Medicare Plan F and Guaranteed Issue Question

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LadyIJ
Posts: 525
Joined: Thu Mar 06, 2014 8:00 pm

Medicare Plan F and Guaranteed Issue Question

Post by LadyIJ » Fri Jul 13, 2018 5:09 pm

I'm recently retired and when I turn 65 my firm will provide me with a Supplemental Plan, but I must sign up for Medicare Parts A & B. This supplement has no monthly premium, but a $500 deductible and then pay 70% of the unpaid bills (i.e. - 70% of the 20% remaining bill) after meeting the $500 deductible. The supplement includes a drug plan with a $50 annual deductible. The sticking point is this: it is considered creditable coverage, but i can only get Guaranteed Issue for Plans Plan A, B, C, F, K, or L when it ends in 3 years. Plan F is going away in 2020 and Plan G - which I would prefer will not be Guaranteed Issue. I'm trying to figure out if I should pay more NOW and forego the firm's plan - I would have to pay $101.25 monthly for G and about $20 for Part D, rather than not knowing what will happen in 2021 . . . if anyone has any insight into the insurance industry or has a more actuarial perspective, I would appreciate any advice. I know I would save about $700 a year (based on my past medical expenditures) with the firm's plan, but I don't know what Plan I would be forced into when Plan F goes away. . . Thanks for any advice on this.
Last edited by LadyIJ on Fri Jul 13, 2018 5:38 pm, edited 1 time in total.

drawpoker
Posts: 2055
Joined: Mon May 19, 2014 6:33 pm
Location: Delmarva

Re: Medicare Part F and Guaranteed Issue Question

Post by drawpoker » Fri Jul 13, 2018 5:15 pm

It is not just Plan F that is going away. Plan C will not be available either. (Both C & F provided 'first dollar' coverage, that is the doctrine that is going by the wayside)
You didn't mention Plan N. Do none of the insurers in your area offer Plan N?
I don't think you would want either K or L. Very, very skimpy coverage, both leave you wide open for BigTime OOP

btw, you should re-title your thread - There is no Medicare Part F, it will just confuse people. It is Plan F.

LadyIJ
Posts: 525
Joined: Thu Mar 06, 2014 8:00 pm

Re: Medicare Plan F and Guaranteed Issue Question

Post by LadyIJ » Fri Jul 13, 2018 5:39 pm

Thanks, I did - I'm only interested in G, and it makes me wonder if I should pay a bit more now and take the Plan G rather than the uncertainly of what will be offered in 2021, considering they are saying Guaranteed Issue for Plan A, B, C, F, K, or L only, meaning A,B,K and L Guaranteed Issue, will have to qualify for PLAN G.

drawpoker
Posts: 2055
Joined: Mon May 19, 2014 6:33 pm
Location: Delmarva

Re: Medicare Plan F and Guaranteed Issue Question

Post by drawpoker » Fri Jul 13, 2018 5:50 pm

Well, you know what the employer-offered plan costs: 0 But, you are facing that $500 deductible and then co-pays forever (albeit somewhat small it sounds like)
With G, you know from the git-go what the damages will be for the year: Part B deductible amount (currently $183) plus your monthly premiums for 12 months. That's it, your OOP from then on zero.
I guess the answer is - take whatever the rate is now for Plan G in your area, and try and project what the premiums will be 3 years from now. That might be a starting point.
Of course, to throw another monkey wrench into it, there is no statutory guarantee that the former employer has to continue with the same plan, same benefits, same costs. That plan that looks good now could suddenly morph into something with a $1,000 deductible and co-pay amounts bumped up much higher.
It's a crapshoot, no doubt about it.
Where are you, anyway? "Guaranteed issue" sounds good, but is pretty much meaningless in states like NY where all the insurers are required to observe community rated policies with continuous, year round open enrollment. Which is why their Medigap rates are sky high. :shock:
Edited to add: Just now saw that you wrote Plan G in your area would cost $101 for a 65- year old. That is an extremely good price, well below national average, in fact. My advice would be Go for It!

Right now, Ohio is the place to be for Plan G. Here are the recent quotes for a 65-year old female non-smoker there.

https://www.csgactuarial.com/2018/07/wh ... lement-30/

(Warning, contains frank and adult material that will make some of you Cry :P :P when you see these bargain basement prices that aren't available to most of us :( :(

LadyIJ
Posts: 525
Joined: Thu Mar 06, 2014 8:00 pm

Re: Medicare Plan F and Guaranteed Issue Question

Post by LadyIJ » Sat Jul 14, 2018 7:51 am

and the plan they are offering - yes it is $500 deductible, but they can raise it - it's only for three years -- I'm thinking about spending a little more and starting at the $101. It's in Illinois . . . thanks for your input

LadyIJ
Posts: 525
Joined: Thu Mar 06, 2014 8:00 pm

Re: Medicare Plan F and Guaranteed Issue Question

Post by LadyIJ » Sat Jul 14, 2018 2:24 pm

drawpoker wrote:
Fri Jul 13, 2018 5:50 pm
Well, you know what the employer-offered plan costs: 0 But, you are facing that $500 deductible and then co-pays forever (albeit somewhat small it sounds like)
With G, you know from the git-go what the damages will be for the year: Part B deductible amount (currently $183) plus your monthly premiums for 12 months. That's it, your OOP from then on zero.
I guess the answer is - take whatever the rate is now for Plan G in your area, and try and project what the premiums will be 3 years from now. That might be a starting point.
Of course, to throw another monkey wrench into it, there is no statutory guarantee that the former employer has to continue with the same plan, same benefits, same costs. That plan that looks good now could suddenly morph into something with a $1,000 deductible and co-pay amounts bumped up much higher.
It's a crapshoot, no doubt about it.
Where are you, anyway? "Guaranteed issue" sounds good, but is pretty much meaningless in states like NY where all the insurers are required to observe community rated policies with continuous, year round open enrollment. Which is why their Medigap rates are sky high. :shock:
Edited to add: Just now saw that you wrote Plan G in your area would cost $101 for a 65- year old. That is an extremely good price, well below national average, in fact. My advice would be Go for It!

Right now, Ohio is the place to be for Plan G. Here are the recent quotes for a 65-year old female non-smoker there.

https://www.csgactuarial.com/2018/07/wh ... lement-30/

(Warning, contains frank and adult material that will make some of you Cry :P :P when you see these bargain basement prices that aren't available to most of us :( :(
I forgot to mention every doctor's visit is $30 copay. I can easily go one a month or more. And as you said, the employer, in the next 3 years can raise the deductible and more likely the co-pays. I'm going to go with the Medicare Plan G. Thank you for your comments. Who knows, as you say!

drawpoker
Posts: 2055
Joined: Mon May 19, 2014 6:33 pm
Location: Delmarva

Re: Medicare Plan F and Guaranteed Issue Question

Post by drawpoker » Sat Jul 14, 2018 2:40 pm

LadyIJ wrote:
Sat Jul 14, 2018 2:24 pm
.... I forgot to mention every doctor's visit is $30 copay...... going to go with the Medicare Plan G.....
That $30 might be just for PCP. If you read the fine print, you might discover the co-pay amount is higher for specialists. A lot of insurance works that way.
I think you are making a wise choice. After all, there is something to be said for the gift of sleeping well at night, not bothered by the "what ifs" of what may happen 3 years from now.

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