Medigap Policies--So Much Conflicting Information

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Mintee
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Medigap Policies--So Much Conflicting Information

Post by Mintee » Fri Oct 06, 2017 4:17 pm

I have tried to research the forum for accurate answers to the questions below, but I'm not finding answers. I have talked with a couple insurance agents, but they have provided conflicting info. I'm also not finding specific answers on the Medicare site.

I will be Medicare eligible in December of this year. This is my initial application for a Medicare supplement and a Part D plan.

Here are my questions:
1. If I choose a medigap policy with Obscure Company A because it is the least expensive, can I change to the same plan, say G, with another company during an open enrollment period in another year? One agent told me that there is no open enrollment period, or a time when I can change the company with whom I do business (not the plan. I understand this is difficult to change). Is this accurate?
2. Can I carry the policy to another state? Is this insurance-company specific?
3. Why is Plan G so much less expensive than Plan F? It appears that the only difference is that G doesn't cover the Part B deductible, which is now $183. Is that the only difference? For the plans I've reviewed, thus far, even paying the deductible does not explain the difference in cost. What am I missing?
4. What else should I know? I'm not interested in a Medicare Advantage plan at this point, but I am open to any other info.

I have a call into SHIPP, but I know the office provided incorrect information to another person last year, so I'm wary.

Thank you. I know so many of you have provided info on this topic before, but I am just not finding consistent answers to these questions.

Mintee

kaneohe
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Re: Medigap Policies--So Much Conflicting Information

Post by kaneohe » Fri Oct 06, 2017 5:47 pm

https://www.medicare.gov/supplement-oth ... igap-.html

This link says that there is no Federal right to change medigap plans except under a few specific conditions. Certain states may give you additional rights.....e.g. CA has a birthday rule....for a limited time period each yr. around your birthday (believe it is +/- 30days) you can switch to another plan equal or lower in level than current plan w/o medical underwriting. It is possible that certain companies may offer similar rights.......I have read (but not confirmed) that UHC (AARP) will allow you to do a similar thing.

Spirit Rider
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Re: Medigap Policies--So Much Conflicting Information

Post by Spirit Rider » Fri Oct 06, 2017 10:27 pm

Mintee wrote:
Fri Oct 06, 2017 4:17 pm
1. If I choose a medigap policy with Obscure Company A because it is the least expensive, can I change to the same plan, say G, with another company during an open enrollment period in another year? One agent told me that there is no open enrollment period, or a time when I can change the company with whom I do business (not the plan. I understand this is difficult to change). Is this accurate?
2. Can I carry the policy to another state? Is this insurance-company specific?
3. Why is Plan G so much less expensive than Plan F? It appears that the only difference is that G doesn't cover the Part B deductible, which is now $183. Is that the only difference? For the plans I've reviewed, thus far, even paying the deductible does not explain the difference in cost. What am I missing?
4. What else should I know? I'm not interested in a Medicare Advantage plan at this point, but I am open to any other info.
  1. Technically, the agent was wrong, there is an open enrollment period each year, However, as kaneohe stated except for a handful of states there is no guaranteed issue right. Any change of company and/or Plan may require medical underwriting. This is entirely at the discretion of the insurance carrier.
  2. When you move you can keep your Medigap plan unless it is a Medigap Select plan (essentially a HMO with a limited network). However, the premium may change.
  3. Just a guess, claim amounts are not the only costs to an insurance company. There is maybe reduced administrative costs. Also, it may be a marketing decision. Economics 101 says that the cost of a product or service is not the only determinating factor in the price.

Raabe34
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Re: Medigap Policies--So Much Conflicting Information

Post by Raabe34 » Fri Oct 06, 2017 11:03 pm

Mintee wrote:
Fri Oct 06, 2017 4:17 pm


Here are my questions:
1. If I choose a medigap policy with Obscure Company A because it is the least expensive, can I change to the same plan, say G, with another company during an open enrollment period in another year? One agent told me that there is no open enrollment period, or a time when I can change the company with whom I do business (not the plan. I understand this is difficult to change). Is this accurate?
2. Can I carry the policy to another state? Is this insurance-company specific?
3. Why is Plan G so much less expensive than Plan F? It appears that the only difference is that G doesn't cover the Part B deductible, which is now $183. Is that the only difference? For the plans I've reviewed, thus far, even paying the deductible does not explain the difference in cost. What am I missing?
4. What else should I know? I'm not interested in a Medicare Advantage plan at this point, but I am open to any other info
Mintee
https://www.medicare.gov/supplement-oth ... lapse-2514

1. If you are in a medigap plan you do not have the right to change it at any time. You have to go through underwriting which is something but not super difficult. So possible but not guaranteed.
2. See link
3. A big part of the reason F is getting more expensive is that it is going away around 2020 so the pools will get smaller, I wouldn't want to get into F. Only difference is deductible.
4. Part D is the thing you need to check through Medicare.gov annually because they change a lot annually.

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FrugalInvestor
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Re: Medigap Policies--So Much Conflicting Information

Post by FrugalInvestor » Fri Oct 06, 2017 11:07 pm

Mintee wrote:
Fri Oct 06, 2017 4:17 pm
I have tried to research the forum for accurate answers to the questions below, but I'm not finding answers. I have talked with a couple insurance agents, but they have provided conflicting info. I'm also not finding specific answers on the Medicare site.

I will be Medicare eligible in December of this year. This is my initial application for a Medicare supplement and a Part D plan.

Here are my questions:
1. If I choose a medigap policy with Obscure Company A because it is the least expensive, can I change to the same plan, say G, with another company during an open enrollment period in another year? One agent told me that there is no open enrollment period, or a time when I can change the company with whom I do business (not the plan. I understand this is difficult to change). Is this accurate?

In my state there is no guaranteed issue after your initial enrollment. Actually there is a grace period (either 3 or 6 months) in which you can change to a different plan but no chances after that (I did that to get a lower rate but it's a long story). An insurance company can and sometimes does have an internal policy allowing enrollees to change plans without underwriting but there's no guarantee that such a policy will continue.


2. Can I carry the policy to another state? Is this insurance-company specific?

No, if you move to a different state you typically would be eligible to shop for a new plan there but not to take your existing policy. Plans offered and prices charged vary from state to state even with the same company.

Edit: I was mistaken. This is from the Medicare.gov site....

"I'm moving out of state.
You can keep your current Medigap policy regardless of where you live as long as you still have Original Medicare. If you want to switch to a different Medigap policy, you'll have to check with your current or new insurance company to see if they'll offer you a different policy."


3. Why is Plan G so much less expensive than Plan F? It appears that the only difference is that G doesn't cover the Part B deductible, which is now $183. Is that the only difference? For the plans I've reviewed, thus far, even paying the deductible does not explain the difference in cost. What am I missing?

You are missing nothing. That is the only difference and makes plan G a very good deal in many areas. I think it's better for another reason and that is that as Congress attempts to cut Medicare costs doctors tend to get reimbursed less. I think this could increase the number of doctors that don't accept assignment which means they can charge up to 15% over the Medicare approved amount. Plan G (and F) cover these 'excess charges' so may very well become more valuable over time.


4. What else should I know? I'm not interested in a Medicare Advantage plan at this point, but I am open to any other info.

You should know that Plan F is going away in the next couple of years (mandated by Congress). My take is that since it will take no new enrollees after that the Plan F pool will begin to age which will increase the likelihood of premium increases as compared to Plan G where younger enrollees will be going.

You should know that some of the very high quality Medical Centers where you might want to go should you have a serious illness like cancer do not accept Medicare assignment. This means that you could end up paying a significant amount out-of-pocket if you don't have plan G or plan F. Plan G high deductible will also pay these 'excess charges' but as the name implies has a fairly large annual deductible. You are right, in my opinion, not to consider Medicare Advantage plans as many if not most of these Medical centers will not accept Advantage plans at all.

Based on my experience I think you're looking at things the right way. I chose Plan G and the cheapest Part D drug plan available since I take no medications and Part D allows shopping for a new plan each year.


I have a call into SHIPP, but I know the office provided incorrect information to another person last year, so I'm wary.

Hopefully you can find a good agent as I've found that a good one can be very helpful.

Thank you. I know so many of you have provided info on this topic before, but I am just not finding consistent answers to these questions.

Mintee
Last edited by FrugalInvestor on Sun Oct 08, 2017 9:18 am, edited 1 time in total.
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khh
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Re: Medigap Policies--So Much Conflicting Information

Post by khh » Fri Oct 06, 2017 11:27 pm

FrugalInvestor wrote:
Fri Oct 06, 2017 11:07 pm
2. Can I carry the policy to another state? Is this insurance-company specific?
Mintee wrote:
Fri Oct 06, 2017 4:17 pm
No, if you move to a different state you typically would be eligible to shop for a new plan there but not to take your existing policy. Plans offered and prices charged vary from state to state even with the same company.
Do insurance companies in the state you move to have to accept you without underwriting?

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Mel Lindauer
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Re: Medigap Policies--So Much Conflicting Information

Post by Mel Lindauer » Fri Oct 06, 2017 11:42 pm

FWIW, I moved from PA to FL and my medigap policy was good in both states.

I also was able to switch from one medigap plan insurer to another lower-cost one without any problems or underwriting.
Best Regards - Mel | | Semper Fi

kaneohe
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Re: Medigap Policies--So Much Conflicting Information

Post by kaneohe » Sat Oct 07, 2017 12:53 am

Mel Lindauer wrote:
Fri Oct 06, 2017 11:42 pm
FWIW, I moved from PA to FL and my medigap policy was good in both states.

I also was able to switch from one medigap plan insurer to another lower-cost one without any problems or underwriting.
from the link above:

..I'm moving out of state.
You can keep your current Medigap policy regardless of where you live as long as you still have Original Medicare. If you want to switch to a different Medigap policy, you'll have to check with your current or new insurance company to see if they'll offer you a different policy.

If you decide to switch, you may have to pay more for your new Medigap policy. You may also have to answer some medical questions if you're buying a Medigap policy outside of your Medigap open enrollment period.

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Re: Medigap Policies--So Much Conflicting Information

Post by Mel Lindauer » Sat Oct 07, 2017 9:09 am

kaneohe wrote:
Sat Oct 07, 2017 12:53 am
Mel Lindauer wrote:
Fri Oct 06, 2017 11:42 pm
FWIW, I moved from PA to FL and my medigap policy was good in both states.

I also was able to switch from one medigap plan insurer to another lower-cost one without any problems or underwriting.
from the link above:

..I'm moving out of state.
You can keep your current Medigap policy regardless of where you live as long as you still have Original Medicare. If you want to switch to a different Medigap policy, you'll have to check with your current or new insurance company to see if they'll offer you a different policy.

If you decide to switch, you may have to pay more for your new Medigap policy. You may also have to answer some medical questions if you're buying a Medigap policy outside of your Medigap open enrollment period.
There's a difference between changing coverage (C, F, etc.) and changing providers. I changed providers but not my coverage.
Best Regards - Mel | | Semper Fi

mouses
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Re: Medigap Policies--So Much Conflicting Information

Post by mouses » Sat Oct 07, 2017 5:53 pm

FrugalInvestor wrote:
Fri Oct 06, 2017 11:07 pm

You should know that some of the very high quality Medical Centers where you might want to go should you have a serious illness like cancer do not accept Medicare assignment.
Mass General, Brigham & Women's, and Mass Eye and Ear all accept Medicare. I would be very surprised if there were any significant teaching hospitals that didn't.

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Re: Medigap Policies--So Much Conflicting Information

Post by nisiprius » Sat Oct 07, 2017 6:03 pm

1) Always keep in mind that insurance law is state law. (That's why proposals to allow health insurance to be sold across state lines are controversial). The main thing is that you need to research the situation in your own state.

2)
FrugalInvestor wrote:
Fri Oct 06, 2017 11:07 pm
You should know that some of the very high quality Medical Centers where you might want to go should you have a serious illness like cancer do not accept Medicare assignment.
I hear this said frequently. This may also be something that varies hugely from state to state, as it doesn't seem to be true around where I live.

When I was approaching Medicare age I actually made a list of every doctor I was seeing, had seen recently, or thought I might want to see and checked them out on the Medicare provider's directory. Every one of them accepted Medicare assignment. At that time I was seeing a doctor in a gigantic clinic--hundreds of doctors in dozens of big buildings--and their billing office said "all our doctors accept Medicare assignment." I wondered about "convenience" facilities, but the local Urgent Care accepted Medicare assignment when I went there.

My belief is that it is easier to find doctors and hospitals that accept Medicare assignment than it is to find doctors and hospitals that accept the average HMO or PPO.
Last edited by nisiprius on Sat Oct 07, 2017 6:09 pm, edited 3 times in total.
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Mitchell777
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Re: Medigap Policies--So Much Conflicting Information

Post by Mitchell777 » Sat Oct 07, 2017 6:05 pm

I had forgotten that Plan F was going away in 2020 for new enrollees. So, the pool of people will get sicker and sicker. I know F has a few ways to price, one being age related. I saw some numbers in my area for one insurer where F was $212 at 65 and $350 at age 80 (not the high deductible version). I'm guessing over time that price difference may increase significantly. Is Plan G also going away?

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Re: Medigap Policies--So Much Conflicting Information

Post by FrugalInvestor » Sat Oct 07, 2017 7:24 pm

mouses wrote:
Sat Oct 07, 2017 5:53 pm
FrugalInvestor wrote:
Fri Oct 06, 2017 11:07 pm

You should know that some of the very high quality Medical Centers where you might want to go should you have a serious illness like cancer do not accept Medicare assignment.
Mass General, Brigham & Women's, and Mass Eye and Ear all accept Medicare. I would be very surprised if there were any significant teaching hospitals that didn't.
I don't know about those specific hospitals but be sure you understand the difference between accepting Medicare and accepting Medicare assignment. A provider that doesn't accept assignment can charge 15% over the Medicare approved rates. For extensive treatment this can add up to a big number. Only plans F and G (and F high deductible) will cover these excess charges. The problem is that if you end up with a serious condition you don't know beforehand where you may want or need to go for the best treatment. Having a plan that covers excess charges opens up more options.
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Re: Medigap Policies--So Much Conflicting Information

Post by FrugalInvestor » Sat Oct 07, 2017 7:29 pm

Mitchell777 wrote:
Sat Oct 07, 2017 6:05 pm
I had forgotten that Plan F was going away in 2020 for new enrollees. So, the pool of people will get sicker and sicker. I know F has a few ways to price, one being age related. I saw some numbers in my area for one insurer where F was $212 at 65 and $350 at age 80 (not the high deductible version). I'm guessing over time that price difference may increase significantly. Is Plan G also going away?
No, plan G is relatively new and will continue. As I recall it was developed when Congress decided that offering first dollar coverage is not a good idea (I assume because participants need at least some 'skin in the game). So plan F will be nixed in or after 2020 and in the meantime plan G which doesn't cover the part B annual deductible but is otherwise is identical to F was introduced.
IGNORE the noise! | Our life is frittered away by detail... simplify, simplify. - Henry David Thoreau

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FrugalInvestor
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Re: Medigap Policies--So Much Conflicting Information

Post by FrugalInvestor » Sat Oct 07, 2017 7:40 pm

Here's a good example of a well known provider that does not accept assignment. Also, I don't believe that they accept any Medicare Advantage plans.

http://www.mayoclinic.org/patient-visit ... urance/faq

From the above page:
Does Mayo Clinic accept Medicare patients?

For out-of-state-residents:

Mayo Clinic has chosen (by the board of governors) to be a nonparticipating facility, and thus does not accept assignment from Medicare for out-of-state residents at any of its campuses in Arizona, Florida or Minnesota. Nonparticipating means that Mayo Clinic does not accept the Medicare approved amount as payment in full.

For in-state residents:

Like other health care organizations that do not accept Medicare assignment, Mayo Clinic can bill up to 15 percent above the Medicare allowable amount, for which the patient is financially responsible.

Mayo does not add a straight 15 percent to the bills; rather, Medicare determines how much above the approved amount Mayo can bill. These charges are referred to as Part B excess charges by Medicare. Accordingly, Mayo bills the patient for the full amount of the charges and expects full reimbursement from the patient.

In addition, Medicare will pay the patient directly for services rendered, and the patient will need to reimburse Mayo Clinic.
What you're doing by purchasing a plan that covers excess charges is protecting yourself from potentially large additional charges and, possibly, opening up more high quality treatment options for yourself. If you need this type of treatment the added stress of large uncovered expenses of unknown magnitude is likely not what you or your family will want at that already very stressful time.
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Re: Medigap Policies--So Much Conflicting Information

Post by Spirit Rider » Sat Oct 07, 2017 9:35 pm

FrugalInvestor wrote:
Sat Oct 07, 2017 7:24 pm
A provider that doesn't accept assignment can charge 15% over the Medicare approved rates.
A small correction. Doctors who don't accept assignment are only reimbursed at 95% of the Medicare approved rates. They can only charge 15% over their reimbursement rates. This makes the effective excess charge 9.25% of the Medicare approved rates. It can still add up, but it is not truly 15%.

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Re: Medigap Policies--So Much Conflicting Information

Post by FrugalInvestor » Sat Oct 07, 2017 9:54 pm

Spirit Rider wrote:
Sat Oct 07, 2017 9:35 pm
FrugalInvestor wrote:
Sat Oct 07, 2017 7:24 pm
A provider that doesn't accept assignment can charge 15% over the Medicare approved rates.
A small correction. Doctors who don't accept assignment are only reimbursed at 95% of the Medicare approved rates. They can only charge 15% over their reimbursement rates. This makes the effective excess charge 9.25% of the Medicare approved rates. It can still add up, but it is not truly 15%.
Yes, that's true. It's all very straightforward isn't it?
Last edited by FrugalInvestor on Sat Oct 07, 2017 10:17 pm, edited 3 times in total.
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cashmoney
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Re: Medigap Policies--So Much Conflicting Information

Post by cashmoney » Sat Oct 07, 2017 9:59 pm

FrugalInvestor wrote:
Sat Oct 07, 2017 7:40 pm
Here's a good example of a well known provider that does not accept assignment. Also, I don't believe that they accept any Medicare Advantage plans.

http://www.mayoclinic.org/patient-visit ... urance/faq

From the above page:
Does Mayo Clinic accept Medicare patients?

For out-of-state-residents:

Mayo Clinic has chosen (by the board of governors) to be a nonparticipating facility, and thus does not accept assignment from Medicare for out-of-state residents at any of its campuses in Arizona, Florida or Minnesota. Nonparticipating means that Mayo Clinic does not accept the Medicare approved amount as payment in full.

For in-state residents:

Like other health care organizations that do not accept Medicare assignment, Mayo Clinic can bill up to 15 percent above the Medicare allowable amount, for which the patient is financially responsible.

Mayo does not add a straight 15 percent to the bills; rather, Medicare determines how much above the approved amount Mayo can bill. These charges are referred to as Part B excess charges by Medicare. Accordingly, Mayo bills the patient for the full amount of the charges and expects full reimbursement from the patient.

In addition, Medicare will pay the patient directly for services rendered, and the patient will need to reimburse Mayo Clinic.
What you're doing by purchasing a plan that covers excess charges is protecting yourself from potentially large additional charges and, possibly, opening up more high quality treatment options for yourself. If you need this type of treatment the added stress of large uncovered expenses of unknown magnitude is likely not what you or your family will want at that already very stressful time.


Not really.First off medicare allowable charges are very low to begin with ( i.e. aprox 400.00 for an MRI ) and providers who do not accept assignment must charge about 5% less then the the medicare allowable rate so the net increase in excess charges is only about 10%.In addition because of the 2 % cut in payments required by the Sequestration order in Budget Control Act of 2011 Medicare now only pays 78% of medicare allowable rates , instead of 80%, to providers who don't t accept assignment.The plan F and G do not cover this 2%


https://questions.cms.gov/faq.php?id=5005&faqId=9920

cashmoney
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Re: Medigap Policies--So Much Conflicting Information

Post by cashmoney » Sat Oct 07, 2017 10:09 pm

FrugalInvestor wrote:
Sat Oct 07, 2017 7:29 pm
Mitchell777 wrote:
Sat Oct 07, 2017 6:05 pm
I had forgotten that Plan F was going away in 2020 for new enrollees. So, the pool of people will get sicker and sicker. I know F has a few ways to price, one being age related. I saw some numbers in my area for one insurer where F was $212 at 65 and $350 at age 80 (not the high deductible version). I'm guessing over time that price difference may increase significantly. Is Plan G also going away?
No, plan G is relatively new and will continue. As I recall it was developed when Congress decided that offering first dollar coverage is not a good idea (I assume because participants need at least some 'skin in the game). So plan F will be nixed in or after 2020 and in the meantime plan G which doesn't cover the part B annual deductible but is otherwise is identical to F was introduced.

Actually G has been around since the medicare supplement standardization was introduced in 1992 and F will still be available for purchase after 2020 for anybody who turned 65 before 2020.

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Re: Medigap Policies--So Much Conflicting Information

Post by FrugalInvestor » Sat Oct 07, 2017 10:16 pm

cashmoney wrote:
Sat Oct 07, 2017 10:09 pm
FrugalInvestor wrote:
Sat Oct 07, 2017 7:29 pm
Mitchell777 wrote:
Sat Oct 07, 2017 6:05 pm
I had forgotten that Plan F was going away in 2020 for new enrollees. So, the pool of people will get sicker and sicker. I know F has a few ways to price, one being age related. I saw some numbers in my area for one insurer where F was $212 at 65 and $350 at age 80 (not the high deductible version). I'm guessing over time that price difference may increase significantly. Is Plan G also going away?
No, plan G is relatively new and will continue. As I recall it was developed when Congress decided that offering first dollar coverage is not a good idea (I assume because participants need at least some 'skin in the game). So plan F will be nixed in or after 2020 and in the meantime plan G which doesn't cover the part B annual deductible but is otherwise is identical to F was introduced.

Actually G has been around since the medicare supplement standardization was introduced in 1992 and F will still be available for purchase after 2020 for anybody who turned 65 before 2020.
Much of this stuff varies from state to state. I know that in my area there has been no Plan G available for sale until very recently.
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FrugalInvestor
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Re: Medigap Policies--So Much Conflicting Information

Post by FrugalInvestor » Sat Oct 07, 2017 10:28 pm

cashmoney wrote:
Sat Oct 07, 2017 9:59 pm
FrugalInvestor wrote:
Sat Oct 07, 2017 7:40 pm
Here's a good example of a well known provider that does not accept assignment. Also, I don't believe that they accept any Medicare Advantage plans.

http://www.mayoclinic.org/patient-visit ... urance/faq

From the above page:
Does Mayo Clinic accept Medicare patients?

For out-of-state-residents:

Mayo Clinic has chosen (by the board of governors) to be a nonparticipating facility, and thus does not accept assignment from Medicare for out-of-state residents at any of its campuses in Arizona, Florida or Minnesota. Nonparticipating means that Mayo Clinic does not accept the Medicare approved amount as payment in full.

For in-state residents:

Like other health care organizations that do not accept Medicare assignment, Mayo Clinic can bill up to 15 percent above the Medicare allowable amount, for which the patient is financially responsible.

Mayo does not add a straight 15 percent to the bills; rather, Medicare determines how much above the approved amount Mayo can bill. These charges are referred to as Part B excess charges by Medicare. Accordingly, Mayo bills the patient for the full amount of the charges and expects full reimbursement from the patient.

In addition, Medicare will pay the patient directly for services rendered, and the patient will need to reimburse Mayo Clinic.
What you're doing by purchasing a plan that covers excess charges is protecting yourself from potentially large additional charges and, possibly, opening up more high quality treatment options for yourself. If you need this type of treatment the added stress of large uncovered expenses of unknown magnitude is likely not what you or your family will want at that already very stressful time.


Not really.First off medicare allowable charges are very low to begin with ( i.e. aprox 400.00 for an MRI ) and providers who do not accept assignment must charge about 5% less then the the medicare allowable rate so the net increase in excess charges is only about 10%.In addition because of the 2 % cut in payments required by the Sequestration order in Budget Control Act of 2011 Medicare now only pays 78% of medicare allowable rates , instead of 80%, to providers who don't t accept assignment.The plan F and G do not cover this 2%


https://questions.cms.gov/faq.php?id=5005&faqId=9920
That is very true. The 2% is essentially an out-of-pocket co-pay by the consumer.

And yes, Medicare allowable charges are relatively low but go through cancer (or other serious illness) treatments and you'll find that it still adds up.
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Mitchell777
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Re: Medigap Policies--So Much Conflicting Information

Post by Mitchell777 » Sun Oct 08, 2017 6:40 am

So, if you choose original Medicare plus Plan F, should you want to change Plans (from F to another Plan with same insurer) OR Insurers (from current insurer for F to different insurer for Plan F - actually I guess you'd need to change insurer AND Plan since F goes away in 2020), you may or may not be able to depending on your answers to the medical questions. Is that correct?

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Re: Medigap Policies--So Much Conflicting Information

Post by FrugalInvestor » Sun Oct 08, 2017 9:11 am

Mitchell777 wrote:
Sun Oct 08, 2017 6:40 am
So, if you choose original Medicare plus Plan F, should you want to change Plans (from F to another Plan with same insurer) OR Insurers (from current insurer for F to different insurer for Plan F - actually I guess you'd need to change insurer AND Plan since F goes away in 2020), you may or may not be able to depending on your answers to the medical questions. Is that correct?
F will no longer be available after 2020 for new enrollees. If you are already on F at that time you'll be able to keep it. This has happened in the past with plan J and probably others.

My understanding is that if you want to change plans with the same company anytime after the initial guaranteed issue period you may be subject to underwriting. My broker told me that so far my carrier in our market has allowed plan changes (either upgrades or downgrades) without underwriting but that there's no guarantee that they will continue this policy in the future.

Underwriting is likely should you change companies even keeping the same plan letter.

Here's the Medicare.gov page explaining the rules for switching policies.....

https://www.medicare.gov/supplement-oth ... lapse-2515

Edited for grammar.
Last edited by FrugalInvestor on Sun Oct 08, 2017 9:30 am, edited 4 times in total.
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Re: Medigap Policies--So Much Conflicting Information

Post by FrugalInvestor » Sun Oct 08, 2017 9:24 am

Mel Lindauer wrote:
Fri Oct 06, 2017 11:42 pm
FWIW, I moved from PA to FL and my medigap policy was good in both states.

I also was able to switch from one medigap plan insurer to another lower-cost one without any problems or underwriting.

My initial answer toward the top of this thread was incorrect and I've edited it. Mel is correct.
The following is from the Medicare.gov site.....
I'm moving out of state.
You can keep your current Medigap policy regardless of where you live as long as you still have Original Medicare. If you want to switch to a different Medigap policy, you'll have to check with your current or new insurance company to see if they'll offer you a different policy.
What I'm learning from this whole conversation is that there are a lot of somewhat complicated rules and that since companies can show leniency with their policies the rules may not be the rules. That's good, but it can also introduce confusion. It certainly has for me.
IGNORE the noise! | Our life is frittered away by detail... simplify, simplify. - Henry David Thoreau

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Re: Medigap Policies--So Much Conflicting Information

Post by dm200 » Sun Oct 08, 2017 9:38 am

Mintee wrote:
Fri Oct 06, 2017 4:17 pm
I have tried to research the forum for accurate answers to the questions below, but I'm not finding answers. I have talked with a couple insurance agents, but they have provided conflicting info. I'm also not finding specific answers on the Medicare site.
I will be Medicare eligible in December of this year. This is my initial application for a Medicare supplement and a Part D plan.
Here are my questions:
1. If I choose a medigap policy with Obscure Company A because it is the least expensive, can I change to the same plan, say G, with another company during an open enrollment period in another year? One agent told me that there is no open enrollment period, or a time when I can change the company with whom I do business (not the plan. I understand this is difficult to change). Is this accurate?
2. Can I carry the policy to another state? Is this insurance-company specific?
3. Why is Plan G so much less expensive than Plan F? It appears that the only difference is that G doesn't cover the Part B deductible, which is now $183. Is that the only difference? For the plans I've reviewed, thus far, even paying the deductible does not explain the difference in cost. What am I missing?
4. What else should I know? I'm not interested in a Medicare Advantage plan at this point, but I am open to any other info.
I have a call into SHIPP, but I know the office provided incorrect information to another person last year, so I'm wary.
Thank you. I know so many of you have provided info on this topic before, but I am just not finding consistent answers to these questions.
Mintee
Have you investigated Medicare Advantage (MA) plans available in your area, or the less common Medicare Cost (MC) plans? MA and MC plans differ greatly from one to another and, in my opinion and experience, not all the pros and cons are easily discerned from the plan documents. I believe you need, if possible, to speak with participants.

My wife and I are very pleased participants in an MC plan - and I believe we get very high quality care and have low costs as well.

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Re: Medigap Policies--So Much Conflicting Information

Post by cashmoney » Sun Oct 08, 2017 12:40 pm

FrugalInvestor wrote:
Sun Oct 08, 2017 9:11 am
Mitchell777 wrote:
Sun Oct 08, 2017 6:40 am
So, if you choose original Medicare plus Plan F, should you want to change Plans (from F to another Plan with same insurer) OR Insurers (from current insurer for F to different insurer for Plan F - actually I guess you'd need to change insurer AND Plan since F goes away in 2020), you may or may not be able to depending on your answers to the medical questions. Is that correct?
F will no longer be available after 2020 for new enrollees. If you are already on F at that time you'll be able to keep it. This has happened in the past with plan J and probably others.

My understanding is that if you want to change plans with the same company anytime after the initial guaranteed issue period you may be subject to underwriting. My broker told me that so far my carrier in our market has allowed plan changes (either upgrades or downgrades) without underwriting but that there's no guarantee that they will continue this policy in the future.

Underwriting is likely should you change companies even keeping the same plan letter.

Here's the Medicare.gov page explaining the rules for switching policies.....

https://www.medicare.gov/supplement-oth ... lapse-2515

Edited for grammar.


As long as you turned 65 before 2020 you can still buy plan F after 2020.Some unethical agents out there are using this 2020 change to high pressure clients in to the higher commission plan F .Group Certificate Medicare Supplement carriers such as AARP/ UHC , many BCBS etc. have an unwritten rule that allows plan switches up or down without underwriting and that also allows the policyholder to retain original age band premium rate however rumor is that this is ending soon as agents are being instructed not to mention this benefit to new prospective clients.

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Re: Medigap Policies--So Much Conflicting Information

Post by Mitchell777 » Sun Oct 08, 2017 3:27 pm

I guess my concern about Plan F is that the group has no new (younger) members after 2020 and the group gets sicker. Rates increase significantly as the healthier members leave since they pass underwriting. Others could get stuck with very high rates and maybe can't get out.

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Re: Medigap Policies--So Much Conflicting Information

Post by FrugalInvestor » Sun Oct 08, 2017 3:50 pm

Mitchell777 wrote:
Sun Oct 08, 2017 3:27 pm
I guess my concern about Plan F is that the group has no new (younger) members after 2020 and the group gets sicker. Rates increase significantly as the healthier members leave since they pass underwriting. Others could get stuck with very high rates and maybe can't get out.
This was a concern of mine. Even if healthier members don't leave by passing underwriting the pool will age as younger members are prevented from joining. I chose plan G figuring that those younger enrollees who would have otherwise chosen F will choose it. I also saved considerably more than the annual deductible in premiums.
IGNORE the noise! | Our life is frittered away by detail... simplify, simplify. - Henry David Thoreau

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Re: Medigap Policies--So Much Conflicting Information

Post by cashmoney » Sun Oct 08, 2017 7:03 pm

Mitchell777 wrote:
Sun Oct 08, 2017 3:27 pm
I guess my concern about Plan F is that the group has no new (younger) members after 2020 and the group gets sicker. Rates increase significantly as the healthier members leave since they pass underwriting. Others could get stuck with very high rates and maybe can't get out.


That's a concern and also the fact that plan F' policyholders as a group tend be overutilizers of medicare benefits compared to those who do not purchase a first dollar coverage medigap plans - so that will also spiral premiums up.The Mayo Clinic faithful in North Florida, including my mother, love them some plan F!

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Re: Medigap Policies--So Much Conflicting Information

Post by Zott » Sun Oct 08, 2017 9:45 pm

cashmoney wrote:
Sun Oct 08, 2017 7:03 pm
Mitchell777 wrote:
Sun Oct 08, 2017 3:27 pm
I guess my concern about Plan F is that the group has no new (younger) members after 2020 and the group gets sicker. Rates increase significantly as the healthier members leave since they pass underwriting. Others could get stuck with very high rates and maybe can't get out.


That's a concern and also the fact that plan F' policyholders as a group tend be overutilizers of medicare benefits compared to those who do not purchase a first dollar coverage medigap plans - so that will also spiral premiums up.The Mayo Clinic faithful in North Florida, including my mother, love them some plan F!
Which is another why Plan G premiums can be less than Plan F minus the deductible---insurers find that those who choose G utilize health care less.

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