High deductible Plan G medigap

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Spirit Rider
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Re: High deductible Plan G medigap

Post by Spirit Rider » Sat Jun 27, 2020 9:02 pm

Lalamimi wrote:
Sat Jun 27, 2020 7:39 pm
so I assume if you go straight through M of O it might be less?
Medigap premiums are the same whether you buy direct or go through a broker. This common across different types of insurance.

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nanameg
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Re: High deductible Plan G medigap

Post by nanameg » Sat Jun 27, 2020 10:12 pm

dodecahedron wrote:
Sat Jun 27, 2020 4:27 pm
nanameg wrote:
Sat Jun 27, 2020 3:56 pm
I’m about ready to go ahead with high deductible plan G. It’s less than 1/2 the price of plan G and we’ve been on high deductible plans as a requirement for our HSA for years without any problems. Even though I developed breast cancer in the interim it all went smoothly. I don’t have a fear about high deductible plans.

Am I missing anything?
Have you done comparison shopping of all plans offered by all carriers in your area?

Do you have a shopping tool available that shows you the price of all Medigap plans in your area?

Here is my shopping tool on the NYS gov website. I can put in any zipcode in NY and see the prices of all plans available to someone in my zipcode. For example in my area (try 12345, which is not my zip but close enough to show my choices) and you will see that the Plan F-HD and Plan G-HD premiums are identical for all carriers in my area that offer them, so I figured I might as well go with Plan F-HD at Globe, the least expensive company. Cost is $57/month.

Hopeful, CT offers you a similar shopping tool.

Like you, I am used to high deductible plans and I have a substantial HSA balance which can be used for any out of pocket costs. Also, like you, I live in a state which allows me to switch Medigap plans without underwriting in the future if another plan becomes relatively more attractive in the future.

Also, do you have a plan picked out for your Part D prescription drug coverage? You need that as well. Since I do not currently take any drugs and hope to remain healthy enough to continue to avoid them, I went with the least expensive plan D, from Humana at $13/month.
Thanks for the link to the shopping tool.

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nanameg
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Re: High deductible Plan G medigap

Post by nanameg » Sat Jun 27, 2020 10:13 pm

dodecahedron wrote:
Sat Jun 27, 2020 4:27 pm
nanameg wrote:
Sat Jun 27, 2020 3:56 pm
I’m about ready to go ahead with high deductible plan G. It’s less than 1/2 the price of plan G and we’ve been on high deductible plans as a requirement for our HSA for years without any problems. Even though I developed breast cancer in the interim it all went smoothly. I don’t have a fear about high deductible plans.

Am I missing anything?
Have you done comparison shopping of all plans offered by all carriers in your area?

Do you have a shopping tool available that shows you the price of all Medigap plans in your area?

Here is my shopping tool on the NYS gov website. I can put in any zipcode in NY and see the prices of all plans available to someone in my zipcode. For example in my area (try 12345, which is not my zip but close enough to show my choices) and you will see that the Plan F-HD and Plan G-HD premiums are identical for all carriers in my area that offer them, so I figured I might as well go with Plan F-HD at Globe, the least expensive company. Cost is $57/month.

Hopeful, CT offers you a similar shopping tool.

Like you, I am used to high deductible plans and I have a substantial HSA balance which can be used for any out of pocket costs. Also, like you, I live in a state which allows me to switch Medigap plans without underwriting in the future if another plan becomes relatively more attractive in the future.

Also, do you have a plan picked out for your Part D prescription drug coverage? You need that as well. Since I do not currently take any drugs and hope to remain healthy enough to continue to avoid them, I went with the least expensive plan D, from Humana at $13/month.
I haven’t done plan D yet . Thanks for the reminder.

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nanameg
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Re: High deductible Plan G medigap

Post by nanameg » Sat Jun 27, 2020 10:15 pm

kaneohe wrote:
Sat Jun 27, 2020 6:20 pm
Spirit Rider wrote:
Sat Jun 27, 2020 5:14 pm
kaneohe wrote:
Sat Jun 27, 2020 4:23 pm
The hi deductible for G possibly may be higher than your hi deductible for your HSA plan tho. Appears to be $2340 vs $1350 for HSA high deductible (latter is 2019 and may be higher now).
You are referring to the minimum HDHP deductible allowed (2020 = $1400). The 2020 maximum HDHP out-of-pocket limit is $6900. The majority of ACA HDHP's are > $2340. In my zip code the HDHP deductibles are $2800 - $5400. All the amounts are assuming self-only plan, which all Medigap plans are.
thanks for that important info,Spirit Rider. Would certainly be an important factor in making the decision.
I didn’t realize the deductible amounts could differ. I’ll be sure to check on that too thanks.

yvette
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Re: High deductible Plan G medigap

Post by yvette » Sat Jun 27, 2020 10:44 pm

This is a good pamphlet on how to choose the best Medigap policy:
https://www.medicare.gov/Pubs/pdf/02110 ... -guide.pdf

Here's the CT website for Medigap or supplemental Insurance:
https://portal.ct.gov/CID/Life-And-Heal ... -Advantage

Here are the Companies Approved Medicare Supplement Insurance Policies in CT:
https://portal.ct.gov/CID/Life-And-Heal ... e-Policies

Here are the Monthly Medicare Supplement rates for Standardized Plans for CT:
https://portal.ct.gov/-/media/CID/1_Lif ... _Rates.pdf

Hope this helps. Let me know if any questions.

yvette
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Re: High deductible Plan G medigap

Post by yvette » Sat Jun 27, 2020 10:57 pm

I forgot to inform you that every state has a SHIP program that has counselors to help you in explaining and with choosing the right medigapl policy or medicare advantage if that's the route you want to take and answer your questions for free. In CT, it's called CHOICES. In FL, it's called SHINE.

From the website: The CHOICES Program (Connecticut's programs for Health insurance, Outreach, Information and Eligibility Screening) is designated as the official State Health Insurance Program (SHIP) for Connecticut. It is funded in large part by the Centers for Medicare and Medicaid Services (CMS) of the U.S. Dept. of Health and Human Services. It provides unbiased information and counseling, on Medicare, Medigap, Medicare Managed Care, Medicaid, Medicare Savings Program, Long Term Care Insurance and other related state & federal programs.

http://wcaaa.org/programs/choices-inclu ... nformation

ClaycordJCA
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Re: High deductible Plan G medigap

Post by ClaycordJCA » Sat Jun 27, 2020 11:14 pm

celia wrote:
Wed Jun 10, 2020 7:02 pm
FIREchief wrote:
Wed Jun 10, 2020 6:01 pm
Why can't a Kaiser doctor prescribe a drug that isn't on their formulary?
Kaiser is not just "insurance coverage", but medical groups and hospitals and pharmacies. Why would their pharmacies carry something that their "insurance" wouldn't cover? And if the patient took the prescription to CVS, CVS won't accept Kaiser coverage, also leaving the patient to pay full price (or use a discount card). But I guess the doctor could write such a prescription after informing the patient about the non-coverage.
The issue is not limited to Kaiser or HMOs. My employer-provided Cigna PPO insurance has twice decided to discontinue coverage for COPD medications that I was taking. They won’t cover a migraine preventative medication for my wife if she also receives Botox.

kaneohe
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Re: High deductible Plan G medigap

Post by kaneohe » Sat Jun 27, 2020 11:54 pm

dodecahedron wrote:
Sat Jun 27, 2020 4:27 pm
............................................

Have you done comparison shopping of all plans offered by all carriers in your area?

Do you have a shopping tool available that shows you the price of all Medigap plans in your area?

Here is my shopping tool on the NYS gov website. I can put in any zipcode in NY and see the prices of all plans available to someone in my zipcode. For example in my area (try 12345, which is not my zip but close enough to show my choices) and you will see that the Plan F-HD and Plan G-HD premiums are identical for all carriers in my area that offer them, so I figured I might as well go with Plan F-HD at Globe, the least expensive company. Cost is $57/month.

...........................................................
That's a neat shopping tool..............but I wonder how they get to put one number/plan/company. I would have thought that age is a variable that would affect many (most?) plans.

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nanameg
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Re: High deductible Plan G medigap

Post by nanameg » Sun Jun 28, 2020 4:24 am

yvette wrote:
Sat Jun 27, 2020 10:44 pm
This is a good pamphlet on how to choose the best Medigap policy:
https://www.medicare.gov/Pubs/pdf/02110 ... -guide.pdf

Here's the CT website for Medigap or supplemental Insurance:
https://portal.ct.gov/CID/Life-And-Heal ... -Advantage

Here are the Companies Approved Medicare Supplement Insurance Policies in CT:
https://portal.ct.gov/CID/Life-And-Heal ... e-Policies

Here are the Monthly Medicare Supplement rates for Standardized Plans for CT:
https://portal.ct.gov/-/media/CID/1_Lif ... _Rates.pdf

Hope this helps. Let me know if any questions.
Great! Thank you

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nanameg
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Re: High deductible Plan G medigap

Post by nanameg » Sun Jun 28, 2020 5:05 am

nanameg wrote:
Sun Jun 28, 2020 4:24 am
yvette wrote:
Sat Jun 27, 2020 10:44 pm
This is a good pamphlet on how to choose the best Medigap policy:
https://www.medicare.gov/Pubs/pdf/02110 ... -guide.pdf

Here's the CT website for Medigap or supplemental Insurance:
https://portal.ct.gov/CID/Life-And-Heal ... -Advantage

Here are the Companies Approved Medicare Supplement Insurance Policies in CT:
https://portal.ct.gov/CID/Life-And-Heal ... e-Policies

Here are the Monthly Medicare Supplement rates for Standardized Plans for CT:
https://portal.ct.gov/-/media/CID/1_Lif ... _Rates.pdf

Hope this helps. Let me know if any questions.
Great! Thank you
I’m not sure if I’ve got this right but I think with a high deductible plan you don’t pay the deductible in full before Medicare starts paying like you do with private plans. My understanding is that Medicare starts paying the 80% and you pay the remaining 20% until u reach the deductible amount and then the insurance company takes over. Is that correct so far as you know?

yvette
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Re: High deductible Plan G medigap

Post by yvette » Sun Jun 28, 2020 8:14 am

Yes, you are correct. The Medigap has a deductible that you have to meet before they will pay the 20%. If you take a high deductible, you can see if the doctor will accept medicare payment as a full payment for an office visit. You'll likely to meet the deductible if you go often to the doctor &/or you have to go to the hospital. Your medical history can help you determine if it makes sense to go with the high deductible.

You also have deductibles for Part A (Hospital) and Part B (Medical). 2020 Premium and deductible information for Part A & Part B can be found here.
https://www.cms.gov/newsroom/fact-sheet ... eductibles

It's also important that you understand Guaranteed issue rights (also called "Medigap protections"). They are rights you have in certain situations when insurance companies must offer you certain Medigap policies without impact to premiums. Here's the information to consider:
https://www.medicare.gov/supplements-ot ... sue-rights

Hope this helps.

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nanameg
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Re: High deductible Plan G medigap

Post by nanameg » Sun Jun 28, 2020 8:35 am

yvette wrote:
Sun Jun 28, 2020 8:14 am
Yes, you are correct. The Medigap has a deductible that you have to meet before they will pay the 20%. If you take a high deductible, you can see if the doctor will accept medicare payment as a full payment for an office visit. You'll likely to meet the deductible if you go often to the doctor &/or you have to go to the hospital. Your medical history can help you determine if it makes sense to go with the high deductible.

You also have deductibles for Part A (Hospital) and Part B (Medical). 2020 Premium and deductible information for Part A & Part B can be found here.
https://www.cms.gov/newsroom/fact-sheet ... eductibles

It's also important that you understand Guaranteed issue rights (also called "Medigap protections"). They are rights you have in certain situations when insurance companies must offer you certain Medigap policies without impact to premiums. Here's the information to consider:
https://www.medicare.gov/supplements-ot ... sue-rights

Hope this helps.
Thanks very much

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dodecahedron
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Re: High deductible Plan G medigap

Post by dodecahedron » Sun Jun 28, 2020 8:51 am

kaneohe wrote:
Sat Jun 27, 2020 11:54 pm
dodecahedron wrote:
Sat Jun 27, 2020 4:27 pm
............................................

Have you done comparison shopping of all plans offered by all carriers in your area?

Do you have a shopping tool available that shows you the price of all Medigap plans in your area?

Here is my shopping tool on the NYS gov website. I can put in any zipcode in NY and see the prices of all plans available to someone in my zipcode. For example in my area (try 12345, which is not my zip but close enough to show my choices) and you will see that the Plan F-HD and Plan G-HD premiums are identical for all carriers in my area that offer them, so I figured I might as well go with Plan F-HD at Globe, the least expensive company. Cost is $57/month.

...........................................................
That's a neat shopping tool..............but I wonder how they get to put one number/plan/company. I would have thought that age is a variable that would affect many (most?) plans.
NY does not allow insurers to base Medigap premiums on age (or any other variable than location.) So everyone in the same region who chooses a given plan from a given insurance carrier pays the same premium. This is known as community rating. Community rating means that I would probably save money if I moved to another state which does age-based pricing in my younger years and moved back here later. Not planning to do that--I like it here!

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FIREchief
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Re: High deductible Plan G medigap

Post by FIREchief » Sun Jun 28, 2020 10:47 am

yvette wrote:
Sun Jun 28, 2020 8:14 am
Your medical history can help you determine if it makes sense to go with the high deductible.
I would agree with this for somebody who has significant, chronic health issues (i.e. they know that they will be a large consumer of healthcare services). For everybody else, history is of little value as it is their medical future that will determine if a high deductible plan is preferable (and, as with investing, nobody knows the future :annoyed ). I'm leaning towards a high deductible Medigap plan because I generally don't like to pay for insurance that I really don't need.
I am not a lawyer, accountant or financial advisor. Any advice or suggestions that I may provide shall be considered for entertainment purposes only.

LSLover
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Re: High deductible Plan G medigap

Post by LSLover » Sun Jun 28, 2020 11:54 am

A high-deductible Plan G is certainly an excellent, cost-effective Medigap, which retains provider flexibility without the Advantage plan oversight and networks. Consider it a catastrophic insurance plan that kicks in when you really need it. Otherwise, just pay your occasional 20% and save big on your monthly recurring payments.

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nanameg
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Re: High deductible Plan G medigap

Post by nanameg » Sun Jun 28, 2020 12:51 pm

LSLover wrote:
Sun Jun 28, 2020 11:54 am
A high-deductible Plan G is certainly an excellent, cost-effective Medigap, which retains provider flexibility without the Advantage plan oversight and networks. Consider it a catastrophic insurance plan that kicks in when you really need it. Otherwise, just pay your occasional 20% and save big on your monthly recurring payments.
Agreed! Thanks!

Spirit Rider
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Re: High deductible Plan G medigap

Post by Spirit Rider » Sun Jun 28, 2020 11:08 pm

A high-deductible Plan G is especially beneficial for someone with a substantial HSA balance. Medicare Supplement premiums are not a qualified medical expense. However, OOP costs are and can be paid with tax-free HSA distributions.

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FrugalInvestor
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Re: High deductible Plan G medigap

Post by FrugalInvestor » Sun Jun 28, 2020 11:59 pm

kaneohe wrote:
Mon Jun 08, 2020 5:50 pm
You may want to consider future use of this plan. If you start to get serious medical expenses and want to change plans to avoid the high deductible.............typically you are allowed to move to lesser plans but not higher plans so possibly moving to G might be difficult. Check the details for your state.
At first glance G high deductible seemed like the most reasonable financial choice to me but I ended up choosing regular G for a couple of reasons. First, I didn't want to risk ending up with an expensive chronic condition and a large deductible year after year. Second, I see a lot of elderly people who end up with serious memory problems so I wanted the simplest plan for me or my wife to administer in old age. Having to deal with a bunch of medical bills when my mind is not sharp seems like it could be a large burden.

I've made it a high priority to simplify our financial accounts so I and/or my wife will hopefully be able to successfully manage them into advanced age. As far as I'm concerned medical insurance (Medicare) is an important part of this bigger picture.
Have a plan, stay the course, and simplify, and while you're at it, Ignore the Noise!

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nanameg
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Re: High deductible Plan G medigap

Post by nanameg » Mon Jun 29, 2020 5:58 am

FrugalInvestor wrote:
Sun Jun 28, 2020 11:59 pm
kaneohe wrote:
Mon Jun 08, 2020 5:50 pm
You may want to consider future use of this plan. If you start to get serious medical expenses and want to change plans to avoid the high deductible.............typically you are allowed to move to lesser plans but not higher plans so possibly moving to G might be difficult. Check the details for your state.
At first glance G high deductible seemed like the most reasonable financial choice to me but I ended up choosing regular G for a couple of reasons. First, I didn't want to risk ending up with an expensive chronic condition and a large deductible year after year. Second, I see a lot of elderly people who end up with serious memory problems so I wanted the simplest plan for me or my wife to administer in old age. Having to deal with a bunch of medical bills when my mind is not sharp seems like it could be a large burden.

I've made it a high priority to simplify our financial accounts so I and/or my wife will hopefully be able to successfully manage them into advanced age. As far as I'm concerned medical insurance (Medicare) is an important part of this bigger picture.
Good points to raise.

I have to be sure of the exact number of the the deductible and if they increase significantly over time but from what I see now the price of the premium is so low that you can save easily for the deductible if need be by just not paying the higher premium.

Also u don’t pay the deductible first and then Medicare kicks in from what I understand...Medicare continues to pay 80% and you pay 20% until u hit the deductible. I think you’re billed from Medicare..the drs bills don’t come directly to you.

But I’m calling SHIP today and will discuss further.

Seasonal
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Re: High deductible Plan G medigap

Post by Seasonal » Mon Jun 29, 2020 6:27 am

dodecahedron wrote:
Sat Jun 27, 2020 4:27 pm
Here is my shopping tool on the NYS gov website. I can put in any zipcode in NY and see the prices of all plans available to someone in my zipcode. For example in my area (try 12345, which is not my zip but close enough to show my choices) and you will see that the Plan F-HD and Plan G-HD premiums are identical for all carriers in my area that offer them, so I figured I might as well go with Plan F-HD at Globe, the least expensive company. Cost is $57/month.
How has it been with Globe? They are cheaper than other HD plans, but seem weaker financially and have a worse reputation for customer service.

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cheese_breath
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Re: High deductible Plan G medigap

Post by cheese_breath » Mon Jun 29, 2020 8:30 am

nanameg wrote:
Mon Jun 29, 2020 5:58 am

Also u don’t pay the deductible first and then Medicare kicks in from what I understand...Medicare continues to pay 80% and you pay 20% until u hit the deductible. I think you’re billed from Medicare..the drs bills don’t come directly to you.
The deductibles are billed directly to you from the medical providers, but it takes a little while. First they go through Medicare and medigap, and then the provider bills you for whatever's still unpaid after that.
The surest way to know the future is when it becomes the past.

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nanameg
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Re: High deductible Plan G medigap

Post by nanameg » Mon Jun 29, 2020 9:31 am

cheese_breath wrote:
Mon Jun 29, 2020 8:30 am
nanameg wrote:
Mon Jun 29, 2020 5:58 am

Also u don’t pay the deductible first and then Medicare kicks in from what I understand...Medicare continues to pay 80% and you pay 20% until u hit the deductible. I think you’re billed from Medicare..the drs bills don’t come directly to you.
The deductibles are billed directly to you from the medical providers, but it takes a little while. First they go through Medicare and medigap, and then the provider bills you for whatever's still unpaid after that.
Ok thanks

JackoC
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Re: High deductible Plan G medigap

Post by JackoC » Mon Jun 29, 2020 9:43 am

cheese_breath wrote:
Wed Jun 10, 2020 10:35 pm
During the six months beginning the day of DW's stroke she was hospitalized four times for periods of a week or more, taken to hospital emergency rooms twice but not admitted, and used up 98 of the 100 day maximum Medicare skilled nursing allocation. I don't have the figures handy, but as I recall the cost was over $500,000. Medicare paid 80%, and her plan N medigap policy paid the other 20%. And never once did I have to ask if the hospitals, physicians, technicians or nursing homes were 'in network'.
To broaden I hope not derail the discussion, what do people think about Plan K, which my location comes with low deductible and $5,880 out of pocket limit, as when you exceed 100 day skilled nursing maximum or 365 day hospital max. Under Plan L (none available my location) it's $2,940. On the ones discussed so far there's no theoretical limit to your liability in the areas Medicare or plan doesn't cover, right? The Plan K offered where I am is around $120/mo v $50's-$60's for the cheapest alternatives. I'm just beginning to scope this out and pay attention to discussions, a couple of years out.

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nanameg
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Re: High deductible Plan G medigap

Post by nanameg » Mon Jun 29, 2020 11:17 am

JackoC wrote:
Mon Jun 29, 2020 9:43 am
cheese_breath wrote:
Wed Jun 10, 2020 10:35 pm
During the six months beginning the day of DW's stroke she was hospitalized four times for periods of a week or more, taken to hospital emergency rooms twice but not admitted, and used up 98 of the 100 day maximum Medicare skilled nursing allocation. I don't have the figures handy, but as I recall the cost was over $500,000. Medicare paid 80%, and her plan N medigap policy paid the other 20%. And never once did I have to ask if the hospitals, physicians, technicians or nursing homes were 'in network'.
To broaden I hope not derail the discussion, what do people think about Plan K, which my location comes with low deductible and $5,880 out of pocket limit, as when you exceed 100 day skilled nursing maximum or 365 day hospital max. Under Plan L (none available my location) it's $2,940. On the ones discussed so far there's no theoretical limit to your liability in the areas Medicare or plan doesn't cover, right? The Plan K offered where I am is around $120/mo v $50's-$60's for the cheapest alternatives. I'm just beginning to scope this out and pay attention to discussions, a couple of years out.
I’ve not really paid attention to the other plans since G is the most popular and offers the most coverage.

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dodecahedron
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Re: High deductible Plan G medigap

Post by dodecahedron » Mon Jun 29, 2020 8:59 pm

Seasonal wrote:
Mon Jun 29, 2020 6:27 am
dodecahedron wrote:
Sat Jun 27, 2020 4:27 pm
Here is my shopping tool on the NYS gov website. I can put in any zipcode in NY and see the prices of all plans available to someone in my zipcode. For example in my area (try 12345, which is not my zip but close enough to show my choices) and you will see that the Plan F-HD and Plan G-HD premiums are identical for all carriers in my area that offer them, so I figured I might as well go with Plan F-HD at Globe, the least expensive company. Cost is $57/month.
How has it been with Globe? They are cheaper than other HD plans, but seem weaker financially and have a worse reputation for customer service.
No actual experience with customer service other than getting the account and automated billing set up, which were facilitated by an independent insurance agent (no cost to me, whatever commission he gets is paid by Globe without affecting my premium.)

That said, with a high deductible Plan G, if I manage to stay in my usual good health, it may be a number of years before I actually have a claim they have to pay.

My understanding is that Medigap insurance does not give any wiggle room for the carrier to deny coverage. If Medicare approves their part, then Medigap carrier portion is well-defined and formulaic. The Medigap carrier does not have any ground to delay payment on grounds of needing to determine medical necessity or whether the hospital charges were appropriate. If I do have a problem with a claim getting processed, I expect my independent agent will go to bat for me to get it dealt with, in order to maintain his reputation, which is a good one. He said none of his clients have had trouble with Globe paying their claims promptly.

As for financial strength, NYS Insurance Dept has a reputation for being one of the tougher regulators and there is some kind of backup state guarantee fund if it comes to that.

Also, if I start to hear about any problems with Globe or if their premiums rise in the future so they are no longer competitive, I have the option to switch my Medigap carrier in the future without underwriting (thanks to living in NY, which gives me that flexibility.)

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