred expenses for Plan G-HD. Wondering if reserve fund annuity...
by ModifiedDuration
Sat Feb 10, 2024 9:16 am
Forum: Personal Finance (Not Investing)
Topic: Medicare Medigap Insurers
Replies: 21
Views: 2796

Re: Medicare Medigap Insurers

Only positive things to say about United American Plan G-HD.

It works like it is supposed to. Also low, stable rates.
by ModifiedDuration
Tue Jan 30, 2024 6:31 pm
Forum: Personal Finance (Not Investing)
Topic: I'm having a hard time deciding if I should pick Medigap Plan G or Plan N because of my history
Replies: 165
Views: 16292

Re: I'm having a hard time deciding if I should pick Medigap Plan G or Plan N because of my history

placeholder wrote: Tue Jan 30, 2024 5:28 pm
FinIndyGal wrote: Tue Jan 30, 2024 12:07 pm Again, this is from the SHINE guy's perspective, but he never mentioned anything about denied claims, etc.
I don't know that a gap provider can deny a claim that medicare approved.
You are correct. A Medigap provider cannot deny a claim that Medicare has approved.
by ModifiedDuration
Mon Jan 22, 2024 3:44 pm
Forum: Personal Finance (Not Investing)
Topic: I'm having a hard time deciding if I should pick Medigap Plan G or Plan N because of my history
Replies: 165
Views: 16292

Re: I'm having a hard time deciding if I should pick Medigap Plan G or Plan N because of my history

If anyone has some examples of the types of problems that can arise that would require an agent's assistance later (other than the company raising their premiums a significant amount), I'd greatly appreciate and welcome them. I'm still struggling with this because several people commented that they've never had an issue with UHC AARP after they started their supplemental plan. Here is what Boomer Benefits says their Client Service Team can help with. It’s really not issues with your Medigap insurer, but more Medicare issues in general: “Claim research and resolution [denied claims, claims coded incorrectly by the service provider, etc.], drug exceptions, Medicare appeals, annual rate shopping, and much more” https://boomerbenefits.com/clie...
by ModifiedDuration
Sun Jan 21, 2024 2:19 pm
Forum: Personal Finance (Not Investing)
Topic: Medicare Plan G, N, or G-HD?
Replies: 49
Views: 6560

Re: Medicare Plan G, N, or G-HD?

The upside is that if you make it to your early-mid 80s, the UHC plan is often always lower than everybody else. Agree. I was not a strong believer in UHC but have become a convert. What I like is the sliding discount is fixed at 3% (or a new 2% block recently introduced). This slightly lower increase compared to the average attained age increase of 3.5% to 4% in my state, along with the community rating, would seem to indicate the UHC will come out cheaper assuming you make it to your 80's. Two points on that. First, if the UHC discounted price is $100 and they give you a 39% discount, you would pay $61. When that first increase kicks in, your price goes from $61 to $64, which is not a 3% increase but is a $4.9% increase. Next year would ...
by ModifiedDuration
Sun Jan 21, 2024 11:28 am
Forum: Personal Finance (Not Investing)
Topic: Medicare Plan G, N, or G-HD?
Replies: 49
Views: 6560

Re: Medicare Plan G, N, or G-HD?

tj wrote: Sun Jan 21, 2024 11:03 am
The big difference between G/N and G HD is that the G HD does not cover the Part A deductible.
The Part A deductible would count toward the G-HD maximum out-of-pocket, though.

So, basically it ends up that any year you are admitted to the hospital as an in-patient or have very high Part B expenses (such as for chemotherapy), one would end up hitting the maximum out-of-pocket with G-HD and that would be a losing year vis-a-vis G and N.

In other years, G-HD would probably result in a savings (probably a significant savings) vs G and N.

Then, it becomes a question as to the premium spread between G-HD and G/N in one’s zip code and running scenarios at various Medicare-approved expense levels.
by ModifiedDuration
Sat Jan 20, 2024 1:51 pm
Forum: Personal Finance (Not Investing)
Topic: Medicare Plan G, N, or G-HD?
Replies: 49
Views: 6560

Re: Medicare Plan G, N, or G-HD?

:dollar I have plan G, and am glad I do. I could have got by with a less expensive, lesser coverage plan for almost 15 years and been happy with it. But more recently I'm glad I have G because of issues I never imagined I'd have when I originally signed up for Medicare. I thought all the Medigap plans have the same medical coverage, and the only differences are the costs (premiums, deductibles, etc). Especially for plans G, GHD, and N. I know Plan N doesn't cover excess charges, which are fairly rare and I think ca be avoided. Assuming the coverage is the same, it comes down to cost and the paperwork to manage the bills. You are correct. Actually Medicare determines your medical coverage. Once you choose Original Medicare, whether you choos...
by ModifiedDuration
Sat Jan 20, 2024 9:56 am
Forum: Personal Finance (Not Investing)
Topic: I'm having a hard time deciding if I should pick Medigap Plan G or Plan N because of my history
Replies: 165
Views: 16292

Re: I'm having a hard time deciding if I should pick Medigap Plan G or Plan N because of my history

tj wrote: Sat Jan 20, 2024 9:43 am Did you attempt to get a G HD from Boomer Benefits?
No, when I signed-up for Medicare I incorrectly thought Boomer Benefits was a large, impersonal national agency to be avoided.

Anyway, I have Plan G-HD with United American (and I knew that was the plan and insurer I wanted) and Boomer Benefits is not an agent for United American (my guess is because of the low commission).

Now that Medicare Nationwide is also no longer an agent for United American and actively pushes Plan N instead, if I wanted a Plan G-HD I would probably go with Medigap Seminars, due to the dedicated support they offer after the purchase of a Medigap Plan through them:

https://medigapseminars.org/medicare-advocate-services/
by ModifiedDuration
Sat Jan 20, 2024 9:39 am
Forum: Personal Finance (Not Investing)
Topic: Physicians Mutual Innovative Plan G Medigap
Replies: 18
Views: 4008

Re: Physicians Mutual Innovative Plan G Medigap

Medicare did not pay for the routine annual physical. Medicare does not cover it. But, that is a benefit of the Physicians Mutual Medicare Supplement policies (excluding Plan A): Preventive services are covered. I turn 65 later this year and am considering a PM Innovative Plan G (or HDG). Discovering Medicare does not cover the annual physical and many other preventive services was a bit shocking. PM’s premium prices are not the best. But, if you do an annual physical every year, see a dermatologist annually to catch skin cancer before its cancer, then it may be worthwhile. Dermatologist screening is not considered preventative for those under 65, so i'd be surprised if it is post-65. My understanding was that Physicians Mutual has an opti...
by ModifiedDuration
Sat Jan 20, 2024 9:30 am
Forum: Personal Finance (Not Investing)
Topic: I'm having a hard time deciding if I should pick Medigap Plan G or Plan N because of my history
Replies: 165
Views: 16292

Re: I'm having a hard time deciding if I should pick Medigap Plan G or Plan N because of my history

Caveat to my earlier message: If you go with an agent, know that they literally make twice as much commission selling you a Medicare Advantage Plan vs a Plan G Medigap and make not inconsequential more selling you a Plan G vs a Plan N. Always have your radar up on whether you are being sold or being educated. Some get around the illegality of getting under the table kickbacks from insurers by getting “marketing dollars” from an insurance group so if they are pimping a certain company to a ridiculous degree you may want to be careful there as well. Another excellent point and since the agent’s commission is based on the Medicare Supplement premium, it is not in their best interest to tell you all about Plan G-HD that might actually be in yo...
by ModifiedDuration
Sat Jan 20, 2024 8:50 am
Forum: Personal Finance (Not Investing)
Topic: I'm having a hard time deciding if I should pick Medigap Plan G or Plan N because of my history
Replies: 165
Views: 16292

Re: I'm having a hard time deciding if I should pick Medigap Plan G or Plan N because of my history

Dmevsjd wrote: Sat Jan 20, 2024 8:23 am It costs you nothing to hire an agent and they can assist over the years too to determine if a switch to another company or lettered plan is workable should your present group jab you for ridiculous increases (of course, if you can pass health questions which is where they can earn their keep in knowing which companies have less restrictive questions, etc.).
Excellent point. Not only would the agent know what insurers have less restrictive questions, but, hopefully, they could very well know what insurers would let you through medical underwriting in your specific situation.
by ModifiedDuration
Sat Jan 20, 2024 8:46 am
Forum: Personal Finance (Not Investing)
Topic: I'm having a hard time deciding if I should pick Medigap Plan G or Plan N because of my history
Replies: 165
Views: 16292

Re: I'm having a hard time deciding if I should pick Medigap Plan G or Plan N because of my history

On almost everything, I go with the least expensive. On important things, I go high end. Health is the most important of the important things, as I see it. My mom was in the hospital for a week recently. Medicare reduced the hospital charges from $58k to 9k, paid 7.5k and her supplemental insurance paid the rest. Mom’s portion out of pocket (obviously she paid into it for 50 years)? $0. So, had she not had Medigap, her bill for her hospital stay would have been a "whopping" $1500? That sounds like an argument for not buying Medigap at all! Does anyone have real-life examples where Medigap saved them at least 20K per illness? Otherwise, I'm thinking many Bogleheads could self-insure for anything Parts A/B don't cover. Unless you a...