Turning 65, Medicaire questions

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rivercrosser
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Re: Turning 65, Medicaire questions

Post by rivercrosser » Thu May 21, 2020 9:59 pm

3feetpete wrote:
Thu May 21, 2020 1:17 pm
A couple of things to consider if you decide to go with Medicare plus supplemental.

Choose the plan that makes the most sense for you and then the lowest cost provider for that plan. Don't worry about customer satisfaction ratings of the supplement company. The truth is that you will never deal with the supplemental insurance company. All bills go to Medicare and then Medicare tells the insurance company how much to pay. End of story.

Consider a high deductable plan. Medicare pays 80% of the bill with a fairly low deductible. So the supplemental insurance only covers the last 20%. In my case the high deductible was $1,000 per year lower in premiums than the no deductible. So I would have to have $5,000 in medical expenses before I spent that $1,000 savings. (20% of $5,000 = $1,000). I only go to the doctors a couple of times a year.

For prescripions go to the medicare website. They have a tool to help you find the best Part D plan for you. Enter your medications and the tool will find all the providers in your area and put them in order by total cost for you. Do this annually in November or early December. If you have any medications that you suspect are driving the cost up. Try seeing what you can get them for with a coupon on GoodRx.
I went on medicare this past February. Hadn't been to doctor for years. Figured I'd do the wellness checkup etc at some point. One trip to the er the other week for a kidney stone and I racked up over $6500.00. Then less than 2 weeks later a heart attack and a stent with a night in the hospital. Haven't seen that claim yet. I'm sticking with the regular plan G. It's a guessing game. On my part D I ended up with 2 drugs for $0.00 but one will cost me the $435.00 deductible and then about $35.00 a month. No generic. I tried 3 different discount cards with no luck. I'm going to check out the GoodRx you mentioned.

rivercrosser
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Re: Turning 65, Medicaire questions

Post by rivercrosser » Thu May 21, 2020 10:14 pm

rivercrosser wrote:
Thu May 21, 2020 9:59 pm
3feetpete wrote:
Thu May 21, 2020 1:17 pm
A couple of things to consider if you decide to go with Medicare plus supplemental.

Choose the plan that makes the most sense for you and then the lowest cost provider for that plan. Don't worry about customer satisfaction ratings of the supplement company. The truth is that you will never deal with the supplemental insurance company. All bills go to Medicare and then Medicare tells the insurance company how much to pay. End of story.

Consider a high deductable plan. Medicare pays 80% of the bill with a fairly low deductible. So the supplemental insurance only covers the last 20%. In my case the high deductible was $1,000 per year lower in premiums than the no deductible. So I would have to have $5,000 in medical expenses before I spent that $1,000 savings. (20% of $5,000 = $1,000). I only go to the doctors a couple of times a year.

For prescripions go to the medicare website. They have a tool to help you find the best Part D plan for you. Enter your medications and the tool will find all the providers in your area and put them in order by total cost for you. Do this annually in November or early December. If you have any medications that you suspect are driving the cost up. Try seeing what you can get them for with a coupon on GoodRx.
I went on medicare this past February. Hadn't been to doctor for years. Figured I'd do the wellness checkup etc at some point. One trip to the er the other week for a kidney stone and I racked up over $6500.00. Then less than 2 weeks later a heart attack and a stent with a night in the hospital. Haven't seen that claim yet. I'm sticking with the regular plan G. It's a guessing game. On my part D I ended up with 2 drugs for $0.00 but one will cost me the $435.00 deductible and then about $35.00 a month if I do 90 day mail order. No generic. I tried 3 different discount cards with no luck. I'm going to check out the GoodRx you mentioned.
Just looked. GoodRx wouldn't work with it.

Glamdring
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Re: Turning 65, Medicaire questions

Post by Glamdring » Thu May 21, 2020 10:42 pm

Can my wife and I get different plans? I rarely go to the doctor and high deductibles will work out the best for me. My wife has to Go in regularly for tests so a low deductible and low co- pay is best for her.

Can we get separate plans or are there advantages for a married couple to be on the same plan?

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FrugalInvestor
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Re: Turning 65, Medicaire questions

Post by FrugalInvestor » Thu May 21, 2020 10:55 pm

Glamdring wrote:
Thu May 21, 2020 10:42 pm
Can my wife and I get different plans? I rarely go to the doctor and high deductibles will work out the best for me. My wife has to Go in regularly for tests so a low deductible and low co- pay is best for her.

Can we get separate plans or are there advantages for a married couple to be on the same plan?
You each buy your own plan(s).

Also, buying a plan based on past medical needs doesn't necessarily make a lot of sense. We buy insurance for the future which can often be very different from the past.
IGNORE the noise!

vested1
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Re: Turning 65, Medicaire questions

Post by vested1 » Fri May 22, 2020 7:05 am

3feetpete wrote:
Thu May 21, 2020 1:17 pm
A couple of things to consider if you decide to go with Medicare plus supplemental.

Choose the plan that makes the most sense for you and then the lowest cost provider for that plan. Don't worry about customer satisfaction ratings of the supplement company. The truth is that you will never deal with the supplemental insurance company. All bills go to Medicare and then Medicare tells the insurance company how much to pay. End of story.

Consider a high deductable plan. Medicare pays 80% of the bill with a fairly low deductible. So the supplemental insurance only covers the last 20%. In my case the high deductible was $1,000 per year lower in premiums than the no deductible. So I would have to have $5,000 in medical expenses before I spent that $1,000 savings. (20% of $5,000 = $1,000). I only go to the doctors a couple of times a year.

For prescripions go to the medicare website. They have a tool to help you find the best Part D plan for you. Enter your medications and the tool will find all the providers in your area and put them in order by total cost for you. Do this annually in November or early December. If you have any medications that you suspect are driving the cost up. Try seeing what you can get them for with a coupon on GoodRx.
Maybe for you, but only a wishful dream for me. Between my wife and me I deal with 25 different agencies for our healthcare. That's because each of our previous employers requires us to go through their intermediary in order to receive the HRA (Health Reimbursement Account) that they each provide, which adds up to 12k a year, making our health care costs almost zero. I could list them all but what's the point? Dealing with the intermediaries for the 12k yearly reimbursement is almost not worth it.

My wife's Part D provider (regular and specialty for tier 5 drug) are easy to work with, but I still need to contact them occasionally. Both of our part N providers are also easy to deal with, yet I still need to contact them at times. My part D is a nightmare to deal with, even though my prescription costs are negligible, and I've had to make Medicare complaints to get issues resolved or to even get my prescriptions. My wife's health intermediary agency, Via Benefits, is easy to deal with but my former employer's intermediary, AON, goes out of their way to make things difficult and dealing with them is like a full time job when there is an issue, which occurs frequently.

In my experience, being the one who deals with insurance issues, health care decisions and the effort involved were easy before Medicare, and that now it is a constant battle. I think the issues with Medicare are highly variable depending on where you live and which companies you need to interface with.

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Stinky
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Re: Turning 65, Medicaire questions

Post by Stinky » Fri May 22, 2020 7:53 am

vested1 wrote:
Fri May 22, 2020 7:05 am
In my experience, being the one who deals with insurance issues, health care decisions and the effort involved were easy before Medicare, and that now it is a constant battle. I think the issues with Medicare are highly variable depending on where you live and which companies you need to interface with.
As is so often the case, YMMV.

DW and I both have Medicare Advantage plans. Only one provider to deal with for all medical and drug needs. We go to the doctor or pharmacy, present our MA card, pay our copay (if any), and go on our way. Piece of cake.

I don’t doubt that dealing with multiple providers can be complex. But that’s not our experience.
It's a GREAT day to be alive - Travis Tritt

VincentP
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Re: Turning 65, Medicaire questions

Post by VincentP » Fri May 22, 2020 10:38 am

My advice is to contact your local SHIP (State Health Insurance Assistance Program). office. They are staffed by trained volunteers who provide free unbiased advice. They are not selling anything. You can set up a free appointment/or talk over the phone and they can go over all the ins and outs of medicare with you in 60-90 minutes. They can help you price and quality shop your choices. You can leave the session with specific choices being made. You can go back/or call as often as you like, until you feel comfortable with your choices.

DetroitRick
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Re: Turning 65, Medicaire questions

Post by DetroitRick » Fri May 22, 2020 11:08 am

Glamdring wrote:
Thu May 21, 2020 10:42 pm
Can my wife and I get different plans? I rarely go to the doctor and high deductibles will work out the best for me. My wife has to Go in regularly for tests so a low deductible and low co- pay is best for her.

Can we get separate plans or are there advantages for a married couple to be on the same plan?
Definitely, no particular need to choose same plan. But also keep in mind that many supplement insurers do offer household discounts if multiple household members use same insurer (even with different supplement plans). Not a huge deal, but worth some consideration. Of the larger supplement insurers that I'm currently considering in my state (I'm 8 months from Medicare), one offers a 5% household discount, the other 12%.

OnTrack
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Re: Turning 65, Medicaire questions

Post by OnTrack » Fri May 22, 2020 11:23 pm

vested1 wrote:
Fri May 22, 2020 7:05 am
... Both of our part N providers are also easy to deal with, yet I still need to contact them at times. My part D is a nightmare to deal with, ...
Just a clarification. There is no Medicare "part N" (there is a "plan N"). There are Medicare parts A (hospital), B (doctors, outpatient, etc.), C (Medicare Advantage) and D (Prescription drugs). Then there are Medicare supplements (aka Medigap) plans A, B, C, D, F, G,K, L, M and N. As of January 1, 2020, Medigap plans sold to new people with Medicare aren't allowed to cover the Part B deductible. Because of this, Plans C and F are not available to people new to Medicare starting on January 1, 2020. Plans F and G also offer a high-deductible plan in some states. So, for example, there is a big difference between "part A" and "plan A".

Tracker968
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Re: Turning 65, Medicaire questions

Post by Tracker968 » Sat May 23, 2020 12:02 am

I didn't read through all the previous posts so apologize if this has already been discussed; I asked several of the top Medicare supplement providers in my area why I should choose them versus someone else. Didn't get any good answers. They said they all have the same coverage. Brokers just recommended the one with the lowest premium. I wasn't able to get much info on the history of rate increases either, but admit that I didn't try super hard to dig this out. Eventually realized I should ask them what would happen if I moved to a different state. That's where coverage and costs were different. If this is a possibility in your future, then I suggest you ask this question.

windpig
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Re: Turning 65, Medicaire questions

Post by windpig » Sat May 23, 2020 2:24 pm

I'm also in Seattle. I started on Medicare last November, dropped being on wife's plan at work. I went with the Regence Plan G. I figure I can always change later, I wanted the best. Some states don't allow you to change plans going forward without a physical. For your plan D it seems that you want to use the medicare website and enter the prescriptions you are an to see which plan is the best for you. I'm using Silverscripts. The plan G does not cover the yearly deductible for part B, buts only $85 or so. I figure I have about the best medical you can get, all for about $4500 a year. Dental plans are pretty much "pay ahead" plans, I stayed on my wife's dental plan.

$144.60 part B
$188.00 plan G
$ 31.00 plan D

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FIREchief
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Re: Turning 65, Medicaire questions

Post by FIREchief » Sat May 23, 2020 3:03 pm

windpig wrote:
Sat May 23, 2020 2:24 pm
I went with the Regence Plan G. I figure I can always change later, I wanted the best. Some states don't allow you to change plans going forward without a physical.
That's kind of where I'm at right now (I have a few years do decide). I don't want to over think this. If we can easily afford Plan G (or, perhaps Plan G high deductible), I just don't feel compelled to mess around with Medicare Advantage. I could always change later.
Some states don't allow you to change plans going forward without a physical.
I think it is much stronger than that. Insurance underwriting is likely much more than a physical with high marks. Maybe somebody who has attempted to join a Medigap plan later can share their experience. I'm envisioning something like a life insurance application where you disclose the history of the (health) world and better hope they can't find something to challenge in one of your answers when the crisis hits. If it sounds like I don't trust insurance companies, then you're likely hearing me correctly. I'm not so certain that insurance companies are even interested in signing up new, older Medicare recipients after their initial enrollment periods. If I were running the insurance company, I would just assume that the person wants to sign up because they know something about their health that hasn't fully hit yet.
Last edited by FIREchief on Sat May 23, 2020 4:47 pm, edited 1 time in total.
I am not a lawyer, accountant or financial advisor. Any advice or suggestions that I may provide shall be considered for entertainment purposes only.

cashmoney
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Re: Turning 65, Medicaire questions

Post by cashmoney » Sat May 23, 2020 4:14 pm

Tracker968 wrote:
Sat May 23, 2020 12:02 am
I didn't read through all the previous posts so apologize if this has already been discussed; I asked several of the top Medicare supplement providers in my area why I should choose them versus someone else. Didn't get any good answers. They said they all have the same coverage. Brokers just recommended the one with the lowest premium. I wasn't able to get much info on the history of rate increases either, but admit that I didn't try super hard to dig this out. Eventually realized I should ask them what would happen if I moved to a different state. That's where coverage and costs were different. If this is a possibility in your future, then I suggest you ask this question.


1.Community -rated vs attained age vs issue age premium pricing if it applies in your state
2.current premium
3.rate history.Some carriers such as mutual of Omaha will start a new block of business under a new name with very competitive premiums to start with only to and jack premiums up as much as 20% after a couple of years.Then rinse and repeat
4.Does the carrier you allow you to switch plans( ie from N to G) without underwriting and also retain issue age rate.Most don't but some like UHC and the Blues do in most states do.

Secondary importance is customer service and extra benefits beyond Medicare covered benefits.Some companies such as UHC and Humana in some states will pay for a gym membership in many states.There is talk that some medicare supplement carriers will also be adding routine dental benefits in 2021.

If you move your rates will be adjusted to the insurance carriers rate in the new state. If your carrier doesnt operate in that state you have a guarantee issue to buy from other insurance carriers but your starting rate will most likely be higher.For example if you buy plan G in an issue age state such as Fl at age 65 then move to another issue age state at age 70 your new premium is based on a 70 year old.If your current insurance carrier is available in new issue age state you would retain age 65 premium pricing.

Disclosure I am a licensed insurance broker.

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FIREchief
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Re: Turning 65, Medicaire questions

Post by FIREchief » Sat May 23, 2020 4:53 pm

cashmoney wrote:
Sat May 23, 2020 4:14 pm
Tracker968 wrote:
Sat May 23, 2020 12:02 am
I didn't read through all the previous posts so apologize if this has already been discussed; I asked several of the top Medicare supplement providers in my area why I should choose them versus someone else. Didn't get any good answers. They said they all have the same coverage. Brokers just recommended the one with the lowest premium. I wasn't able to get much info on the history of rate increases either, but admit that I didn't try super hard to dig this out. Eventually realized I should ask them what would happen if I moved to a different state. That's where coverage and costs were different. If this is a possibility in your future, then I suggest you ask this question.


1.Community -rated vs attained age vs issue age premium pricing if it applies in your state
2.current premium
3.rate history.Some carriers such as mutual of Omaha will start a new block of business under a new name with very competitive premiums to start with only to and jack premiums up as much as 20% after a couple of years.Then rinse and repeat
4.Does the carrier you allow you to switch plans( ie from N to G) without underwriting and also retain issue age rate.Most don't but some like UHC and the Blues do in most states do.

Secondary importance is customer service and extra benefits beyond Medicare covered benefits.Some companies such as UHC and Humana in some states will pay for a gym membership in many states.There is talk that some medicare supplement carriers will also be adding routine dental benefits in 2021.

If you move your rates will be adjusted to the insurance carriers rate in the new state. If your carrier doesnt operate in that state you have a guarantee issue to buy from other insurance carriers but your starting rate will most likely be higher.For example if you buy plan G in an issue age state such as Fl at age 65 then move to another issue age state at age 70 your new premium is based on a 70 year old.If your current insurance carrier is available in new issue age state you would retain age 65 premium pricing.

Disclosure I am a licensed insurance broker.
That's great info cashmoney. Thanks! I'm particularly interested in #3. That seems like a risk point for anybody going the Medigap route. Do you know if some states have effective control over such rate increases? Is historical rate information readily available?
I am not a lawyer, accountant or financial advisor. Any advice or suggestions that I may provide shall be considered for entertainment purposes only.

nanameg
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Re: Turning 65, Medicaire questions

Post by nanameg » Sat May 23, 2020 5:09 pm

From what I’ve read high deductible plan G is the way to go. Medicare Advantage is a high commission plan pushed by brokers but not advantageous to the client. Is that true?

cashmoney
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Re: Turning 65, Medicaire questions

Post by cashmoney » Sat May 23, 2020 5:21 pm

FIREchief wrote:
Sat May 23, 2020 4:53 pm
cashmoney wrote:
Sat May 23, 2020 4:14 pm
Tracker968 wrote:
Sat May 23, 2020 12:02 am
I didn't read through all the previous posts so apologize if this has already been discussed; I asked several of the top Medicare supplement providers in my area why I should choose them versus someone else. Didn't get any good answers. They said they all have the same coverage. Brokers just recommended the one with the lowest premium. I wasn't able to get much info on the history of rate increases either, but admit that I didn't try super hard to dig this out. Eventually realized I should ask them what would happen if I moved to a different state. That's where coverage and costs were different. If this is a possibility in your future, then I suggest you ask this question.


1.Community -rated vs attained age vs issue age premium pricing if it applies in your state
2.current premium
3.rate history.Some carriers such as mutual of Omaha will start a new block of business under a new name with very competitive premiums to start with only to and jack premiums up as much as 20% after a couple of years.Then rinse and repeat
4.Does the carrier you allow you to switch plans( ie from N to G) without underwriting and also retain issue age rate.Most don't but some like UHC and the Blues do in most states do.

Secondary importance is customer service and extra benefits beyond Medicare covered benefits.Some companies such as UHC and Humana in some states will pay for a gym membership in many states.There is talk that some medicare supplement carriers will also be adding routine dental benefits in 2021.

If you move your rates will be adjusted to the insurance carriers rate in the new state. If your carrier doesnt operate in that state you have a guarantee issue to buy from other insurance carriers but your starting rate will most likely be higher.For example if you buy plan G in an issue age state such as Fl at age 65 then move to another issue age state at age 70 your new premium is based on a 70 year old.If your current insurance carrier is available in new issue age state you would retain age 65 premium pricing.

Disclosure I am a licensed insurance broker.
That's great info cashmoney. Thanks! I'm particularly interested in #3. That seems like a risk point for anybody going the Medigap route. Do you know if some states have effective control over such rate increases? Is historical rate information readily available?

The carriers ask state for rate increase based on claim experience.If the claims loss ratio exceeds the benchmark for the state they have to file to state to get increase and if the CLR is lower then they have to lower premiums.Not really sure if there is any limit on increase they will approve but I imagine there is a limit before it becomes a insolvency issue.

cashmoney
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Re: Turning 65, Medicaire questions

Post by cashmoney » Sat May 23, 2020 6:18 pm

nanameg wrote:
Sat May 23, 2020 5:09 pm
From what I’ve read high deductible plan G is the way to go. Medicare Advantage is a high commission plan pushed by brokers but not advantageous to the client. Is that true?

Some agents sell both MA and Med supplement but many will only sell Medicare Supplement because there are no marketing restrictions or annual certification/training required be able to market those.These agent can cold call and knock on doors whereas an agent certified to sell MA can't.I hear of medicare supplement only agents bashing Medicare Advantage plans just because of that..Like anything there are pros and cons to both type of plans but a good agent will advise based on a needs analysis and recommend the most suitable plan.The longer someone is happy with their plan the more the agent will earn in commission since an agent main monetary motivation for the long run is renewal commisions.MA commissions are standardized whereas medicare supplement commissions can vary between carriers and between plans .Usually the commission is based on the amount of premium so yes an agent will make less selling a hi deductible G compared to a standardized G .Here is the thing I believe the hi G is a great value and I will tell my clients it is but in general nobody wants to buy it.In my state the N plan is actually the best value after the hi deductible plans for most people but I have told many times by client they don't won't it because there is a 20.00 co pay for office visits even though it would typically save them about over 200.00 annual compared to plan G.

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FIREchief
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Re: Turning 65, Medicaire questions

Post by FIREchief » Sat May 23, 2020 7:12 pm

cashmoney wrote:
Sat May 23, 2020 6:18 pm
Here is the thing I believe the hi G is a great value and I will tell my clients it is but in general nobody wants to buy it.In my state the N plan is actually the best value after the hi deductible plans for most people but I have told many times by client they don't won't it because there is a 20.00 co pay for office visits even though it would typically save them about over 200.00 annual compared to plan G.
It's nice to hear that from somebody who really understands the plans and rates. At this point, if I had to choose, I would likely take a G high-deductible plan. To your point, it is likely more emotion than rational thought that leads people to eschew high deductible plans, or even plans with a few dollars more in co-pays. As a further off-set, I believe that Medigap policy fees are not allowable as eligible medical expenses for HSA withdrawals, but those higher co-pays certainly would be. That's meaningful for those who expect to enter Medicare years with significant HSA balances.
I am not a lawyer, accountant or financial advisor. Any advice or suggestions that I may provide shall be considered for entertainment purposes only.

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FIREchief
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Re: Turning 65, Medicaire questions

Post by FIREchief » Sat May 23, 2020 7:15 pm

cashmoney wrote:
Sat May 23, 2020 5:21 pm
FIREchief wrote:
Sat May 23, 2020 4:53 pm
cashmoney wrote:
Sat May 23, 2020 4:14 pm
Tracker968 wrote:
Sat May 23, 2020 12:02 am
I didn't read through all the previous posts so apologize if this has already been discussed; I asked several of the top Medicare supplement providers in my area why I should choose them versus someone else. Didn't get any good answers. They said they all have the same coverage. Brokers just recommended the one with the lowest premium. I wasn't able to get much info on the history of rate increases either, but admit that I didn't try super hard to dig this out. Eventually realized I should ask them what would happen if I moved to a different state. That's where coverage and costs were different. If this is a possibility in your future, then I suggest you ask this question.


1.Community -rated vs attained age vs issue age premium pricing if it applies in your state
2.current premium
3.rate history.Some carriers such as mutual of Omaha will start a new block of business under a new name with very competitive premiums to start with only to and jack premiums up as much as 20% after a couple of years.Then rinse and repeat
4.Does the carrier you allow you to switch plans( ie from N to G) without underwriting and also retain issue age rate.Most don't but some like UHC and the Blues do in most states do.

Secondary importance is customer service and extra benefits beyond Medicare covered benefits.Some companies such as UHC and Humana in some states will pay for a gym membership in many states.There is talk that some medicare supplement carriers will also be adding routine dental benefits in 2021.

If you move your rates will be adjusted to the insurance carriers rate in the new state. If your carrier doesnt operate in that state you have a guarantee issue to buy from other insurance carriers but your starting rate will most likely be higher.For example if you buy plan G in an issue age state such as Fl at age 65 then move to another issue age state at age 70 your new premium is based on a 70 year old.If your current insurance carrier is available in new issue age state you would retain age 65 premium pricing.

Disclosure I am a licensed insurance broker.
That's great info cashmoney. Thanks! I'm particularly interested in #3. That seems like a risk point for anybody going the Medigap route. Do you know if some states have effective control over such rate increases? Is historical rate information readily available?

The carriers ask state for rate increase based on claim experience.If the claims loss ratio exceeds the benchmark for the state they have to file to state to get increase and if the CLR is lower then they have to lower premiums.Not really sure if there is any limit on increase they will approve but I imagine there is a limit before it becomes a insolvency issue.
Thanks. That's reassuring. It sounds like even if a company tried to grow business with artificially lower premiums, there would still be a cap on (eventual and inevitable) rate increases.
I am not a lawyer, accountant or financial advisor. Any advice or suggestions that I may provide shall be considered for entertainment purposes only.

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