Medigap Provider Decision Help Please for 65 YO

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Agent 99
Posts: 89
Joined: Wed May 25, 2016 6:44 pm

Re: Medigap Provider Decision Help Please for 65 YO

Post by Agent 99 »

ModifiedDuration wrote: Thu May 12, 2022 9:21 pm
money2churn wrote: Thu May 12, 2022 8:35 pm Very informative topic and pertinent to me as I'm nearing the time to decide on a plan for myself. As I read it, by virtue of being in a state(Oregon) that bans "balance billing" then Plan N's "excess charges" clause should be a non-issue. Am I missing something here?
It appears that the way the law was written in Oregon, Excess Charges for Medicare are still allowed.

The states that currently do not allow Excess Charges are:
Ohio
Vermont
New York
Minnesota
Connecticut
Rhode Island
Pennsylvania
Massachusetts

It is worthy noting that a very small percent of physicians, depending where you read about 3%, do not participate in Medicare (do not accept assignment) and could bill for Excess Charges.

In other words, Excess Charges are rather uncommon.
A friend was referred to an orthopedic surgeon who turned out not to accept Medicare at all. I did some quick research. There are approximately 25,500 orthopedic surgeons in the country and roughly 1% don’t accept Medicare. The largest group of nonparticipating MDs are psychiatrists. I don’t recall the % though.
Agent 99
Posts: 89
Joined: Wed May 25, 2016 6:44 pm

Re: Medigap Provider Decision Help Please for 65 YO

Post by Agent 99 »

bradinsky wrote: Thu May 12, 2022 7:27 pm
buckeye7983 wrote: Thu May 12, 2022 4:55 pm
Agent 99 wrote: Thu May 12, 2022 2:45 pmI spoke with UHC today. No G-HD as MrRE discovered in my state as well. For G the premium is $104.67. It includes 2 discounts totalling $92.92 off the base rate. For years 1-3 they discount for early age (not young mind you!) at 45%. The next 10 years the discount decreases by 2%, then 15% decrease (age 78) (my notes are confusing here) but at age 86 the premium is the standard base rate which in 2022 is $197.59.

For my state and area, the average annual increase over the past 6 years was 4%.

Autopay provides a $4 discount.

Must become AARP member which is now $12 for first year and then $16 if auto renew.

She did try to get me to apply on the phone but I didn’t even though she said I could cancel. She sent me a pdf of the application and in an effort to draw more info from me (email, Medicare #, etc.) she said she was filling in the application for me so I just have to sign and return. At medicare # I put the brakes on and said I can fill it in myself. But she was clever in her methods to enroll me as far as possible. I’m sure many people need that kind of help and it is good customer service but I did have to say more than a few times that I will take the next steps rather than having them contact me again or continue to fill out my application on my behalf. For example, in the beginning of the call she asked for my email which I didn’t give but by the time she was filling in the application she got it from me! I won’t hold this against UHC but it is annoying as is the attempt to get me enrolled in AARP right then and there. She said “seamless” and I knew I had to say no.

Then there were the marketing questions that result in getting bombarded with emails. It sounds so official and pertinent to the quote process however it is not. I’ll be doing a lot of unsubscribing in the next few weeks.

My head is spinning from all of this. Now I’m leaning toward UHC. Their market share is among the top in my state. I’m disappointed with BCBS because of the “new to medicare” discount that was not transparent on their webpage and the agent’s lack of reaction when I asked what happens after a year and I’m hit with a $20 increase.

I feel UHC has been the most upfront about their discounts and the price is the lowest coming in at $104.67.
Seems like for many, AARP/UHC Medigap Plan G is a good default choice:

Avoids denial of care/restrictive networks that can be a problem with Medicare Advantage plans.

Community pricing instead of Attained Age (although age-based discounts lead to similar effect).

By far largest market share (unlikely to leave market, maybe more scrutinized by regulators so harder to pull shenanigans?).

On average, may have greater total cost than G-HD, but less paperwork/hassles at advanced age and more seamless if/when develop expensive and/or chronic illness.

Thanks everyone, especially MrRE for a very informative thread.
We switched our plan “G” from AARP/UHC to Medical Mutual of Ohio in 2020 & they have been great.

Why did you switch?
bradinsky
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Joined: Sat Jul 21, 2018 6:32 am
Location: Ohio

Re: Medigap Provider Decision Help Please for 65 YO

Post by bradinsky »

Agent 99 wrote: Thu May 12, 2022 9:47 pm
bradinsky wrote: Thu May 12, 2022 7:27 pm
buckeye7983 wrote: Thu May 12, 2022 4:55 pm
Agent 99 wrote: Thu May 12, 2022 2:45 pmI spoke with UHC today. No G-HD as MrRE discovered in my state as well. For G the premium is $104.67. It includes 2 discounts totalling $92.92 off the base rate. For years 1-3 they discount for early age (not young mind you!) at 45%. The next 10 years the discount decreases by 2%, then 15% decrease (age 78) (my notes are confusing here) but at age 86 the premium is the standard base rate which in 2022 is $197.59.

For my state and area, the average annual increase over the past 6 years was 4%.

Autopay provides a $4 discount.

Must become AARP member which is now $12 for first year and then $16 if auto renew.

She did try to get me to apply on the phone but I didn’t even though she said I could cancel. She sent me a pdf of the application and in an effort to draw more info from me (email, Medicare #, etc.) she said she was filling in the application for me so I just have to sign and return. At medicare # I put the brakes on and said I can fill it in myself. But she was clever in her methods to enroll me as far as possible. I’m sure many people need that kind of help and it is good customer service but I did have to say more than a few times that I will take the next steps rather than having them contact me again or continue to fill out my application on my behalf. For example, in the beginning of the call she asked for my email which I didn’t give but by the time she was filling in the application she got it from me! I won’t hold this against UHC but it is annoying as is the attempt to get me enrolled in AARP right then and there. She said “seamless” and I knew I had to say no.

Then there were the marketing questions that result in getting bombarded with emails. It sounds so official and pertinent to the quote process however it is not. I’ll be doing a lot of unsubscribing in the next few weeks.

My head is spinning from all of this. Now I’m leaning toward UHC. Their market share is among the top in my state. I’m disappointed with BCBS because of the “new to medicare” discount that was not transparent on their webpage and the agent’s lack of reaction when I asked what happens after a year and I’m hit with a $20 increase.

I feel UHC has been the most upfront about their discounts and the price is the lowest coming in at $104.67.
Seems like for many, AARP/UHC Medigap Plan G is a good default choice:

Avoids denial of care/restrictive networks that can be a problem with Medicare Advantage plans.

Community pricing instead of Attained Age (although age-based discounts lead to similar effect).

By far largest market share (unlikely to leave market, maybe more scrutinized by regulators so harder to pull shenanigans?).

On average, may have greater total cost than G-HD, but less paperwork/hassles at advanced age and more seamless if/when develop expensive and/or chronic illness.

Thanks everyone, especially MrRE for a very informative thread.
We switched our plan “G” from AARP/UHC to Medical Mutual of Ohio in 2020 & they have been great.

Why did you switch?
MMO approached us in September of that year & offered us significant yearly savings and the ability to switch without medical underwriting. We were very familiar with them because they were our health insurance carrier while employed for 20 years.
tj
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Re: Medigap Provider Decision Help Please for 65 YO

Post by tj »

I don't think UHC has g hd in any state. UHC does have . massive market share in many (most?) states though.
ModifiedDuration
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Re: Medigap Provider Decision Help Please for 65 YO

Post by ModifiedDuration »

Agent 99 wrote: Thu May 12, 2022 9:46 pm A friend was referred to an orthopedic surgeon who turned out not to accept Medicare at all. I did some quick research. There are approximately 25,500 orthopedic surgeons in the country and roughly 1% don’t accept Medicare. The largest group of nonparticipating MDs are psychiatrists. I don’t recall the % though.
A participating Medicare provider means they accept Medicare-approved rates as full payment (accept assignment).

A non-participating provider accepts Medicare, but may bill the patient an extra 15% Excess Charge.

Then, there are providers who have opted out of Medicare and don’t accept it.
ModifiedDuration
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Re: Medigap Provider Decision Help Please for 65 YO

Post by ModifiedDuration »

tj wrote: Thu May 12, 2022 11:43 pm I don't think UHC has g hd in any state. UHC does have . massive market share in many (most?) states though.
Yes, the AARP/UHC co-branded Medigap plans do not offer the high-deductible option anywhere.

The AARP/UHC co-branded Medigap plans have about 34% of the Medigap market nationwide and are offered in all 50 states and the District of Columbia.
Topic Author
MrRE
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Re: Medigap Provider Decision Help Please for 65 YO

Post by MrRE »

Agent 99 wrote: Thu May 12, 2022 9:39 pm MrRE - I’ve understood your graphs of premium v. Age are based on 2022 premiums and not projected premiums. You are usually many steps ahead of me so I might have made the wrong assumption.

I found a United American document in SC serff of nationwide projections based on experience up to 6-2021 for G-HD. The 1/22 rate increase is listed as 0.7% and is 4.5% from 1/23 - 1/55 with loss ratios increasing over this time frame. A footnote says that “experience is subject to significant fluctuations in small blocks of business” as you have pointed out.

Serff. Tracking AMLC-132989531

Another document shows experience but only for 3 years. I guess that’s when they started issuing this plan but there is tons of data for F-HD as modified duration mentioned using in his/her analysis of HD insurers.
Wow! SC state makes insurance companies post way more data and info in SERFF than NJ!


I'm lucky if I can find any Medigap rate information at all for NJ in SERFF.

It seems NJ DOBI isn't making insurance companies post as much on

https://filingaccess.serff.com/sfa/home/NJ

compared to way more postings for SC state on

https://filingaccess.serff.com/sfa/home/SC


Regarding the Nationwide projection you found, that is scary.


With a 4.5% yearly rate increase, loss ratios are projected to still keep going up and up and up.

So it seems far-future rates will have to go up much higher.

And cost-sharing probably must also go up

(like much much higher Medigap plan deductibles, etc.).


This is all so complicated!

I'd really like to read an actuary's view on Medigap rates, strategies, and rules.

Also I wonder what Medigap plan and company an actuary person would pick!


Anyway, that was a very interesting SERFF pdf you found! Thank you! :happy
Agent 99
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Re: Medigap Provider Decision Help Please for 65 YO

Post by Agent 99 »

MrRE. If you haven’t plunged into the SC database here’s the 2022 MOO folder MUTA-133107392. All kinds of data you might find useful. I found the area factor file quite revealing. NJ is .98 and SC is .74! Don’t understand that. I also found a MOO Letter that acknowledges being banned for 5 years for offering product to state retiree medicare but excludes their other companies. I can find data for other companies if you want since I’m a pro at searching SC. Frankly, I’m surprised SC requires that amount of data.

Bradinsky. One of the GenRe articles discussed the competitiveness of the market and that prices are being compressed for some plans. I suppose that’s why UHC-AARP is discounting my premium by $92.92!
Agent 99
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Re: Medigap Provider Decision Help Please for 65 YO

Post by Agent 99 »

ModifiedDuration wrote: Fri May 13, 2022 4:05 am
Agent 99 wrote: Thu May 12, 2022 9:46 pm A friend was referred to an orthopedic surgeon who turned out not to accept Medicare at all. I did some quick research. There are approximately 25,500 orthopedic surgeons in the country and roughly 1% don’t accept Medicare. The largest group of nonparticipating MDs are psychiatrists. I don’t recall the % though.
A participating Medicare provider means they accept Medicare-approved rates as full payment (accept assignment).

A non-participating provider accepts Medicare, but may bill the patient an extra 15% Excess Charge.

Then, there are providers who have opted out of Medicare and don’t accept it.
This provider told her to sign a private pay contract before he would accept her as a patient. Needless to say she found another surgeon.
Topic Author
MrRE
Posts: 120
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Re: Medigap Provider Decision Help Please for 65 YO

Post by MrRE »

Agent 99 wrote: Fri May 13, 2022 9:28 am MrRE. If you haven’t plunged into the SC database here’s the 2022 MOO folder MUTA-133107392. All kinds of data you might find useful. I found the area factor file quite revealing. NJ is .98 and SC is .74! Don’t understand that. I also found a MOO Letter that acknowledges being banned for 5 years for offering product to state retiree medicare but excludes their other companies. I can find data for other companies if you want since I’m a pro at searching SC. Frankly, I’m surprised SC requires that amount of data.

Bradinsky. One of the GenRe articles discussed the competitiveness of the market and that prices are being compressed for some plans. I suppose that’s why UHC-AARP is discounting my premium by $92.92!
Thank you Agent 99. The MOO Lifetime Loss Ratio Calculation for their G-HD nationwide was surprising.

It showed very low loss ratios current and predicted for a long time.
(Low loss ratios due to: too low claims paid vs. too high premiums charged).

The loss ratios are so low that MOO would be under 65% and have to give refunds after the required several years of that situation.

But they say their Pricing Target Lifetime Loss Ratio: 67.6%.

Well this is interesting but I need to focus on picking a G-HD Medigap company from my list.

I greatly appreciate your SERFF search offer but you need to focus on answering your decision questions too.

I think we're both getting distracted by the same things.

We're both trying to find specific answers to questions to pick a Medigap company.

But then while looking for answers, we get distracted when we bump into broader related topics that explain the bigger picture or new Medigap insights.

So for now, I'm focusing on picking a Medigap G-HD company from my list above.


By the way, regarding AARP-UHC, you might be interested in the review I just bumped into.

https://www.valuepenguin.com/aarp-medic ... ent-review

It points out that AARP-UHC community pricing with age discount
(aka: age-guaranteed increases)
isn't allowed in some states.

So, focusing on AARP-UHC rate history for just your state would probably be the most relevant. Rather than national views that mix in unrelated rate structures.

Just a thought.
Dottie57
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Location: Earth Northern Hemisphere

Re: Medigap Provider Decision Help Please for 65 YO

Post by Dottie57 »

WillRetire wrote: Sun May 01, 2022 1:36 pm OP:
You are raising good questions. There are tradeoffs. Medigap plan G whose premiums are "community-rated" is a great choice. It gives you the most protection you can buy, and it protects you from the highest % premium increases when you reach your 80s & beyond. If you can afford it now, you will probably be able to afford it in your later years. Premium increases will be on par with healthcare inflation. Ask the provider what the annual increases *in the base rate* have been for the past 5-10 years. In our state the base premium % increases have averaged 4% per year.

Worry less about overpaying now, and more about having great coverage later when you need it, & protection against super-high % increases when you are very elderly and possibly frail or sick. It is a lot easier to drop "down" to lesser coverage than it is to go up.

An anecdote: An elderly relative picked a Plan F 2 decades ago with pricing that was attained-age. At age 85 he felt he could not afford the premiums for both he and his wife. He switched to a $0 premium advantage plan because of that. He hopes his good health continues to the end. "Hope" is not a good planning strategy. Perhaps if his original plan was "community-rated", the increases would have been more affordable.

Good luck!
[edited misspelling]
+1
Agent 99
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Joined: Wed May 25, 2016 6:44 pm

Re: Medigap Provider Decision Help Please for 65 YO

Post by Agent 99 »

This post should be considered an informational distraction.

Interesting trove of information form the UHC-AARP horse’s mouth

AARP Medicare Supplement Insurance Plans
This website contains statistics for the AARP® Medicare Supplement Insurance Plans insured by UnitedHealthcare Insurance Company or an affiliate (UnitedHealthcare®).

https://www.aarpsupplementalhealth.com/ ... stats.html

Customer satisfaction survey results - overall satisfaction is good

Advertising substantiation claims audit - highlights

“On average, base rates increased by 3.2% annually between 2015 and 2020.

The base rate increases varied over this range of years. In 2015, base rates increased by 0.7% versus the previous year, whereas in 2016, they increased by 3.0%. For the latest year in the range, 2020, the increase was 4.6%.

The base rate increases varied among the many plans that were included in the analysis. In 2020, 18% of insured members experienced a base rate increase of 3% or less, 35% experienced a base rate increase between 3% up to 5%, and 47% experienced a base rate increase between 5% up to 10%. 0.2% of members experienced a base rate increase over 10%.
Thus, while it is true that the average base rate increase was 3.2% from 2015 through 2020, there is variation around this average. This is why, when publicizing the accurate claim that the average rate increase was 3.2%, mention is made that base rate increases vary by specific plan, by state, and by year.

It should be noted that the claim was audited and substantiated for base rates. The total amounts being charged to insured members may vary more than the base rates. This is because some insured members receive discounted rates for early enrollment, and these discounts wear off over the years.

The audit therefore substantiated a claim being made specifically for base rate increases. The substantiated claim is that, on average, base rates have increased by 3.2% annually from 2015 through 2020, while varying by specific plan, state, and year.”

Base rate increase for this period examples: SC 3.1%, NJ 2.4% and highest OR 6%.

Average time in plan is 10.59 years.

I found the link in a document on the SERFF. As someone mentioned earlier this is a group plan. Anyone looking for data on SERFF for UHC-AARP needs to select the box for the group supplemental plans rather than the individual.

I have changed my mind so often in this process but now I’m strongly leaning toward UHC. The pros and cons listed in the link MrRE posted are funny to me. All the pros aren’t important to me and having to join AARP is the major con on my list at this moment. So it seems that in the end of this exercise price percolates to the top as the winning factor.

It turns out that doing this medigap plan research has been studied by economists. This paper puts all this effort in econometric perspective. Looks like my searching cost the medigap market than had I not searched!

https://host.kelley.iu.edu/mwildenb/medigap.pdf

“One important feature of the Medigap market is plan standardization, meaning that within a given plan type, the same set of benefits and coverage needs to be offered, regardless of which insurer sells the plan. Irrespective of plan standardization, we observe substantial price variation across insurers within a market (with an average coefficient of variation larger than 0.2 in most cases), which we define at the state level. In explaining observed price variation, we first present reduced-form evidence that suggests both product differentiation and search frictions play important roles. We then estimate our search model using aggregate data on prices and market shares.

Our estimates indicate that search costs are substantial: the estimated median search cost is $30 per search. There is also large variation in search costs across the population. In our counterfactuals, we study the competitive effects of lowering search costs. Assuming firms set prices to maximize profits, we determine to what extent prices would change if quotes are obtained at no cost. According to our simulations, weighted average prices decrease by $71, which is 4.7 percent of the average yearly policy premium. Consumer welfare, which includes savings on search costs as well as the expansion of the market, increases by up to $374 on average if search costs are zero.”
bradinsky
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Location: Ohio

Re: Medigap Provider Decision Help Please for 65 YO

Post by bradinsky »

Agent 99,
I’m sure that you will be happy with whoever you choose. You certainly have done your due diligence! Please keep us posted as to how things progress. Best of luck!
pandersfishy
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Re: Medigap Provider Decision Help Please for 65 YO

Post by pandersfishy »

Agent 99 wrote: Sat May 14, 2022 1:25 pm
I have changed my mind so often in this process but now I’m strongly leaning toward UHC. The pros and cons listed in the link MrRE posted are funny to me. All the pros aren’t important to me and having to join AARP is the major con on my list at this moment. So it seems that in the end of this exercise price percolates to the top as the winning factor.
Just a minor point about joining AARP to be eligible for UHC. You don't have to maintain the membership past the first year. In fact, I joined using my expired member number from at least 8 or 10 years prior...and my wife then joined using the same number. So it is at worst a one time, I think $16 con.

Hope this helps.
Topic Author
MrRE
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Re: Medigap Provider Decision Help Please for 65 YO

Post by MrRE »

Agent 99 wrote: Sat May 14, 2022 1:25 pm This post should be considered an informational distraction.

Interesting trove of information form the UHC-AARP horse’s mouth

AARP Medicare Supplement Insurance Plans
This website contains statistics for the AARP® Medicare Supplement Insurance Plans insured by UnitedHealthcare Insurance Company or an affiliate (UnitedHealthcare®).

https://www.aarpsupplementalhealth.com/ ... stats.html

Customer satisfaction survey results - overall satisfaction is good

Advertising substantiation claims audit - highlights

“On average, base rates increased by 3.2% annually between 2015 and 2020.

------ SNIP -------
That was interesting to me too.

I mentioned that on the previous page.
But what they are not saying is,
although rates for all heir plans nationally
might have only increased 3.2% on average over many years,
they are actually only talking about the increase to the "base rate"!

The base rate is the price at the flat part of the rate curve
when a person's age discount stops and the curve becomes flat.

Here is a link to AARP-UHC's rate advertising-claim "proof" document:

https://www.aarpsupplementalhealth.com/ ... Claims.pdf

that I got at this site below, as explained in the video:

https://www.aarpsupplementalhealth.com/ ... stats.html


You have to read their fine print to realize that:
It should be noted that the claim was audited and substantiated for base rates. The total amounts being charged to insured members may vary more than the base rates. This is because some insured members receive discounted rates for early enrollment, and these discounts wear off over the years.
You can look at my rate plots from earlier in the thread for AARP-UHC G and you will see what I mean.

Look for the purple line on the plot for AARP-UHC G.
Look for where the curve goes flat at age 77 for NJ policies.
That is the "base rate".
People get a discount for every year before that.
And that makes people happy enough to not realize
it's a guaranteed long-term rate increase up to that point.
Of course, after the curve gets flat,
then people do have just a 3.2% base rate increase
per their history of rate increases.
So there is a good side to the rate structure.

So overall, I think AARP-UHC has created a very sneaky way to say things
that make them seem better than they really are.

Perhaps that's one reason they are so popular.
A lot of people don't really understand what is going on!


So regarding their low rate increase claim,
if you add their average rate increase for the base rate
plus the rate increase due to age,
then the overall rate increase is not 3.2%.
It's much higher!


The only way the rate can not go up
for people on the non-flat part of the curve
is if the "base rate" goes down more than
the age-change rate is guaranteed to go up.

So I think that could mislead some people.

So the main point I'm trying to make is that:
one needs to be very careful in
how they interpret information that they are given.
It can often be deceiving due to sneaky marketing
and unusual rate structures.
cashmoney
Posts: 423
Joined: Thu Jun 29, 2017 11:15 pm

Re: Medigap Provider Decision Help Please for 65 YO

Post by cashmoney »

pandersfishy wrote: Sat May 14, 2022 6:02 pm
Agent 99 wrote: Sat May 14, 2022 1:25 pm
I have changed my mind so often in this process but now I’m strongly leaning toward UHC. The pros and cons listed in the link MrRE posted are funny to me. All the pros aren’t important to me and having to join AARP is the major con on my list at this moment. So it seems that in the end of this exercise price percolates to the top as the winning factor.
Just a minor point about joining AARP to be eligible for UHC. You don't have to maintain the membership past the first year. In fact, I joined using my expired member number from at least 8 or 10 years prior...and my wife then joined using the same number. So it is at worst a one time, I think $16 con.

Hope this helps.

Another thing that is nice about the UHC AARP Supplement is that in some states they let policyholders switch between plans with no underwriting and still maintain their entry age band ie you take N at age 65 and decide to switch to plan G at age 70 you pay age 65 rate.UHC and the BCBS plans are the only carriers that I know of that allow this some states.

If you live in NC, ND, OH, SC ,AZ,IL,IN,PA or TX UHC has rolled out lower cost plans that carve out some of the wellness benefits like gym membership under the AARP UHICA name ( united health insurance company of america vs united health insurance company).Premiums are lower and discounts are bigger than the AARP UHIC plans.I believe it will be coming to other states soon.



disclaimer licensed agent.
Topic Author
MrRE
Posts: 120
Joined: Mon Feb 19, 2018 7:15 pm

Re: Medigap Provider Decision Help Please for 65 YO

Post by MrRE »

cashmoney wrote: Mon May 09, 2022 11:41 pm
------ SNIP -------

The AARP Medicare Supplement is a group policy that is why they issue a Certificate instead of a Policy and require a AARP membership .AARP has had this agreement with UHC since 1997 before that it was with Prudential.I have never heard of anyone getting a refund with a medicare supplement group certificate or any medicare supplement for that matter but I guess it's possible.The ACA ruling about different MLR amount for group vs individual has to do with Employer group health plans I believe.If you have a link otherwise would love to see it.

Wording from a Group Certificate:

"We call this document your Certificate. A Group Policy
has been issued to the Trustees of the AARP Insurance
Plan and your Certificate is proof of your coverage under
the Group Policy. "


disclaimer licensed agent
I just read on the insurance-forums.com

https://insurance-forums.com/community/ ... 777/page-3

that a certificate is different than a normal policy.

It said:
Another little trick MOFO did back in the early 90's is they issued certificates for a while... You don't get a policy, you get a certificate of coverage issued by an association. The coverage is good as long as the association is viable. Once the association folds your coverage goes away.

Certificates are not backed by a state guaranty fund. As Tom pointed out, they are not guaranteed renewable.
I wonder if AARP-UHC Medigap plan certificates are similar in any way.
Agent 99
Posts: 89
Joined: Wed May 25, 2016 6:44 pm

Re: Medigap Provider Decision Help Please for 65 YO

Post by Agent 99 »

Thank you Bradinsky. It would be a hoot if my soon to be former insurance company attempts to woo me back! Just as an aside - I am paying about $530 as a survivor benefit from my DHs former employer. When they sent me the package that I would automatically be enrolled in their Medicare plan (I’ve thrown out the paperwork so I don’t know what they called it) the premium remained at $530 with all the copays, coins, oversight etc. I was dumbstruck and got an oh well when I said to my the employer BCBS plan rep that the unaffiliated BCBS Medigap plan is significantly less.

MrRE - as I stated earlier you are two steps ahead of me on discovery. Just so much info packed into this thread. I probably have read and reread the same documents many times without even knowing it. Next time I inject myself into one of your threads I will be more diligent about checking prior posts! Thanks again for all your effort and for motivating me to spend more time on this than I had initially thought was necessary. Going from $530 a month to about $330 (Medicare, Medigap, part D and existing dental) is kind of worth turning 65. Let me think of the ways I can use that $200. Oh AARP membership for one!

Cashmoney - thanks for letting me know about the aarp membership. The agent tried hard to get me to enroll for the first year fee of $12 with auto enrollment into 2nd year for only $16. And this was after I said I wanted to fill the application without her help. I must say she was really trying hard to close and I almost fell for it until she asked my medicare number.

Pandersfishy - BCBS and AARP both offered me gym benes for $20/month and a bunch of discounts. I know many med. advantage plan members who do silver sneakers, my nonagenarian mother did, and it was a good experience. I will reconsider next year after my current option expires.
Agent 99
Posts: 89
Joined: Wed May 25, 2016 6:44 pm

Re: Medigap Provider Decision Help Please for 65 YO

Post by Agent 99 »

MrRE wrote: Sat May 14, 2022 7:18 pm
cashmoney wrote: Mon May 09, 2022 11:41 pm
------ SNIP -------

The AARP Medicare Supplement is a group policy that is why they issue a Certificate instead of a Policy and require a AARP membership .AARP has had this agreement with UHC since 1997 before that it was with Prudential.I have never heard of anyone getting a refund with a medicare supplement group certificate or any medicare supplement for that matter but I guess it's possible.The ACA ruling about different MLR amount for group vs individual has to do with Employer group health plans I believe.If you have a link otherwise would love to see it.

Wording from a Group Certificate:

"We call this document your Certificate. A Group Policy
has been issued to the Trustees of the AARP Insurance
Plan and your Certificate is proof of your coverage under
the Group Policy. "


disclaimer licensed agent
I just read on the insurance-forums.com

https://insurance-forums.com/community/ ... 777/page-3

that a certificate is different than a normal policy.

It said:
Another little trick MOFO did back in the early 90's is they issued certificates for a while... You don't get a policy, you get a certificate of coverage issued by an association. The coverage is good as long as the association is viable. Once the association folds your coverage goes away.

Certificates are not backed by a state guaranty fund. As Tom pointed out, they are not guaranteed renewable.
I wonder if AARP-UHC Medigap plan certificates are similar in any way.
UHC-AARP certificate

https://www.medicare.uhc.com/UCPPlanDoc ... r4AuJCRZxw

This coverage is guaranteed renewable which means that we can cancel it only if certain events happen. Any of these events gives us the right to cancel your coverage under this Plan:
1. You have not paid your Premium on time.
2. The Group Policy has ended. See “About this Plan”
for more information about the Group Policy.
3. You misstated one or more Material Facts when you
applied for this Plan. See “Effects of statements you
made to us” for more information.

I suppose cancellation would cause 50% of the medigap population in the US to riot! I wonder how they handled it when UHC took over for Prudential...
Agent 99
Posts: 89
Joined: Wed May 25, 2016 6:44 pm

Re: Medigap Provider Decision Help Please for 65 YO

Post by Agent 99 »

And this which sounds very much like any other plan that gets terminated:

What happens if Medicare plans from UnitedHealthcare leave the Medicare Program or leave the Service Area where you live?

If we leave the Medicare program or discontinue Medicare plans from UnitedHealthcare in your Service Area, we will notify you in writing. If either of these situations occurs, you will be allowed to change the way you receive Medicare coverage. Your choices will always include Original Medicare, and they may also include joining another Medicare Advantage plan, if such plans are available in your area and are accepting new Members.

We have a contract with CMS. At the end of each year, the contract is reviewed, and either we or CMS may decide to terminate the contract. It is also possible our contract may terminate at some other time. If the contract is going to terminate, we will generally notify you at least ninety (90) days in advance. Your advance notice may be as little as thirty (30) days, or even fewer days if CMS terminates our contract in the middle of the year. Until we notify you in writing that you must disenroll from Medicare plans from UnitedHealthcare and indicate the date when your membership ends, you will continue as a Member of Medicare plans from UnitedHealthcare, and you must continue to receive all covered services from contracted medical providers until the date your disenrollment is effective. All covered services and rules described in this document will continue until your membership ends.

Once we have notified you in writing we are leaving the Medicare program or the area where you live, you may switch to another way of getting your Medicare benefits at any time. If you decide to switch from Medicare plans from UnitedHealthcare to Original Medicare, you will have the right to buy a Medigap policy regardless of your health. This is called “guaranteed issue rights.” Locate your state below to find the local agency to contact about how and when to buy a Medigap policy if you need one.
cashmoney
Posts: 423
Joined: Thu Jun 29, 2017 11:15 pm

Re: Medigap Provider Decision Help Please for 65 YO

Post by cashmoney »

MrRE wrote: Sat May 14, 2022 7:18 pm
cashmoney wrote: Mon May 09, 2022 11:41 pm
------ SNIP -------

The AARP Medicare Supplement is a group policy that is why they issue a Certificate instead of a Policy and require a AARP membership .AARP has had this agreement with UHC since 1997 before that it was with Prudential.I have never heard of anyone getting a refund with a medicare supplement group certificate or any medicare supplement for that matter but I guess it's possible.The ACA ruling about different MLR amount for group vs individual has to do with Employer group health plans I believe.If you have a link otherwise would love to see it.

Wording from a Group Certificate:

"We call this document your Certificate. A Group Policy
has been issued to the Trustees of the AARP Insurance
Plan and your Certificate is proof of your coverage under
the Group Policy. "


disclaimer licensed agent
I just read on the insurance-forums.com

https://insurance-forums.com/community/ ... 777/page-3

that a certificate is different than a normal policy.

It said:
Another little trick MOFO did back in the early 90's is they issued certificates for a while... You don't get a policy, you get a certificate of coverage issued by an association. The coverage is good as long as the association is viable. Once the association folds your coverage goes away.

Certificates are not backed by a state guaranty fund. As Tom pointed out, they are not guaranteed renewable.
I wonder if AARP-UHC Medigap plan certificates are similar in any way.


They are guaranteed renewable as long as you pay the premium.If UHC and AARP parted ways then yes the certificate ends however chances are extremely high that this would never happen because one : the arrangement between AARP and UHC is one of the most successful marketing partnerships in the history of the world and two: AARP would most likely find another insurance company to take the block of business if UHC didn't want to extend the contract..Worse case scenario you would be given a guarantee issue to enroll in another med supp carrier individual policy.

This is a scare tactic.That one agent on the insurance forum who constantly bashes AARP UHC had his appointment terminated by UHC so that is why he goes negative on them.
bradinsky
Posts: 928
Joined: Sat Jul 21, 2018 6:32 am
Location: Ohio

Re: Medigap Provider Decision Help Please for 65 YO

Post by bradinsky »

Since our transition from private health insurance to Medicare & supplemental plan G about 4 1/2 years ago, this has proven to be the best insurance coverage we have had in 30 years. 5 years ago, our monthly premiums for “okay” insurance were $2300/month. Today, for Medicare, supplemental plan G & allowing for the $233 yearly deductible for each of us, we average a combined total of $600 per month out of pocket. And we can see any doctor or specialist we choose without pre approval.
Topic Author
MrRE
Posts: 120
Joined: Mon Feb 19, 2018 7:15 pm

Re: Medigap Provider Decision Help Please for 65 YO

Post by MrRE »

bradinsky wrote: Sat May 14, 2022 8:57 pm Since our transition from private health insurance to Medicare & supplemental plan G about 4 1/2 years ago, this has proven to be the best insurance coverage we have had in 30 years. 5 years ago, our monthly premiums for “okay” insurance were $2300/month.
------- snip -------
-

Many insurance agents on insurance-forums.com would say:

You are due to become the next Medigap "shell game" victim!

It can take about 5 years for the ins. co's "shell game" to impact rates.

How does the "shell game" work
and why do many Medigap ins. co's use it?


Here's the "shell game" short explanation:

Apparently many Medigap insurance companies:
- Lure in new policy holders with very low rates
- Close the pool, let closed pool's rates rise, trapping the unhealthy people in the closed pool
- Offer basically the same policy using a different corporate sub-entity (the shell game part)
- Rinse and repeat


The shell game strategy is so sneaky because it hides the high rates of the closed pools.

- The closed pool high rates don't show up on current rate lists!


So the ins. co's can trick people into thinking they have much lower rate increases.

People are also tricked into getting locked-in to closed pools.

The only way out is to pay a higher sub-standard rate if they can pass the underwriting questions.

The ins. co's have many people's minds boggled by all this!
Even some agents don't understand it.
Especially the new agents.

If you want to learn more, Google-search site:insurance-forums.com for "shell game" like this:

https://www.google.com/search?q=%22shel ... forums.com
User avatar
CWRadio
Posts: 536
Joined: Sat Feb 02, 2008 10:04 am
Location: In the Michigan ionosphere

Re: Medigap Provider Decision Help Please for 65 YO

Post by CWRadio »

Here's the "shell game" short explanation:

Apparently many Medigap insurance companies:
- Lure in new policy holders with very low rates
- Close the pool, let closed pool's rates rise, trapping the unhealthy people in the closed pool
- Offer basically the same policy using a different corporate sub-entity (the shell game part)
- Rinse and repeat


The shell game strategy is so sneaky because it hides the high rates of the closed pools.

- The closed pool high rates don't show up on current rate lists!
I got hit by the "shell game" I purchase Transamerica Plan G at a good price and now the Transamerica no longer sells Medigap Insurance.
TransAmerica no longer issues new Medigap plans, effective September 28, 2020.
I need to do medical underwriting if I want to switch insurance companies in my state (Mi). Paul
bradinsky
Posts: 928
Joined: Sat Jul 21, 2018 6:32 am
Location: Ohio

Re: Medigap Provider Decision Help Please for 65 YO

Post by bradinsky »

MrRE,
You act like this process is a shell game, full of trickery, smoke & mirrors. At the end of the day, all you need to do is make a decision. You’ve done your legwork & now it’s coming up on that time. Hopefully you choose wisely, but more important than that, you need to remain healthy. Regardless of how much research you do, your long term health will have more impact than all the numbers you crunch. That & how much Medicare changes the policies & rules. Good luck to you!!
Last edited by bradinsky on Sun May 15, 2022 7:58 am, edited 1 time in total.
ModifiedDuration
Posts: 709
Joined: Sat Dec 05, 2015 4:33 pm

Re: Medigap Provider Decision Help Please for 65 YO

Post by ModifiedDuration »

bradinsky wrote: Sun May 15, 2022 7:31 am MRE,
You act like this process is a shell game, full of trickery, smoke & mirrors. At the end of the day, all you need to do is make a decision. You’ve done your legwork & now it’s coming up on that time. Hopefully you choose wisely, but more important than that, you need to remain healthy. Regardless of how much research you do, your long term health will have more impact than all the numbers you crunch. That & how much Medicare changes the policies & rules. Good luck to you!!
Exactly.

And it’s really just two companies that are known for playing the shell game - Aetna and especially Mutual of Omaha. Just avoid those two companies.

Also, a Medigap policy should be in place on the first day you are on Medicare. Otherwise you run the risk of having an expensive unexpected medical event occurring and you being on the hook for 20% of Part B until you can sign-up (and heaven forbid that’s not chemotherapy, which can be very, very expensive).
Topic Author
MrRE
Posts: 120
Joined: Mon Feb 19, 2018 7:15 pm

Re: Medigap Provider Decision Help Please for 65 YO

Post by MrRE »

ModifiedDuration wrote: Sun May 15, 2022 7:55 am
bradinsky wrote: Sun May 15, 2022 7:31 am MRE,
You act like this process is a shell game, full of trickery, smoke & mirrors. At the end of the day, all you need to do is make a decision. You’ve done your legwork & now it’s coming up on that time. Hopefully you choose wisely, but more important than that, you need to remain healthy. Regardless of how much research you do, your long term health will have more impact than all the numbers you crunch. That & how much Medicare changes the policies & rules. Good luck to you!!
Exactly.

And it’s really just two companies that are known for playing the shell game - Aetna and especially Mutual of Omaha. Just avoid those two companies.

Also, a Medigap policy should be in place on the first day you are on Medicare. Otherwise you run the risk of having an expensive unexpected medical event occurring and you being on the hook for 20% of Part B until you can sign-up (and heaven forbid that’s not chemotherapy, which can be very, very expensive).
I get the impression there are many more play the shell game besides the 2 you mentioned.

They have to play the game to stay competitive.

Those that didn't play the shell game in the past are starting to play the game more recently.

As explained here where it says "Besides mofo and aetna"

https://insurance-forums.com/community/ ... st-1096583
ModifiedDuration
Posts: 709
Joined: Sat Dec 05, 2015 4:33 pm

Re: Medigap Provider Decision Help Please for 65 YO

Post by ModifiedDuration »

MrRE wrote: Sun May 15, 2022 8:12 am
ModifiedDuration wrote: Sun May 15, 2022 7:55 am
bradinsky wrote: Sun May 15, 2022 7:31 am MRE,
You act like this process is a shell game, full of trickery, smoke & mirrors. At the end of the day, all you need to do is make a decision. You’ve done your legwork & now it’s coming up on that time. Hopefully you choose wisely, but more important than that, you need to remain healthy. Regardless of how much research you do, your long term health will have more impact than all the numbers you crunch. That & how much Medicare changes the policies & rules. Good luck to you!!
Exactly.

And it’s really just two companies that are known for playing the shell game - Aetna and especially Mutual of Omaha. Just avoid those two companies.

Also, a Medigap policy should be in place on the first day you are on Medicare. Otherwise you run the risk of having an expensive unexpected medical event occurring and you being on the hook for 20% of Part B until you can sign-up (and heaven forbid that’s not chemotherapy, which can be very, very expensive).
I get the impression there are many more play the shell game besides the 2 you mentioned.

They have to play the game to stay competitive.

Those that didn't play the shell game in the past are starting to play the game more recently.

As explained here where it says "Besides mofo and aetna"

https://insurance-forums.com/community/ ... st-1096583
That post on the link is just an agent listing that some insurance companies are related to or are subsidiaries of other insurance companies. It appears he is confused about insurance companies having different subsidiaries (usually for tax and/or regulatory reasons) and the shell game.

As another agent responded to the mention of Bankers Fidelity Assurance and Bankers Fidelity Life (and then went on to discuss other companies):

“Not exactly the same thing. They are split in GA, using BFAC for plan F only and BFLIC for G.

New Era, New Era Midwest and Phil Am have mostly been one carrier, one state. New Era Midwest replaced New Era in GA a year or so ago but when they hand out rate increases it is across the board. Same increase for new business and existing.”

That agent mentioned United American and Global Life. United American is a subsidiary of Global Life. That’s it. That’s the connection. United American does not play any sort of shell game.

What it comes down to is someone looking to choose a Medigap plan would, in most cases, pick between Plan G, G-HD, and N and should have the Medigap Plan in place as soon as they are on Medicare.

Look at the various standardized Medigap plans, the premiums of the insurance companies available where you live at different beneficiary ages, and the prior rate increase history of the insurance companies.

Individual circumstances and preferences would determine which Medigap plan to obtain and then it comes down to doing the best analysis and comparison you can on the long-term cost of the policies with individual insurance companies.

Oh, and stay away from Mutual on Omaha and Aetna.
Topic Author
MrRE
Posts: 120
Joined: Mon Feb 19, 2018 7:15 pm

Re: Medigap Provider Decision Help Please for 65 YO

Post by MrRE »

ModifiedDuration wrote: Sun May 15, 2022 8:51 am
MrRE wrote: Sun May 15, 2022 8:12 am
ModifiedDuration wrote: Sun May 15, 2022 7:55 am
bradinsky wrote: Sun May 15, 2022 7:31 am MRE,
You act like this process is a shell game, full of trickery, smoke & mirrors. At the end of the day, all you need to do is make a decision. You’ve done your legwork & now it’s coming up on that time. Hopefully you choose wisely, but more important than that, you need to remain healthy. Regardless of how much research you do, your long term health will have more impact than all the numbers you crunch. That & how much Medicare changes the policies & rules. Good luck to you!!
Exactly.

And it’s really just two companies that are known for playing the shell game - Aetna and especially Mutual of Omaha. Just avoid those two companies.

Also, a Medigap policy should be in place on the first day you are on Medicare. Otherwise you run the risk of having an expensive unexpected medical event occurring and you being on the hook for 20% of Part B until you can sign-up (and heaven forbid that’s not chemotherapy, which can be very, very expensive).
I get the impression there are many more play the shell game besides the 2 you mentioned.

They have to play the game to stay competitive.

Those that didn't play the shell game in the past are starting to play the game more recently.

As explained here where it says "Besides mofo and aetna"

https://insurance-forums.com/community/ ... st-1096583
That post on the link is just an agent listing that some insurance companies are related to or are subsidiaries of other insurance companies. It appears he is confused about insurance companies having different subsidiaries (usually for tax and/or regulatory reasons) and the shell game.

As another agent responded to the mention of Bankers Fidelity Assurance and Bankers Fidelity Life (and then went on to discuss other companies):

“Not exactly the same thing. They are split in GA, using BFAC for plan F only and BFLIC for G.

New Era, New Era Midwest and Phil Am have mostly been one carrier, one state. New Era Midwest replaced New Era in GA a year or so ago but when they hand out rate increases it is across the board. Same increase for new business and existing.”

That agent mentioned United American and Global Life. United American is a subsidiary of Global Life. That’s it. That’s the connection. United American does not play any sort of shell game.

What it comes down to is someone looking to choose a Medigap plan would, in most cases, pick between Plan G, G-HD, and N and should have the Medigap Plan in place as soon as they are on Medicare.

Look at the various standardized Medigap plans, the premiums of the insurance companies available where you live at different beneficiary ages, and the prior rate increase history of the insurance companies.

Individual circumstances and preferences would determine which Medigap plan to obtain and then it comes down to doing the best analysis and comparison you can on the long-term cost of the policies with individual insurance companies.

Oh, and stay away from Mutual on Omaha and Aetna.
-

I would be wary that minimizing the shell game players to just 2 companies,
sounds like a "story-line" an agent would use to book business with any other company.

Many agents on insurance-forums.com seem to think that many companies are playing the shell game.


See the link here where it says "Almost all of them do it now.":

https://insurance-forums.com/community/ ... st-1281307

Also read another agent here says "Agree 100%":

https://insurance-forums.com/community/ ... st-1310241

I think companies now have to play the shell game to be competitive.
bradinsky
Posts: 928
Joined: Sat Jul 21, 2018 6:32 am
Location: Ohio

Re: Medigap Provider Decision Help Please for 65 YO

Post by bradinsky »

MrRE wrote: Sun May 15, 2022 9:16 am
ModifiedDuration wrote: Sun May 15, 2022 8:51 am
MrRE wrote: Sun May 15, 2022 8:12 am
ModifiedDuration wrote: Sun May 15, 2022 7:55 am
bradinsky wrote: Sun May 15, 2022 7:31 am MRE,
You act like this process is a shell game, full of trickery, smoke & mirrors. At the end of the day, all you need to do is make a decision. You’ve done your legwork & now it’s coming up on that time. Hopefully you choose wisely, but more important than that, you need to remain healthy. Regardless of how much research you do, your long term health will have more impact than all the numbers you crunch. That & how much Medicare changes the policies & rules. Good luck to you!!
Exactly.

And it’s really just two companies that are known for playing the shell game - Aetna and especially Mutual of Omaha. Just avoid those two companies.

Also, a Medigap policy should be in place on the first day you are on Medicare. Otherwise you run the risk of having an expensive unexpected medical event occurring and you being on the hook for 20% of Part B until you can sign-up (and heaven forbid that’s not chemotherapy, which can be very, very expensive).
I get the impression there are many more play the shell game besides the 2 you mentioned.

They have to play the game to stay competitive.

Those that didn't play the shell game in the past are starting to play the game more recently.

As explained here where it says "Besides mofo and aetna"

https://insurance-forums.com/community/ ... st-1096583
That post on the link is just an agent listing that some insurance companies are related to or are subsidiaries of other insurance companies. It appears he is confused about insurance companies having different subsidiaries (usually for tax and/or regulatory reasons) and the shell game.

As another agent responded to the mention of Bankers Fidelity Assurance and Bankers Fidelity Life (and then went on to discuss other companies):

“Not exactly the same thing. They are split in GA, using BFAC for plan F only and BFLIC for G.

New Era, New Era Midwest and Phil Am have mostly been one carrier, one state. New Era Midwest replaced New Era in GA a year or so ago but when they hand out rate increases it is across the board. Same increase for new business and existing.”

That agent mentioned United American and Global Life. United American is a subsidiary of Global Life. That’s it. That’s the connection. United American does not play any sort of shell game.

What it comes down to is someone looking to choose a Medigap plan would, in most cases, pick between Plan G, G-HD, and N and should have the Medigap Plan in place as soon as they are on Medicare.

Look at the various standardized Medigap plans, the premiums of the insurance companies available where you live at different beneficiary ages, and the prior rate increase history of the insurance companies.

Individual circumstances and preferences would determine which Medigap plan to obtain and then it comes down to doing the best analysis and comparison you can on the long-term cost of the policies with individual insurance companies.

Oh, and stay away from Mutual on Omaha and Aetna.
-

I would be wary that minimizing the shell game players to just 2 companies,
sounds like a "story-line" an agent would use to book business with any other company.

Many agents on insurance-forums.com seem to think that many companies are playing the shell game.


See the link here where it says "Almost all of them do it now.":

https://insurance-forums.com/community/ ... st-1281307

I think companies now have to play the shell game to be competitive.
My belief is that you are wrong & maybe a bit too cynical.
Topic Author
MrRE
Posts: 120
Joined: Mon Feb 19, 2018 7:15 pm

Re: Medigap Provider Decision Help Please for 65 YO

Post by MrRE »

bradinsky wrote: Sun May 15, 2022 9:30 am
MrRE wrote: Sun May 15, 2022 9:16 am
ModifiedDuration wrote: Sun May 15, 2022 8:51 am
MrRE wrote: Sun May 15, 2022 8:12 am
ModifiedDuration wrote: Sun May 15, 2022 7:55 am

Exactly.

And it’s really just two companies that are known for playing the shell game - Aetna and especially Mutual of Omaha. Just avoid those two companies.

Also, a Medigap policy should be in place on the first day you are on Medicare. Otherwise you run the risk of having an expensive unexpected medical event occurring and you being on the hook for 20% of Part B until you can sign-up (and heaven forbid that’s not chemotherapy, which can be very, very expensive).
I get the impression there are many more play the shell game besides the 2 you mentioned.

They have to play the game to stay competitive.

Those that didn't play the shell game in the past are starting to play the game more recently.

As explained here where it says "Besides mofo and aetna"

https://insurance-forums.com/community/ ... st-1096583
That post on the link is just an agent listing that some insurance companies are related to or are subsidiaries of other insurance companies. It appears he is confused about insurance companies having different subsidiaries (usually for tax and/or regulatory reasons) and the shell game.

As another agent responded to the mention of Bankers Fidelity Assurance and Bankers Fidelity Life (and then went on to discuss other companies):

“Not exactly the same thing. They are split in GA, using BFAC for plan F only and BFLIC for G.

New Era, New Era Midwest and Phil Am have mostly been one carrier, one state. New Era Midwest replaced New Era in GA a year or so ago but when they hand out rate increases it is across the board. Same increase for new business and existing.”

That agent mentioned United American and Global Life. United American is a subsidiary of Global Life. That’s it. That’s the connection. United American does not play any sort of shell game.

What it comes down to is someone looking to choose a Medigap plan would, in most cases, pick between Plan G, G-HD, and N and should have the Medigap Plan in place as soon as they are on Medicare.

Look at the various standardized Medigap plans, the premiums of the insurance companies available where you live at different beneficiary ages, and the prior rate increase history of the insurance companies.

Individual circumstances and preferences would determine which Medigap plan to obtain and then it comes down to doing the best analysis and comparison you can on the long-term cost of the policies with individual insurance companies.

Oh, and stay away from Mutual on Omaha and Aetna.
-

I would be wary that minimizing the shell game players to just 2 companies,
sounds like a "story-line" an agent would use to book business with any other company.

Many agents on insurance-forums.com seem to think that many companies are playing the shell game.


See the link here where it says "Almost all of them do it now.":

https://insurance-forums.com/community/ ... st-1281307

I think companies now have to play the shell game to be competitive.
My belief is that you are wrong & maybe a bit too cynical.
I would greatly appreciate any evidence anyone can give to show the agents are wrong.

Also which company can I trust to not switch to the shell game?

Read here where an insurance agent says "the competition is starting to replicate that model (if you can't beat them, join them)":

https://insurance-forums.com/community/ ... st-1102417
bradinsky
Posts: 928
Joined: Sat Jul 21, 2018 6:32 am
Location: Ohio

Re: Medigap Provider Decision Help Please for 65 YO

Post by bradinsky »

MrRE wrote: Sun May 15, 2022 9:51 am
bradinsky wrote: Sun May 15, 2022 9:30 am
MrRE wrote: Sun May 15, 2022 9:16 am
ModifiedDuration wrote: Sun May 15, 2022 8:51 am
MrRE wrote: Sun May 15, 2022 8:12 am

I get the impression there are many more play the shell game besides the 2 you mentioned.

They have to play the game to stay competitive.

Those that didn't play the shell game in the past are starting to play the game more recently.

As explained here where it says "Besides mofo and aetna"

https://insurance-forums.com/community/ ... st-1096583
That post on the link is just an agent listing that some insurance companies are related to or are subsidiaries of other insurance companies. It appears he is confused about insurance companies having different subsidiaries (usually for tax and/or regulatory reasons) and the shell game.

As another agent responded to the mention of Bankers Fidelity Assurance and Bankers Fidelity Life (and then went on to discuss other companies):

“Not exactly the same thing. They are split in GA, using BFAC for plan F only and BFLIC for G.

New Era, New Era Midwest and Phil Am have mostly been one carrier, one state. New Era Midwest replaced New Era in GA a year or so ago but when they hand out rate increases it is across the board. Same increase for new business and existing.”

That agent mentioned United American and Global Life. United American is a subsidiary of Global Life. That’s it. That’s the connection. United American does not play any sort of shell game.

What it comes down to is someone looking to choose a Medigap plan would, in most cases, pick between Plan G, G-HD, and N and should have the Medigap Plan in place as soon as they are on Medicare.

Look at the various standardized Medigap plans, the premiums of the insurance companies available where you live at different beneficiary ages, and the prior rate increase history of the insurance companies.

Individual circumstances and preferences would determine which Medigap plan to obtain and then it comes down to doing the best analysis and comparison you can on the long-term cost of the policies with individual insurance companies.

Oh, and stay away from Mutual on Omaha and Aetna.
-

I would be wary that minimizing the shell game players to just 2 companies,
sounds like a "story-line" an agent would use to book business with any other company.

Many agents on insurance-forums.com seem to think that many companies are playing the shell game.


See the link here where it says "Almost all of them do it now.":

https://insurance-forums.com/community/ ... st-1281307

I think companies now have to play the shell game to be competitive.
My belief is that you are wrong & maybe a bit too cynical.
I would greatly appreciate any evidence anyone can give to show the agents are wrong.

Also which company can I trust to not switch to the shell game?

Read here where an insurance agent says "the competition is starting to replicate that model (if you can't beat them, join them)":

https://insurance-forums.com/community/ ... st-1102417
I think you can find conspiracy theorists on almost every subject in this country today. Make your best choice on a provider & move forward with that decision. It’s not that complicated!
Agent 99
Posts: 89
Joined: Wed May 25, 2016 6:44 pm

Re: Medigap Provider Decision Help Please for 65 YO

Post by Agent 99 »

MrRE - please remind me, which companies are you considering?
ModifiedDuration
Posts: 709
Joined: Sat Dec 05, 2015 4:33 pm

Re: Medigap Provider Decision Help Please for 65 YO

Post by ModifiedDuration »

bradinsky wrote: Sun May 15, 2022 9:57 am I think you can find conspiracy theorists on almost every subject in this country today. Make your best choice on a provider & move forward with that decision. It’s not that complicated!
Excellent advice.
tj
Posts: 5961
Joined: Thu Dec 24, 2009 12:10 am

Re: Medigap Provider Decision Help Please for 65 YO

Post by tj »

Agent 99 wrote: Sun May 15, 2022 9:59 am MrRE - please remind me, which companies are you considering?
Oddly enough, he seems very keen on Mutual of Omaha!
Carl53
Posts: 2240
Joined: Sun Mar 07, 2010 8:26 pm

Re: Medigap Provider Decision Help Please for 65 YO

Post by Carl53 »

It is my understanding that if I have a G plan that I can switch to another G plan by another provider during the annual enrollment period without underwriting as long as I have no lapse in coverage. I actually attempted to switch from Medical Mutual of Ohio to Mutual of Omaha this year to save about $25/month. It did not happen due to Aon's computer system having a hiccup that day when I was supposed to provide a voice validation and no one seemed to be knowledgeable enough on either end to be able to correct the problem.
ModifiedDuration
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Re: Medigap Provider Decision Help Please for 65 YO

Post by ModifiedDuration »

Carl53 wrote: Sun May 15, 2022 10:39 am It is my understanding that if I have a G plan that I can switch to another G plan by another provider during the annual enrollment period without underwriting as long as I have no lapse in coverage. I actually attempted to switch from Medical Mutual of Ohio to Mutual of Omaha this year to save about $25/month. It did not happen due to Aon's computer system having a hiccup that day when I was supposed to provide a voice validation and no one seemed to be knowledgeable enough on either end to be able to correct the problem.
There is no annual enrollment period for Medigap plans.

In most states you would have to go through medical
underwriting to switch (which can be done at any time during the year), unless there are special circumstances (bankruptcy of Medigap provider, etc.) or you live in a state with more lenient rules.

There is a Fall Open Enrollment Period, but that is for Medicare Advantage and Part D (prescription) plans.

There is also a separate Medicare Advantage Open Enrollment Period from January 1 through March 31.
bradinsky
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Re: Medigap Provider Decision Help Please for 65 YO

Post by bradinsky »

ModifiedDuration wrote: Sun May 15, 2022 10:51 am
Carl53 wrote: Sun May 15, 2022 10:39 am It is my understanding that if I have a G plan that I can switch to another G plan by another provider during the annual enrollment period without underwriting as long as I have no lapse in coverage. I actually attempted to switch from Medical Mutual of Ohio to Mutual of Omaha this year to save about $25/month. It did not happen due to Aon's computer system having a hiccup that day when I was supposed to provide a voice validation and no one seemed to be knowledgeable enough on either end to be able to correct the problem.
There is no annual enrollment period for Medigap plans.

In most states you would have to go through medical
underwriting to switch (which can be done at any time during the year), unless there are special circumstances (bankruptcy of Medigap provider, etc.) or you live in a state with more lenient rules.

There is a Fall Open Enrollment Period, but that is for Medicare Advantage and Part D (prescription) plans.

There is also a separate Medicare Advantage Open Enrollment Period from January 1 through March 31.
+1 When DW & I switched from UHC to Medical Mutual of Ohio, MMO waived the medical underwriting. Otherwise, we would have remained with UHC for the duration.
buckeye7983
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Re: Medigap Provider Decision Help Please for 65 YO

Post by buckeye7983 »

Agent 99 wrote: Sun May 15, 2022 9:59 am MrRE - please remind me, which companies are you considering?
UHC now has a couple Plan G options available (currently only available in some states):

I think "Plan G + wellness extras" is the older and is offered by UnitedHealthcare Insurance Company. It includes a free gym membership and some dental/vision/hearing "perks" which are referred to as "shiny objects" and "crapola" at the insurance agents and brokers forum. :shock:

I think "Plan G" is newer and is offered by UnitedHealthcare Insurance Company of America. It does not include the "perks" and costs about $10 less per month.

Any opinions/info on which one of these is more likely to be closed to new enrollees in the future, with subsequent premiums spiralling upward as the "closed block" gets older and sicker?

Thanks!
money2churn
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Re: Medigap Provider Decision Help Please for 65 YO

Post by money2churn »

MrRE wrote: Sun May 15, 2022 9:51 am
bradinsky wrote: Sun May 15, 2022 9:30 am
MrRE wrote: Sun May 15, 2022 9:16 am
ModifiedDuration wrote: Sun May 15, 2022 8:51 am
MrRE wrote: Sun May 15, 2022 8:12 am

I get the impression there are many more play the shell game besides the 2 you mentioned.

They have to play the game to stay competitive.

Those that didn't play the shell game in the past are starting to play the game more recently.

As explained here where it says "Besides mofo and aetna"

https://insurance-forums.com/community/ ... st-1096583
That post on the link is just an agent listing that some insurance companies are related to or are subsidiaries of other insurance companies. It appears he is confused about insurance companies having different subsidiaries (usually for tax and/or regulatory reasons) and the shell game.

As another agent responded to the mention of Bankers Fidelity Assurance and Bankers Fidelity Life (and then went on to discuss other companies):

“Not exactly the same thing. They are split in GA, using BFAC for plan F only and BFLIC for G.

New Era, New Era Midwest and Phil Am have mostly been one carrier, one state. New Era Midwest replaced New Era in GA a year or so ago but when they hand out rate increases it is across the board. Same increase for new business and existing.”

That agent mentioned United American and Global Life. United American is a subsidiary of Global Life. That’s it. That’s the connection. United American does not play any sort of shell game.

What it comes down to is someone looking to choose a Medigap plan would, in most cases, pick between Plan G, G-HD, and N and should have the Medigap Plan in place as soon as they are on Medicare.

Look at the various standardized Medigap plans, the premiums of the insurance companies available where you live at different beneficiary ages, and the prior rate increase history of the insurance companies.

Individual circumstances and preferences would determine which Medigap plan to obtain and then it comes down to doing the best analysis and comparison you can on the long-term cost of the policies with individual insurance companies.

Oh, and stay away from Mutual on Omaha and Aetna.
-

I would be wary that minimizing the shell game players to just 2 companies,
sounds like a "story-line" an agent would use to book business with any other company.

Many agents on insurance-forums.com seem to think that many companies are playing the shell game.


See the link here where it says "Almost all of them do it now.":

https://insurance-forums.com/community/ ... st-1281307

I think companies now have to play the shell game to be competitive.
My belief is that you are wrong & maybe a bit too cynical.
I would greatly appreciate any evidence anyone can give to show the agents are wrong.

Also which company can I trust to not switch to the shell game?

Read here where an insurance agent says "the competition is starting to replicate that model (if you can't beat them, join them)":

https://insurance-forums.com/community/ ... st-1102417
Well if you can't trust any of them( which appears to be the position you've arrived at) then what are you left with, self-insuring?
money2churn
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Re: Medigap Provider Decision Help Please for 65 YO

Post by money2churn »

ModifiedDuration wrote: Thu May 12, 2022 9:21 pm
money2churn wrote: Thu May 12, 2022 8:35 pm Very informative topic and pertinent to me as I'm nearing the time to decide on a plan for myself. As I read it, by virtue of being in a state(Oregon) that bans "balance billing" then Plan N's "excess charges" clause should be a non-issue. Am I missing something here?
It appears that the way the law was written in Oregon, Excess Charges for Medicare are still allowed.

The states that currently do not allow Excess Charges are:
Ohio
Vermont
New York
Minnesota
Connecticut
Rhode Island
Pennsylvania
Massachusetts

It is worthy noting that a very small percent of physicians, depending where you read about 3%, do not participate in Medicare (do not accept assignment) and could bill for Excess Charges.

In other words, Excess Charges are rather uncommon.

Great info, thanks!
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dodecahedron
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Re: Medigap Provider Decision Help Please for 65 YO

Post by dodecahedron »

Carl53 wrote: Sun May 15, 2022 10:39 am It is my understanding that if I have a G plan that I can switch to another G plan by another provider during the annual enrollment period without underwriting as long as I have no lapse in coverage.
Not true in most states, but true in a few.

This thread makes me feel exceptionally fortunate to live in NY where all Medicare enrollees have guaranteed ability to switch without underwriting to another Medigap or MA plan of their choice at least annually. (And those covered by the state's free EPIC extra drug coverage plan have an additional special enrollment period option that can be exercised in any month at their discretion.) And all premiums are guaranteed community-rated.

So there are no opportunities for insurers in NY to play the "shell games" described above. That said, our Medigap premiums for most plans are likely substantially higher than the "introductory" offers in other states, but Plan G-HD premiums around $60 to $70/month (depending on region, NYC is more expensive than Upstate) still seem quite reasonable to me.

Currently quite happy with my $0 monthly premium Medicare Advantage 5-Star PPO including Part D plus free EPIC (with the guaranteed ability to switch to Plan G-HD on less than a month's notice at any time as backup should my current good health status change in the future.)

Seriously, folks like the OP who are worried about future Medigap shell games should consider relocating to NY (or another similarly friendly state) at least for long enough to be considered a "permanent change of residence" as a possible escape option in the future.

I believe the OP is in NJ, so if future Medigap rates get oppressive, NY is just a bridge across the Hudson away!
ModifiedDuration
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Re: Medigap Provider Decision Help Please for 65 YO

Post by ModifiedDuration »

New York has some crazy prices for Medigap.

In New York City and Long Island, the lowest price Plan G is $280 a month (community-rated).

So, total annual cost would be $3,160 plus $233 for Part B deductible, or $3,393 total.

Plan G-HD’s lowest premium is $68 a month for NYC and Long Island.

Maximum out-of-pocket is $816 plus $2,490 G-HD deductible, or $3,306 total.

So, any year that you have “reasonable” Medicare costs, you would save a real bundle with G-HD (if I was in NYC or Long Island last year, I would have saved over $2,000 with G-HD vs regular G).

Here is the unusual part - any year where you have extremely large Medicare costs, you would still save a few bucks with G-HD.

Moral of the story: don’t get Plan G in NYC or Long Island (unless you know that you will have very high medical expenses for a few months; in that case, consider switching over to Plan G and then a few months later switch back to G-HD).
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dodecahedron
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Re: Medigap Provider Decision Help Please for 65 YO

Post by dodecahedron »

ModifiedDuration wrote: Sun May 15, 2022 2:00 pm New York has some crazy prices for Medigap.

In New York City and Long Island, the lowest price Plan G is $280 a month (community-rated).

So, total annual cost would be $3,160 plus $233 for Part B deductible, or $3,393 total.

Plan G-HD’s lowest premium is $68 a month for NYC and Long Island.

Maximum out-of-pocket is $816 plus $2,490 G-HD deductible, or $3,306 total.

So, any year that you have “reasonable” Medicare costs, you would save a real bundle with G-HD (if I was in NYC or Long Island last year, I would have saved over $2,000 with G-HD vs regular G).

Here is the unusual part - any year where you have extremely large Medicare costs, you would still save a few bucks with G-HD.

Moral of the story: don’t get Plan G in NYC or Long Island (unless you know that you will have very high medical expenses for a few months; in that case, consider switching over to Plan G and then a few months later switch back to G-HD).
Yes, the low-deductible plans in NY, especially downstate, are all pretty expensive compared to other states that lack NY's flexibility with guaranteed switching rights, but the NY premiums for the two high deductible G-HD and F-HD are really quite reasonable (and have been fairly stable for the years I have been following them.)

Edited to add: also, yet another point in favor of going with G-HD instead of G is that those of us with HSAs can tax efficiently use our HSA plans to pay for out-of-pocket medical costs including deductibles and coinsurance but HSA funds can't be used for Medigap premiums.
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MrRE
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Re: Medigap Provider Decision Help Please for 65 YO

Post by MrRE »

Agent 99 wrote: Sun May 15, 2022 9:59 am MrRE - please remind me, which companies are you considering?
Thanks for asking :happy

This chart (posted earlier) shows all possible choices I have in NJ
with updated quoted latest G-HD rates.

Image

Companies I eliminated due to poor recent financials per NAIC, only:

- Amerihealth NJ
lost money last 2 years,
also their Medigap NJ lives dropped recently by 10x
to a low number

Companies I eliminated due to
very tiny Medigap market share in NJ
per NAIC data, or due to no data available:

- Federal Life
- United States Fire Ins
- Philadelphia American
- United American
- Humana Achieve (no NJ lives data)

Company with the highest Medigap market share in NJ per NAIC data:

- Omaha Ins Co (OIC)

I estimate Omaha's Plan G-HD to have maybe 50 policy holders

(using 2020 NAIC enrollment data for NJ Medigap and CSG Actuarial's approximations for F and F-HD mix as proxies for G and G-HD mix. NJ G-HD% is not available.)

But even if I'm an order of magnitude too low, then 10x would be 500 G-HD policy holders for Omaha.

The other companies each have about 25 lives or less in G-HD (or 250 if I'm 10x off).


- Colonial Penn used to be a big market holder. But it seems Colonial closed all of their NJ Medigap pools to new entrants. And it seems they might playing the "shell game" by using Bankers to offer Medigap policies.

- Humana is offering policies by their Achieve, Value, and also Benefit Plan of Ill. divisions. But I can only get 1 actual quote by Humana toll free number. So perhaps Humana is playing the shell game. It seems strange the quote engine and NJ SHIP rates show three different rates, one low, one medium, one high. So I rule-out all three Humana variants as shell-gamers.

So given all that, in all cases, we are talking about a small number of policy holders for any G-HD plan pool in NJ.

Does a tiny policy pool matter? I don't know for sure.


My concerns with such tiny G-HD policy pools are:

Rates could start to sky-rocket in the G-HD plan I pick due to sudden high claims by others in the policy pool because the pool is so small.

Or rates could start to sky-rocket in the G-HD plan I pick due to the policy pool getting closed to new entrants and healthy policy holders leaving for lower rates elsewhere.

But I also don't even know if G and G-HD pools are treated as separate in a company that offers both in a state.

Perhaps the G and G-HD pools are lumped together for risk purposes. I saw that a per a 2020 AHIP study NAIC data seems to lump the pools together.

So what should or could I do?
What would you do in real life in this situation?


If could get a G-HD policy anyway.
Then if rates go up, switch companies if I can.

But eventually a personal health incident might make that strategy unavailable due to underwriting questions. Of course there is always the one-time switch into MA for a year and then getting 1 time pass to get back into Medigap. Or I could move to NY as suggested above. :happy

Or I could get a Plan G instead.
Then hold out until more policy holders jump into a Plan G-HD. Then switch to that G-HD pool.
But of course that pool could always start dropping.

Or I could get a different plan like plan N.
N isn't as costly as G but has much bigger policy pool sizes than G-HD in NJ.

Or I could save money and get an MA-PD plan with $0 premium that includes dental and vision and Rx:
- According to the Milliman Jan 2022 study funded by UHG:
people with MA-PD plans on average have much lower costs than people with Medigap plans, especially at older ages when rates are higher
- I could invest the money I would have spent on Medigap premiums

I think you could make a reasonable case for all of the above options. (Except move to NY :happy )

Meanwhile the 6 month clock of "unconditional acceptance into Medigap" is ticking. What would you do in real life in this situation? :happy

Please forgive any typos above.
buckeye7983
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Re: Medigap Provider Decision Help Please for 65 YO

Post by buckeye7983 »

MrRE wrote: Sun May 15, 2022 8:54 pm
So what should or could I do?
What would you do in real life in this situation?


If could get a G-HD policy anyway.
Then if rates go up, switch companies if I can.

But eventually a personal health incident might make that strategy unavailable due to underwriting questions. Of course there is always the one-time switch into MA for a year and then getting 1 time pass to get back into Medigap. Or I could move to NY as suggested above. :happy

Or I could get a Plan G instead.
Then hold out until more policy holders jump into a Plan G-HD. Then switch to that G-HD pool.
But of course that pool could always start dropping.

Or I could get a different plan like plan N.
N isn't as costly as G but has much bigger policy pool sizes than G-HD in NJ.

Or I could save money and get an MA-PD plan with $0 premium that includes dental and vision and Rx:
- According to the Milliman Jan 2022 study funded by UHG:
people with MA-PD plans on average have much lower costs than people with Medigap plans, especially at older ages when rates are higher
- I could invest the money I would have spent on Medigap premiums

I think you could make a reasonable case for all of the above options. (Except move to NY :happy )

Meanwhile the 6 month clock of "unconditional acceptance into Medigap" is ticking. What would you do in real life in this situation? :happy

Please forgive any typos above.
MrRE-

Thank you again for all your thorough research. What would I do if I were you?

I think I would get a Medigap Plan G unless finances are so tight that the premium is untenable:

I would assume there are several Plan G choices available in New Jersey that have large numbers of participants, which should decrease the likelihood of untoward outcomes like closing plan down or markedly increased rates because a few participants were very sick.

Less paperwork than HD

Been around longer than HD, so insurance companies/regulators, etc. are more comfortable with them, probably making undesired changes less likely.

I have talked to numerous retired physicians. All of them chose Traditional Medicare with Plan G Medigap.

If you start with G-HD, but later want to switch to G, it is probably because you now have an expensive/chronic illness, in which case you likely will not pass underwriting.

Which Plan G?

I would choose a Plan G company that has a large number of subscribers, has been in the state for a long time, does not have a history of playing the shell game, and has a high financial rating.

UHC/AARP seems to be the company that best meets these criteria in the most states (although I am a little unsure what the whole UHIC vs UHICA means). I would use it as the default choice to compare others against. Is there another company that better meets these criteria in New Jersey?

I think this choice should not be evaluated like an investment, but as insurance. It doesn't seem worth it to try to save a few dollars a month by choosing a company that is more likely to play shell games, etc. Pick a policy which is least likely to have untoward surprises.

Thanks again! :sharebeer
Wolfpacker
Posts: 37
Joined: Thu Dec 15, 2016 10:33 am
Location: Northern Virginia

Re: Medigap Provider Decision Help Please for 65 YO

Post by Wolfpacker »

MrRE wrote: Sun May 15, 2022 8:54 pm
Agent 99 wrote: Sun May 15, 2022 9:59 am MrRE - please remind me, which companies are you considering?
Thanks for asking :happy

This chart (posted earlier) shows all possible choices I have in NJ
with updated quoted latest G-HD rates.

Image

Companies I eliminated due to poor recent financials per NAIC, only:

- Amerihealth NJ
lost money last 2 years,
also their Medigap NJ lives dropped recently by 10x
to a low number

Companies I eliminated due to
very tiny Medigap market share in NJ
per NAIC data, or due to no data available:

- Federal Life
- United States Fire Ins
- Philadelphia American
- United American
- Humana Achieve (no NJ lives data)

Company with the highest Medigap market share in NJ per NAIC data:

- Omaha Ins Co (OIC)

I estimate Omaha's Plan G-HD to have maybe 50 policy holders

(using 2020 NAIC enrollment data for NJ Medigap and CSG Actuarial's approximations for F and F-HD mix as proxies for G and G-HD mix. NJ G-HD% is not available.)

But even if I'm an order of magnitude too low, then 10x would be 500 G-HD policy holders for Omaha.

The other companies each have about 25 lives or less in G-HD (or 250 if I'm 10x off).


- Colonial Penn used to be a big market holder. But it seems Colonial closed all of their NJ Medigap pools to new entrants. And it seems they might playing the "shell game" by using Bankers to offer Medigap policies.

- Humana is offering policies by their Achieve, Value, and also Benefit Plan of Ill. divisions. But I can only get 1 actual quote by Humana toll free number. So perhaps Humana is playing the shell game. It seems strange the quote engine and NJ SHIP rates show three different rates, one low, one medium, one high. So I rule-out all three Humana variants as shell-gamers.

So given all that, in all cases, we are talking about a small number of policy holders for any G-HD plan pool in NJ.

Does a tiny policy pool matter? I don't know for sure.


My concerns with such tiny G-HD policy pools are:

Rates could start to sky-rocket in the G-HD plan I pick due to sudden high claims by others in the policy pool because the pool is so small.

Or rates could start to sky-rocket in the G-HD plan I pick due to the policy pool getting closed to new entrants and healthy policy holders leaving for lower rates elsewhere.

But I also don't even know if G and G-HD pools are treated as separate in a company that offers both in a state.

Perhaps the G and G-HD pools are lumped together for risk purposes. I saw that a per a 2020 AHIP study NAIC data seems to lump the pools together.

So what should or could I do?
What would you do in real life in this situation?


If could get a G-HD policy anyway.
Then if rates go up, switch companies if I can.

But eventually a personal health incident might make that strategy unavailable due to underwriting questions. Of course there is always the one-time switch into MA for a year and then getting 1 time pass to get back into Medigap. Or I could move to NY as suggested above. :happy

Or I could get a Plan G instead.
Then hold out until more policy holders jump into a Plan G-HD. Then switch to that G-HD pool.
But of course that pool could always start dropping.

Or I could get a different plan like plan N.


N isn't as costly as G but has much bigger policy pool sizes than G-HD in NJ.

Or I could save money and get an MA-PD plan with $0 premium that includes dental and vision and Rx:
- According to the Milliman Jan 2022 study funded by UHG:
people with MA-PD plans on average have much lower costs than people with Medigap plans, especially at older ages when rates are higher
- I could invest the money I would have spent on Medigap premiums

I think you could make a reasonable case for all of the above options. (Except move to NY :happy )

Meanwhile the 6 month clock of "unconditional acceptance into Medigap" is ticking. What would you do in real life in this situation? :happy

Please forgive any typos above.
Mr RE: Check your "private message" from me--my thoughts that might help in your decision.
Agent 99
Posts: 89
Joined: Wed May 25, 2016 6:44 pm

Re: Medigap Provider Decision Help Please for 65 YO

Post by Agent 99 »

I just enrolled in UHC/AARP Plan G and joined AARP for a year. No more copays, coinsurance, huge deductibles, approvals and denials! Good bye private health insurance hello Medicare.

For a moment I considered Plan N. The premium was $20 less. I figured I would have to go to a doctor 12 times and pay $20 copay to equal Plan G annual premium, or 1 ER and 10.5 doctor visits, or 2 ERs... Then I said STOP IT!

Next project, drug plan...

MrRE - Be careful if you decide to go with MA. If you move to another county in NJ your plan benefits can change drastically. This happened to my neighbor and it wasn’t pleasant. My 91.5 yo mom has MA but she is not moving, she has good healthcare in her community and her existing providers are all part of the plan. It’s been good for her under those conditions. For me if I develop any condition beyond basic preventive disease and broken bones the last place I want to get healthcare is SC. I speak from experience.

Going HD - I am confused you are considering the one provider that has gotten bad coverage in that forum you cite and elsewhere. It doesn’t sound like the plan can last long with only 10 enrollees. I’m sure you will analyze how that can affect premiums and your options in the future.
bradinsky
Posts: 928
Joined: Sat Jul 21, 2018 6:32 am
Location: Ohio

Re: Medigap Provider Decision Help Please for 65 YO

Post by bradinsky »

Good choice Agent 99!
Agent 99
Posts: 89
Joined: Wed May 25, 2016 6:44 pm

Re: Medigap Provider Decision Help Please for 65 YO

Post by Agent 99 »

Thanks for coaching me Bradinsky!
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