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

[FinIndyGal]

I'll be on Medicare for the first time starting next month and need to set up a Medigap plan, but I'm burnt out trying to figure this out. I'd really appreciate any advice that you can provide regarding my particular situation. I was happy to find this post because I have the same concerns as ForestWolf after ad nauseum research and watching tons of videos, including by Christopher Westfall.
viewtopic.php?t=399726

Since this thread is almost a year old, I wanted to see if you think Medigap Plan N at this point is better long term for someone living in Florida that's new to Medicare in 2024 because Plan G now has guaranteed issue rights? My biggest concern about going with Plan N is that I've had melanoma twice. The last time was in 2019 where I was in the hospital for a month, had four surgeries, physical therapy and all kinds of things because of it. I've actually never had so many medical appointments in my entire life combined as I did that year! I initially thought that I'd go with Plan G, but I started questioning myself after seeing Christopher's videos where he emphasized that Plan G will insure sicker people who don't have to go through medical underwriting and the rate increases will be much higher than Plan N in the future. However, I also wonder if you think that there's a possibility that Plan N will later become a guaranteed issue right plan just like Plan G did when Plan F closed? Florida supplement premiums are on an issue-age basis. I don't believe there are any laws against excess charges, and, from my experience in 2019, you don't know who the anesthesiologist (as one example) is going to be when you're about to go into surgery, so that's a little scary.

This is a huge decision for me, mainly because I feel my history of melanoma is hanging over my head and Florida will require underwriting later if I want to change plans. I'm usually very healthy and thankfully only go to the doctor for the normal preventative visits like wellness, blood tests, the dermatologist at least once a quarter unless there's an issue, etc. The problem is that no one has a crystal ball to know what our future health situations will be, and I'm living proof that things can change very quickly. I recall only too well that I thought I was fine when I was driving to my dermatologist appointment in 2019 and less than a week later my life was turned upside down.

Given these facts, would you choose Plan G or N if you were me? I guess I should call some brokers next to determine the prices and best company to use, but I first wanted to get the advice of trusted Bogleheads as to what plan is best for me under these circumstances. Thank you!

[DebiT]

Assuming that Plan G is only guaranteed issue when you are new to Medicare (some states are different), I would absolutely use Plan G. Plan N will always be cheaper, but is the difference life changing money for you? I have no conditions, but this was my reasoning. You can always change your mind and go to Plan N later, but again, why would you? One of my “mottos” in recent years is “which mistake would I rather live with?” In this situation, paying more for Plan G and thinking you wasted money because God willing you never really needed it, or paying less for Plan N and wishing you had gone with Plan G?

[Silk McCue]

My wife just started Medicare this month in Florida and chose the UHC Supplement G. The price difference between G and N is less than $30 per month and that is not significant for our budget. Given the out of pocket maximum on the G plan of $240 and no limit on the N it is a no brainer to go with G from a financial and recording keeping perspective. She is healthy now but none of us an know how our health will progress as we age, and we just don't want to be dealing with ongoing out of pocket expenses and the necessary paperwork that may arise in the decades to come.

Cheers

[FrankLUSMC]

Plan G a no brainer since you have had melanoma. Plan N has no benefit for you with that.

[TechieTechie]

Get Plan G, without a doubt....your OOP is capped. Let's say you go with N, but 5 years from now, you want to switch to G (to save on OOP costs). It will require a full underwriting, and due to your medical history, you will have a hard time (read: impossible) passing underwriting in the future.

We just went thru this with my Mom. She moved off a great Plan G b/c some stupid swindler convinced her get onto a Medicare Advantage Plan b/c it would save her maybe $40 a month. But the coverage was terrible. And was impossible to get her re-covered under a decent Medigap G plan (along w moving back to Medicare) because of her smoking and COPD history.

Choose wisely for the long run. Starting off with standard Medicare with a good Medigap Plan G will be the best insurance you can get for the long run (come what may, medically and whereever you may live). Yes, the G premiums may increase annually, but they will pale when compared to the OOP costs on N (and trust me, that's what insurance companies are banking on...that folks will be lulled into the safety of the initial low insurance costs, not thinking about the total costs of their medical care).

[ModifiedDuration]

First question is: what is the price difference between G and N in your zip code?

If it is $5 a month, then G.

If it is $105 a month, then N.

Whatever the premium difference is between the two, it is a factor to be considered.

However, based on your medical history, one might strongly lean to G anyway, more for your peace of mind than anything.

The difference between the two plans is really just the up to $20 charge for office visits (Excess Charges are rather uncommon and, when they do occur, are usually small anyway).

If it wasn’t for your health concerns, I would probably say N (depending on the premium savings), as it has a healthier pool and, as expected, nationwide has been having lower premium increases than G (notwithstanding the bigger increase for N vs G in Florida the last few years by UHC).

[meowcat]

Premium differences aside, it's important to dive further into this. I, for one, don't mind paying up to a minuscule $20 co-pay for Dr. visits. (follow up visits are exempt from the co-payments) And Excess charges are all but dead, and getting deader. I'd choose plan N. The biggest reason, however, is that plan N, overall, has had price increases that are a tiny fraction of plan G price increases.

[FinIndyGal]

Thank you so much to everyone who has replied so far. I'm very grateful for your feedback and words of wisdom. I haven't called a broker yet to verify, but it seems that AARP/United Healthcare and Florida Blue have the majority of the Medigap policies in Florida. While there appears to be 29-30 policies in my zip code with numerous companies, I looked on the Medicare.gov site to get an initial idea of pricing with just those two for now. It shows a Plan G with UHC is $190 and Plan N is $162 ($28 a month difference). I'm not an AARP member so I think I'd have to subscribe to get that plan. It also shows a Plan G with Florida Blue is $214, and Plan N is $177 ($37 a month difference). I assume these prices are accurate. I'm leaning more toward Plan G right now, but I'd obviously welcome and appreciate any additional insight based on this information.

[TechieTechie]

Thank you so much to everyone who has replied so far. I'm very grateful for your feedback and words of wisdom. I haven't called a broker yet to verify, but it seems that AARP/United Healthcare and Florida Blue have the majority of the Medigap policies in Florida. While there appears to be 29-30 policies in my zip code with numerous companies, I looked on the Medicare.gov site to get an initial idea of pricing with just those two for now. It shows a Plan G with UHC is $190 and Plan N is $162 ($28 a month difference). I'm not an AARP member so I think I'd have to subscribe to get that plan. It also shows a Plan G with Florida Blue is $214, and Plan N is $177 ($37 a month difference). I assume these prices are accurate. I'm leaning more toward Plan G right now, but I'd obviously welcome and appreciate any additional insight based on this information.

Look into the details with a fine tooth comb. Most Florida Blue plans (at least when I was helping my Dad 2+ years ago) did not cover out of state medical care (and you'd have to re-apply should you move from FL....and again, with your history, you'd be hard pressed to pass underwriting). And, United Health care has a really bad history of denying claims. Be very, very careful picking a Plan G as you only have 1 shot to get it right.

You may find more specific guidance on https://www.insurance-forums.com/

[ModifiedDuration]

Thank you so much to everyone who has replied so far. I'm very grateful for your feedback and words of wisdom. I haven't called a broker yet to verify, but it seems that AARP/United Healthcare and Florida Blue have the majority of the Medigap policies in Florida. While there appears to be 29-30 policies in my zip code with numerous companies, I looked on the Medicare.gov site to get an initial idea of pricing with just those two for now. It shows a Plan G with UHC is $190 and Plan N is $162 ($28 a month difference). I'm not an AARP member so I think I'd have to subscribe to get that plan. It also shows a Plan G with Florida Blue is $214, and Plan N is $177 ($37 a month difference). I assume these prices are accurate. I'm leaning more toward Plan G right now, but I'd obviously welcome and appreciate any additional insight based on this information.

Look into the details with a fine tooth comb. Most Florida Blue plans (at least when I was helping my Dad 2+ years ago) did not cover out of state medical care (and you'd have to re-apply should you move from FL....and again, with your history, you'd be hard pressed to pass underwriting). And, United Health care has a really bad history of denying claims. Be very, very careful picking a Plan G as you only have 1 shot to get it right.

You may find more specific guidance on https://www.insurance-forums.com/

Like Original Medicare, Medicare Supplement plans are accepted nationwide. As long as the provider accepts Original Medicare, they will accept the Supplement.

No issues with denials with a Supplement. If Medicare approves the charge and Medicare pays its share, the Supplement then just pays its portion. The Supplement has nothing to accept or deny. A Plan G is a Plan G, no matter who the insurer is.

If you move out of state, you just keep your Supplement plan.

What matters with a Supplement insurer is price, both the current price and future increases. Many people with Supplements report never (or very infrequently) having to contact their Supplement insurer, except, maybe, in the case of Bankers Life.

[FinIndyGal]

My wife just started Medicare this month in Florida and chose the UHC Supplement G. The price difference between G and N is less than $30 per month and that is not significant for our budget. Given the out of pocket maximum on the G plan of $240 and no limit on the N it is a no brainer to go with G from a financial and recording keeping perspective. She is healthy now but none of us an know how our health will progress as we age, and we just don't want to be dealing with ongoing out of pocket expenses and the necessary paperwork that may arise in the decades to come.

Cheers

Thanks for this very helpful information. Since you're also in Florida, what made your wife choose UHC over other providers, like Florida Blue, etc.? Did she use a broker to help her with this decision, and if so, who? You also make a great point about the paperwork. In 2019, my surgeon put me in the hospital suddenly with no notice after my first surgery due to complications. I didn't have time to prepare for or think about anything. Being in the hospital that long caused me even more stress because I obviously didn't have any of my passwords with me to be able to do bill pays, etc., while I was there. This made the situation that I was in so much worse.

[CWRadio]

Whatever Medigap (supplement) insurance company you pick for your Medigap plan check to see how many "closed block of business." (deadpool) policies the company has.

This is done because the current book of business have people who have become older and therefore have more illnesses meaning more claims. They close that book and raise the rates to cover the increasing losses. Then, they open a new book with younger, healthier folks and charge a lower premium do to lower claims ratios. After a couple of years, rinse and repeat.

In most states you will be unable to change supplement insurance companies without medical underwriting. A few states have a birthday rules that allows you to change Medigap plans without medical underwriting around your birthday.

[ModifiedDuration]

Whatever Medigap (supplement) insurance company you pick for your Medigap plan check to see how many "closed block of business." (deadpool) policies the company has.

This is done because the current book of business have people who have become older and therefore have more illnesses meaning more claims. They close that book and raise the rates to cover the increasing losses. Then, they open a new book with younger, healthier folks and charge a lower premium do to lower claims ratios. After a couple of years, rinse and repeat.

In most states you will be unable to change supplement insurance companies without medical underwriting. A few states have a birthday rules that allows you to change Medigap plans without medical underwriting around your birthday.

Good point and Mutual of Omaha (and its subsidiaries) are the kings of the deadpool game.

[meowcat]

Thank you so much to everyone who has replied so far. I'm very grateful for your feedback and words of wisdom. I haven't called a broker yet to verify, but it seems that AARP/United Healthcare and Florida Blue have the majority of the Medigap policies in Florida. While there appears to be 29-30 policies in my zip code with numerous companies, I looked on the Medicare.gov site to get an initial idea of pricing with just those two for now. It shows a Plan G with UHC is $190 and Plan N is $162 ($28 a month difference). I'm not an AARP member so I think I'd have to subscribe to get that plan. It also shows a Plan G with Florida Blue is $214, and Plan N is $177 ($37 a month difference). I assume these prices are accurate. I'm leaning more toward Plan G right now, but I'd obviously welcome and appreciate any additional insight based on this information.

Look into the details with a fine tooth comb. Most Florida Blue plans (at least when I was helping my Dad 2+ years ago) did not cover out of state medical care (and you'd have to re-apply should you move from FL....and again, with your history, you'd be hard pressed to pass underwriting). And, United Health care has a really bad history of denying claims. Be very, very careful picking a Plan G as you only have 1 shot to get it right.

You may find more specific guidance on https://www.insurance-forums.com/

You may be thinking of Medicare Advantage plans, which are not Medicare, nor are they an advantage, as you've pointed out, they are not nationwide. A Medicare supplement plan can be used coast to coast in all 50 states.

[TechieTechie]

Thank you so much to everyone who has replied so far. I'm very grateful for your feedback and words of wisdom. I haven't called a broker yet to verify, but it seems that AARP/United Healthcare and Florida Blue have the majority of the Medigap policies in Florida. While there appears to be 29-30 policies in my zip code with numerous companies, I looked on the Medicare.gov site to get an initial idea of pricing with just those two for now. It shows a Plan G with UHC is $190 and Plan N is $162 ($28 a month difference). I'm not an AARP member so I think I'd have to subscribe to get that plan. It also shows a Plan G with Florida Blue is $214, and Plan N is $177 ($37 a month difference). I assume these prices are accurate. I'm leaning more toward Plan G right now, but I'd obviously welcome and appreciate any additional insight based on this information.

Look into the details with a fine tooth comb. Most Florida Blue plans (at least when I was helping my Dad 2+ years ago) did not cover out of state medical care (and you'd have to re-apply should you move from FL....and again, with your history, you'd be hard pressed to pass underwriting). And, United Health care has a really bad history of denying claims. Be very, very careful picking a Plan G as you only have 1 shot to get it right.

You may find more specific guidance on https://www.insurance-forums.com/

You may be thinking of Medicare Advantage plans, which are not Medicare, nor are they an advantage, as you've pointed out, they are not nationwide. A Medicare supplement plan can be used coast to coast in all 50 states.

I know the difference between MA plans and regular Medicare, thanks. Florida Blue plans (at least the one my Dad had) had some REALLY weird provisions (but it's been 3+ years, so I've forgotten the details). My point was to just caution the OP to look at the fine print very, very closely. If she is getting Medicare + a Medigap G, she needs to make sure that her Medigap G covers procedures/costs/visits outside the state of Florida....b/c one never knows where they will end up.

[ModifiedDuration]

Thank you so much to everyone who has replied so far. I'm very grateful for your feedback and words of wisdom. I haven't called a broker yet to verify, but it seems that AARP/United Healthcare and Florida Blue have the majority of the Medigap policies in Florida. While there appears to be 29-30 policies in my zip code with numerous companies, I looked on the Medicare.gov site to get an initial idea of pricing with just those two for now. It shows a Plan G with UHC is $190 and Plan N is $162 ($28 a month difference). I'm not an AARP member so I think I'd have to subscribe to get that plan. It also shows a Plan G with Florida Blue is $214, and Plan N is $177 ($37 a month difference). I assume these prices are accurate. I'm leaning more toward Plan G right now, but I'd obviously welcome and appreciate any additional insight based on this information.

Look into the details with a fine tooth comb. Most Florida Blue plans (at least when I was helping my Dad 2+ years ago) did not cover out of state medical care (and you'd have to re-apply should you move from FL....and again, with your history, you'd be hard pressed to pass underwriting). And, United Health care has a really bad history of denying claims. Be very, very careful picking a Plan G as you only have 1 shot to get it right.

You may find more specific guidance on https://www.insurance-forums.com/

You may be thinking of Medicare Advantage plans, which are not Medicare, nor are they an advantage, as you've pointed out, they are not nationwide. A Medicare supplement plan can be used coast to coast in all 50 states.

I know the difference between MA plans and regular Medicare, thanks. Florida Blue plans (at least the one my Dad had) had some REALLY weird provisions (but it's been 3+ years, so I've forgotten the details). My point was to just caution the OP to look at the fine print very, very closely. If she is getting Medicare + a Medigap G, she needs to make sure that her Medigap G covers procedures/costs/visits outside the state of Florida....b/c one never knows where they will end up.

Was this a Medicare Supplement Plan G SELECT policy that your father had?

[TechieTechie]

Was this a Medicare Select policy that your father had?

MD, I honestly can't remember, it's been a couple of years. But I just remember being taken aback that his policies would not cover out of state procedures. I was lulled into a sense of false security with my Mom's original Medicare + Medigap coverage (which was fantastic).

[ModifiedDuration]

Was this a Medicare Select policy that your father had?

MD, I honestly can't remember, it's been a couple of years. But I just remember being taken aback that his policies would not cover out of state procedures. I was lulled into a sense of false security with my Mom's original Medicare + Medigap coverage (which was fantastic).

Yeah, it sounds like a Medicare Supplement Select policy.

That’s the only type of Supplement that would have restrictions on where you could go to get medical care.

[meowcat]

Thanks for the info, MD, I learn something new every day.

[cheese_breath]

... Plan N will always be cheaper...

???

Plan G's premiums should be less, but considering Plan N's copays it may not always be cheaper if you use it a lot. Also, plan G covers Part B excess charges. Plan N does not. But I concede plan N should usually be cheaper. You'd probably need a lot of office or emergency room visits to make up the difference.

I have Plan G. DW had plan N. Both are good.

[FinIndyGal]

Whatever Medigap (supplement) insurance company you pick for your Medigap plan check to see how many "closed block of business." (deadpool) policies the company has.

This is done because the current book of business have people who have become older and therefore have more illnesses meaning more claims. They close that book and raise the rates to cover the increasing losses. Then, they open a new book with younger, healthier folks and charge a lower premium do to lower claims ratios. After a couple of years, rinse and repeat.

In most states you will be unable to change supplement insurance companies without medical underwriting. A few states have a birthday rules that allows you to change Medigap plans without medical underwriting around your birthday.

Good point and Mutual of Omaha (and its subsidiaries) are the kings of the deadpool game.

Thanks to you both for this valuable information. Can I assume that a broker will be able to accurately provide me with this information? How many companies actually do this, and is it a common practice? I honestly need to understand this more after I clear my head tonight so forgive me if these are dumb questions.
I've noticed many negative posts about Mutual of Omaha so I already planned to not consider them. I never realized that Medicare was so complicated!

[FinIndyGal]

Was this a Medicare Select policy that your father had?

MD, I honestly can't remember, it's been a couple of years. But I just remember being taken aback that his policies would not cover out of state procedures. I was lulled into a sense of false security with my Mom's original Medicare + Medigap coverage (which was fantastic).

Yeah, it sounds like a Medicare Supplement Select policy.

That’s the only type of Supplement that would have restrictions on where you could go to get medical care.

Thanks for warning me about this, Techie, and for you explaining it, ModifiedDuration. It seems that I saw somewhere during my recent research something about Select, but I didn't know what it was. I know now to stay away from it!

[skipper]

I initially thought that I'd go with Plan G, but I started questioning myself after seeing Christopher's videos where he emphasized that Plan G will insure sicker people who don't have to go through medical underwriting and the rate increases will be much higher than Plan N in the future. However, I also wonder if you think that there's a possibility that Plan N will later become a guaranteed issue right plan just like Plan G did when Plan F closed?

I am late to the conversation and not qualified to comment definitively, except as a concerned son. I recently helped my mom make a somewhat similar decision. She's still on Plan F and was considering G because the premium was cheaper. With Plan F, she never pays anything ever no matter what she has to do or who she has to see...EVER. Obviously, G is not as good as F in that regard, but my opinion, based on my research, is to generally go with the more established, lowest out-of-pocket, least problematic plan available NOW. No one knows what the future is on any government plan. Go with G now; you can always change to another plan in a future year if it suits you better. I told mom if they let you stay on F, stay on F. I say get on G while the gettin's good.

EDIT: Somehow, I missed TechieTechie's first post. If I could use a slang-curse to emphatically agree, I would. That post is spot-on! I'm going to voice MY OPINION based on long research others may disagree but Advantage plans are a joke and a swindle. If they are advertising HARD to get people on them, you can bet those plans are designed to be better for the providers. The long-term play is to take the "oldest" plan up front and change to a "more modern" plan later if you think it is better. Choose N now and G may not be around when you want it. Like my mom, she's staying on "Grandaddy F" that no one else can get on. Yes, the premiums are a little higher, but there's no other cost and nothing else to think about. That peace of mind is worth all the pocket change premium in the world. I'm getting emotional- I'll stop.

[FinIndyGal]

... Plan N will always be cheaper...

???

Plan G's premiums should be less, but considering Plan N's copays it may not always be cheaper if you use it a lot. Also, plan G covers Part B excess charges. Plan N does not. But I concede plan N should usually be cheaper. You'd probably need a lot of office or emergency room visits to make up the difference.

I have Plan G. DW had plan N. Both are good.

I appreciate your reply and all the help from everyone. It's interesting to me that you and your DW chose different plans. The UHC Plan N is $28 less than Plan G in my zip code and $37 less for Plan N vs. Plan G with Florida Blue. I haven't been able to call a broker or look into the other companies yet to see if there are maybe better options. I'm an overthinker and worrier so I'm driving myself crazy about all of this, but it seems like the majority so far think I should choose Plan G because of my melanoma history. I'm going to revisit all this helpful feedback tomorrow when my brain is fresh. I'll drive myself even crazier trying to figure out what company to go with!

[jabberwockOG]

Assuming that Plan G is only guaranteed issue when you are new to Medicare (some states are different), I would absolutely use Plan G. Plan N will always be cheaper, but is the difference life changing money for you? I have no conditions, but this was my reasoning. You can always change your mind and go to Plan N later, but again, why would you? One of my “mottos” in recent years is “which mistake would I rather live with?” In this situation, paying more for Plan G and thinking you wasted money because God willing you never really needed it, or paying less for Plan N and wishing you had gone with Plan G?

Very wise and well reasoned advice. There are many places and events in life where you can be smart and save money. My view is that Medicare insurance is the wrong pace to take on risk to save a few bucks, unless you have a limited budget and have no choice.

[bradinsky]

G plan all the way! DW & I have had the G plan since we retired almost 7 years ago. 3 total joint replacements & a couple of other surgeries & all we pay is the part B deductible. For us, it’s been a great choice & probably the best insurance we have ever had.

[meowcat]

Plan G, without a doubt, is the best Medicare supplement you can get today. However, plan G's history of price increases can sometimes be pretty dramatic. In comparison, Plan N price increases have shown a history of being a tiny fraction of plan G increases. I don't mind paying a small co-payment for a Dr. visit, (follow-ups are exempt from the co-payment) and many times, the co-payment is much less than $20. I would feel pretty secure about knowing that my supplement plan premiums aren't going to break me sometime down the road. More people than you might think are dropping plan G because the price increases have just gotten out of control.
Oh, and excess charges? Don't worry about them. They are almost non-existent, now. They're pretty much dead, and getting deader as we speak.

[HomeStretch]

Yes, to enroll in a UHC/ARP medical plan, you need to have an active AARP membership.

I would have no issues with using a UHC Medigap plan from a claims denial perspective. They paid their share of claims timely with no claims denial for two parents who had significant healthcare services and bills including one undergoing monthly immunotherapy for melanoma billed at $100k/treatment.

[Dmevsjd]

Long time lurker, first time poster.

I suggest all do research on MACRA which became effective in 2020 disallowing folks from picking Plan F anymore for almost everyone and making Plan G the “guarantee issue rights” (GIR) Medigap plan going forward. Plan G will increase premiums far faster percentage-wise than Plan N in the future IMO due to GIR. It’s only been a few years and the % increase per year difference is already being seen. G is $37 per month more than N where I live. I read that G premium increases are about 7% and N average 4%. What will it look like in 5, 10, 15 years?

GIR is key as if Medicare Advantage plans in an area quit the region or any number of other reasons, what will happen? Well, folks who are happy with MA (read: the fortunate older folks who retain good health) will switch to another MA plan. The sick folks who could not get a Medigap due to not being able to pass health questions are given a lifeline to comprehensive coverage. Eureka! However, what does this mean? It means Plan G beneficiary pools will become sicker and sicker leading to even greater % premium increases than Plan N increases. More and more MA beneficiaries will be looking for an exit when they discover the Mayo, John’s Hopkins and the like don’t accept any MA folks and that list is likely to expand. MA may be the only alternative for many who can’t afford a Medigap plan but those folks aren’t likely reading this forum.

The Excess Charges argument is a scare tactic agents throw out as they make a bigger commission on G sales than N sales (cynical opinion). Almost all docs accept Medicare assignment and it is super easy to research if your docs accept assignment at Medicare.gov.

Plan G is great if you need a lot of medical care. I have to visit a doc 23 times in a year outside my annual Medicare Wellness visit for my Plan N copays plus premiums to reach Plan G premiums. Plan N works for me. Everyone needs to do their own analysis. It takes a lot of research to get up to speed on this stuff but that likely fits a lot of personalities on this site.

[diy60]

Whatever Medigap (supplement) insurance company you pick for your Medigap plan check to see how many "closed block of business." (deadpool) policies the company has.

How does one go about seeing how many closed blocks of business an insurance company has in my state? I ask because after all of my research 5 years ago I still fell victim of the Mutual of Omaha shenanigans.

[meowcat]

Whatever Medigap (supplement) insurance company you pick for your Medigap plan check to see how many "closed block of business." (deadpool) policies the company has.

How does one go about seeing how many closed blocks of business an insurance company has in my state? I ask because after all of my research 5 years ago I still fell victim of the Mutual of Omaha shenanigans.

Find yourself a good Medicare Insurance Agent.

[bertilak]

I originally had plan N but realized it was a pain because of all the small charges I had to pay ($20 office visit, $50 emergency room, visit, annual deductible). Yes, N is cheaper but not by much once all those extra charges come into play. N was just more of a pain. I have F, not G, because I was grandfathered into eligibility.

Switching plans w/o going through medical underwriting may be difficult. I switched from N to F without underwriting because Humana allowed me to. United wouldn't let me.

[DetroitRick]

I'd recommend giving greater weight to your choice of supplement company than to the G vs. N decision. Future rate stability is more material, at least for everyone I considered in doing my own G/N comparison. While future rate stability IS A GUESS, erratic past increases can at least help to eliminate some choices. G vs N is a bit overrated analytical task in my opinion.

As to N pools being (substantially) healthier than G, that defies logic, or at least exaggerates it. Both pools contain people aging into their final high-cost years, and nobody know when they choose at age 65 what happens in the future. And that is best evidenced by the small rate differentials. If the differences were that material, so the premium differences would be as well. Yes, there are exceptions with some carriers and in some areas. I'll also hedge because I have no idea as to Florida premiums and so don't know that the case there will be exactly as I described. And as to the excess charge issue with N, I considered it, but it is rare enough here that I was personally comfortable ignoring it (but worth thinking about).

When I looked at G vs. N a few years ago, for some companies it might have made a slight difference. For others it was trivial. Then I've watched as different price increases change the original dynamic anyway. I've heard things about Florida rate structure, and in the end you need to compare the two rates in your rating area.

When I signed up in 2020, my AARP/UHC G policy was $121.98, while an N policy would have been $102. All these being net of my discounts. Today my rate is $140.74 for my G policy, versus $123.81 had I had an N Supplement. Not a huge difference at either points in time. For the biggest carrier in my market (Blue Cross Blue Shield), that difference was MUCH smaller. And for some carriers it would have been material enough to push me to consider Plan N. But I considered picking the company to be the bigger of the two decisions. I also have had melanoma, and it would not have materially changed the choice economics had I known back when I selected my plan.

If you aren't comfortable chasing info, I would either talk to your state's health insurance assistance program (SHIP or SHIAP, or whatever their name might be) or find a GOOD agent. Good agent means one that handles lots of carriers and will give an unbiased recommendation. So either can help you by providing rate history on the companies you are comparing.

[tj]

Whatever Medigap (supplement) insurance company you pick for your Medigap plan check to see how many "closed block of business." (deadpool) policies the company has.

This is done because the current book of business have people who have become older and therefore have more illnesses meaning more claims. They close that book and raise the rates to cover the increasing losses. Then, they open a new book with younger, healthier folks and charge a lower premium do to lower claims ratios. After a couple of years, rinse and repeat.

In most states you will be unable to change supplement insurance companies without medical underwriting. A few states have a birthday rules that allows you to change Medigap plans without medical underwriting around your birthday.

Good point and Mutual of Omaha (and its subsidiaries) are the kings of the deadpool game.

Thanks to you both for this valuable information. Can I assume that a broker will be able to accurately provide me with this information? How many companies actually do this, and is it a common practice? I honestly need to understand this more after I clear my head tonight so forgive me if these are dumb questions.
I've noticed many negative posts about Mutual of Omaha so I already planned to not consider them. I never realized that Medicare was so complicated!

No you can't assume this. Brokers get paid to sell policies. Brokers sell a lot of mutual of Omaha policies.

Some bogleheads would consider Plan G HD would be the economical option rather than plan N. A lot of brokers don't suggest it because the commission is miniscule.

[tj]

Yes, to enroll in a UHC/ARP medical plan, you need to have an active AARP membership.

I would have no issues with using a UHC Medigap plan from a claims denial perspective. They paid their share of claims timely with no claims denial for two parents who had significant healthcare services and bills including one undergoing monthly immunotherapy for melanoma billed at $100k/treatment.

Do you need to maintain the AARP membership to keep it year after year or just the year of initial enrollment?

[NotWhoYouThink]

One benefit of plan G is easy billing - you pay your premium and Part B deductible, the plan covers the rest. I hope. I've been on it almost 3 months now.

Before that I helped my mom and MIL/FIL with their bills as they got older and unable to handle their finances. Fortunately, they were on plan F (MIL/FIL) and MegaCorp super duper retiree insurance, so there were almost no bills. They had to pay for dental and glasses, but that's it. When you go to 1-3 doctors per week, the paperwork and billing get to be a challenge.

I can handle the challenge now that my medical care is minimal and I have my brain cells in order, but picked plan G as the easiest to manage when I'm older and sicker. That's what pushed me to plan G rather than G High Deductible, which likely would be cheaper for me in the near term.

In my midwestern state, the Medicare Advantage companies advertise quite a lot, and the Medicare advisor I went to said that about 85% of her clients go with MA.

[mhalley]

I seem to recall they don’t bother to check once you are on the plan.

[ModifiedDuration]

Yes, to enroll in a UHC/ARP medical plan, you need to have an active AARP membership.

I would have no issues with using a UHC Medigap plan from a claims denial perspective. They paid their share of claims timely with no claims denial for two parents who had significant healthcare services and bills including one undergoing monthly immunotherapy for melanoma billed at $100k/treatment.

Do you need to maintain the AARP membership to keep it year after year or just the year of initial enrollment?

From what I have heard, you just need the AARP membership for the first year.

[mhalley]

I ran some quick numbers of the cheapest Medicare G and N at different ages in my zip codes. I calculated the difference in annual premiums and number of copays needed to make plan N the same cost as plan G.
Age ……… G. ….. N. ….. Annual difference. ….. Number of $20 co pays
65. ……. .105 ….. 80 ……….. 300. ……… ……….. . 15
75. ……. 141 ……. 106.. ………. 420. ………… …….. 21
85. …….. 190 …… 143…..…… .. 564. ……….. …….. 28
Figure that if you are healthy you might have multiple years of only a few copays.
You would need to check your zip code and preferred provider to see your differences.
This video has a good breakdown of g vs n including copays.
https://m.youtube.com/watch?v=a5FaHIcUMqY&t=531s
But certainly plan G is a no brainer if you have no interest in POSSIBLY saving money in the future.

[cashmoney]

Thank you so much to everyone who has replied so far. I'm very grateful for your feedback and words of wisdom. I haven't called a broker yet to verify, but it seems that AARP/United Healthcare and Florida Blue have the majority of the Medigap policies in Florida. While there appears to be 29-30 policies in my zip code with numerous companies, I looked on the Medicare.gov site to get an initial idea of pricing with just those two for now. It shows a Plan G with UHC is $190 and Plan N is $162 ($28 a month difference). I'm not an AARP member so I think I'd have to subscribe to get that plan. It also shows a Plan G with Florida Blue is $214, and Plan N is $177 ($37 a month difference). I assume these prices are accurate. I'm leaning more toward Plan G right now, but I'd obviously welcome and appreciate any additional insight based on this information.

Both UHC and Florida Blue are written under group certificate and as of now in most cases in Florida allow switching between G and N with no underwriting and still keep rate based on original entry age.Both UHC and Florida Blue as of now to not play the shell game that most other companies in Florida do.Florida Blue use to be higher than most on there premiums for standard med supps and did have a big rate reduction in abot 2010 if i remember correctly wheas UHC has never opened on new book of business in Florida going back to 1998 or so when they took over the block of business from Prudential

disclaimer licensed agent

[Northern Flicker]

If plan G is $190-214/mo., then once the part B deductible cost is added in, that already is a total out of pocket cost similar to the G-HD deductible (which functions as an overall out of pocket maximum). What are G-HD premiums in your zip code?

Add up 12 months of G-HD premium and add to the G-HD deductible

--compare to--

Adding up 12 months of G premium and add in the part B deductible

I suspect they are close enough to justify G-HD unless you expect to hit the G-HD deductible regularly.

[HomeStretch]

Yes, to enroll in a UHC/ARP medical plan, you need to have an active AARP membership.

I would have no issues with using a UHC Medigap plan from a claims denial perspective. They paid their share of claims timely with no claims denial for two parents who had significant healthcare services and bills including one undergoing monthly immunotherapy for melanoma billed at $100k/treatment.

Do you need to maintain the AARP membership to keep it year after year or just the year of initial enrollment?

After initial enrollment, I had to renew my parents’ AARP membership when I called in one year in order to make a policy change.

[diy60]

Yes, to enroll in a UHC/ARP medical plan, you need to have an active AARP membership.

I would have no issues with using a UHC Medigap plan from a claims denial perspective. They paid their share of claims timely with no claims denial for two parents who had significant healthcare services and bills including one undergoing monthly immunotherapy for melanoma billed at $100k/treatment.

Do you need to maintain the AARP membership to keep it year after year or just the year of initial enrollment?

After initial enrollment, I had to renew my parents’ AARP membership when I called in one year in order to make a policy change.

If you don't mind sharing, what kind of policy change was req'd. Usually these Medigap plans are set it and forget it. When I went thru the underwriting questions for UHC they told me I would need to sign up for AARP when I officially submit my application, but when I pressed them they said I could let the membership expire after one year with no consequences to the policy.

[tj]

Thank you so much to everyone who has replied so far. I'm very grateful for your feedback and words of wisdom. I haven't called a broker yet to verify, but it seems that AARP/United Healthcare and Florida Blue have the majority of the Medigap policies in Florida. While there appears to be 29-30 policies in my zip code with numerous companies, I looked on the Medicare.gov site to get an initial idea of pricing with just those two for now. It shows a Plan G with UHC is $190 and Plan N is $162 ($28 a month difference). I'm not an AARP member so I think I'd have to subscribe to get that plan. It also shows a Plan G with Florida Blue is $214, and Plan N is $177 ($37 a month difference). I assume these prices are accurate. I'm leaning more toward Plan G right now, but I'd obviously welcome and appreciate any additional insight based on this information.

Both UHC and Florida Blue are written under group certificate and as of now in most cases in Florida allow switching between G and N with no underwriting and still keep rate based on original entry age.Both UHC and Florida Blue as of now to not play the shell game that most other companies in Florida do.Florida Blue use to be higher than most on there premiums for standard med supps and did have a big rate reduction in abot 2010 if i remember correctly wheas UHC has never opened on new book of business in Florida going back to 1998 or so when they took over the block of business from Prudential

disclaimer licensed agent

Thank you for sharing your wealth of knowledge on this forum.

[cashmoney]

If plan G is $190-214/mo., then once the part B deductible cost is added in, that already is a total out of pocket cost similar to the G-HD deductible (which functions as an overall out of pocket maximum). What are G-HD premiums in your zip code?

Add up 12 months of G-HD premium and add to the G-HD deductible

--compare to--

Adding up 12 months of G premium and add in the part B deductible

I suspect they are close enough to justify G-HD unless you expect to hit the G-HD deductible regularly.

Hi G for most people is lowest cost but one thing to add to your equation is if you think you may stay with the same insurance company for the long term is you can only lock in age 65 age band once on med sup contract so be fairly confident that hi G is want you want for the long term because the guaranteed renewability feature of a med supp contract is more valuable on a 200.00 plan G premium vs a 60.00 hi G premium

[James.534]

They look like they are basically the same plan with the same coverage, difference being lower premium for N, but with the added copay for visits. Both require the standard $240 deductible. After the deductible plan G you have no further added expenses for physician charges. If you have plan N, you have a copay for every physician charge. If you don't go to the doctor much then plan N is a better choice. If you use alot of services then plan G is a better choice. But you never know if it is going to be a good year or a really bad year in advance. If you want piece of mind, then plan G makes more sense.

[HomeStretch]

After initial enrollment, I had to renew my parents’ AARP membership when I called in one year in order to make a policy change.

If you don't mind sharing, what kind of policy change was req'd. Usually these Medigap plans are set it and forget it. When I went thru the underwriting questions for UHC they told me I would need to sign up for AARP when I officially submit my application, but when I pressed them they said I could let the membership expire after one year with no consequences to the policy.

I had to change my parents’ policy from one shared policy to two individual policies. I had to renew their AARP membership to do so.

[cashmoney]

Thank you so much to everyone who has replied so far. I'm very grateful for your feedback and words of wisdom. I haven't called a broker yet to verify, but it seems that AARP/United Healthcare and Florida Blue have the majority of the Medigap policies in Florida. While there appears to be 29-30 policies in my zip code with numerous companies, I looked on the Medicare.gov site to get an initial idea of pricing with just those two for now. It shows a Plan G with UHC is $190 and Plan N is $162 ($28 a month difference). I'm not an AARP member so I think I'd have to subscribe to get that plan. It also shows a Plan G with Florida Blue is $214, and Plan N is $177 ($37 a month difference). I assume these prices are accurate. I'm leaning more toward Plan G right now, but I'd obviously welcome and appreciate any additional insight based on this information.

Both UHC and Florida Blue are written under group certificate and as of now in most cases in Florida allow switching between G and N with no underwriting and still keep rate based on original entry age.Both UHC and Florida Blue as of now to not play the shell game that most other companies in Florida do.Florida Blue use to be higher than most on there premiums for standard med supps and did have a big rate reduction in abot 2010 if i remember correctly wheas UHC has never opened on new book of business in Florida going back to 1998 or so when they took over the block of business from Prudential

disclaimer licensed agent

Thank you for sharing your wealth of knowledge on this forum.

Your welcome glad to share the information since i have learned so much on this forum from some very smart people here and one thing i have learned doing this for over 30 years is that even very smart people can get confounded when it comes to all the rules and parts of Medicare.

[tj]

Thank you so much to everyone who has replied so far. I'm very grateful for your feedback and words of wisdom. I haven't called a broker yet to verify, but it seems that AARP/United Healthcare and Florida Blue have the majority of the Medigap policies in Florida. While there appears to be 29-30 policies in my zip code with numerous companies, I looked on the Medicare.gov site to get an initial idea of pricing with just those two for now. It shows a Plan G with UHC is $190 and Plan N is $162 ($28 a month difference). I'm not an AARP member so I think I'd have to subscribe to get that plan. It also shows a Plan G with Florida Blue is $214, and Plan N is $177 ($37 a month difference). I assume these prices are accurate. I'm leaning more toward Plan G right now, but I'd obviously welcome and appreciate any additional insight based on this information.

Both UHC and Florida Blue are written under group certificate and as of now in most cases in Florida allow switching between G and N with no underwriting and still keep rate based on original entry age.Both UHC and Florida Blue as of now to not play the shell game that most other companies in Florida do.Florida Blue use to be higher than most on there premiums for standard med supps and did have a big rate reduction in abot 2010 if i remember correctly wheas UHC has never opened on new book of business in Florida going back to 1998 or so when they took over the block of business from Prudential

disclaimer licensed agent

Thank you for sharing your wealth of knowledge on this forum.

Your welcome glad to share the information since i have learned so much on this forum from some very smart people here and one thing i have learned doing this for over 30 years is that even very smart people can get confounded when it comes to all the rules and parts of Medicare.

It's impressive that you've been able to keep your business going for 30+ years especially with a commodity product. Congrats!

[meowcat]

Whatever Medigap (supplement) insurance company you pick for your Medigap plan check to see how many "closed block of business." (deadpool) policies the company has.

This is done because the current book of business have people who have become older and therefore have more illnesses meaning more claims. They close that book and raise the rates to cover the increasing losses. Then, they open a new book with younger, healthier folks and charge a lower premium do to lower claims ratios. After a couple of years, rinse and repeat.

In most states you will be unable to change supplement insurance companies without medical underwriting. A few states have a birthday rules that allows you to change Medigap plans without medical underwriting around your birthday.

Good point and Mutual of Omaha (and its subsidiaries) are the kings of the deadpool game.

Thanks to you both for this valuable information. Can I assume that a broker will be able to accurately provide me with this information? How many companies actually do this, and is it a common practice? I honestly need to understand this more after I clear my head tonight so forgive me if these are dumb questions.
I've noticed many negative posts about Mutual of Omaha so I already planned to not consider them. I never realized that Medicare was so complicated!

No you can't assume this. Brokers get paid to sell policies. Brokers sell a lot of mutual of Omaha policies.

Some bogleheads would consider Plan G HD would be the economical option rather than plan N. A lot of brokers don't suggest it because the commission is miniscule.

Plan G HD is a good option for some. Its premiums are downright cheap but comes with higher out of pocket costs. G HD, however, is available in very few areas.