Medigap Provider Decision Help Please for 65 YO

Non-investing personal finance issues including insurance, credit, real estate, taxes, employment and legal issues such as trusts and wills.
bradinsky
Posts: 1500
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: Tue May 17, 2022 3:19 pm Thanks for coaching me Bradinsky!
I’m pretty sure you did it all yourself & I’m sure the choice will be a good one. All of your costs are predictable & you’re free to see any doctor or specialist without pre approval. We love it
buckeye7983
Posts: 212
Joined: Fri Jun 27, 2008 12:35 pm

Re: Medigap Provider Decision Help Please for 65 YO

Post by buckeye7983 »

Agent 99 wrote: Tue May 17, 2022 3:12 pm 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.
Agent 99- I think you made a good choice! In some states, UHC/AARP has two choices for Plan G. They are nearly identical, but the one that costs about $10/month more includes Renew Active (free gym membership) and some dubious dental/vision/hearing benefits.

I will likely choose the more expensive Plan G, even though I am a cost-conscious Boglehead.

It seems healthier and more health-conscious subscribers are more likely to go with the plan that includes free gym membership, which may help keep rate increases down somewhat.

Also, playing to my own sunk cost fallacy (or is it endowment effect?) cognitive bias, I am hoping paying the extra $10/month will provide motivation to use the gym regularly. :wink: Kind of the way those that buy SPIAs tend to live longer.

I have also confirmed that with Renew Active, one can concurrently use as many participating facilities as desired. Actually, this is a really good value for someone who is able and enjoys physical activity.

Hope you enjoy hassle-free healthcare, Agent 99!
Topic Author
MrRE
Posts: 166
Joined: Mon Feb 19, 2018 6:15 pm

Re: Medigap Provider Decision Help Please for 65 YO

Post by MrRE »

Agent 99 wrote: Tue May 17, 2022 3:12 pm 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.
Congratulations Agent 99. AARP-UHC has many good things going for it. The more I read about it, the more I am impressed.

If you change your mind, you can change to any plan within your 30 day trial time, or within the rest of your Medigap 6 month initial enrollment time also I think.

Your AARP-UHC certificate will probably look like the NJ version in SERFF here:

https://filingaccess.serff.com/sfa/home/NJ
SERFF Tracking number: UHLC-130733609

And it shows that AARP-UHC Medigap is Group insurance. You will be in a very large pool so the pool size will never be an issue to qualify for a Minimum Loss Ratio refund if applicable.
Edited update: Mass-marketed group policies are required to meet a 65% minimum loss ratio rather than 75% for non-mass-marketed group policies. So it seems that AARP-UHC group policies perhaps don't have any advantage over non-group policy regarding minimum loss ratio.

Regarding my decision, I just collected a lot of rate history now that I figured out how to do it. I confirmed the numbers with SERFF Outline Of Coverage files. And I was very surprised at the result. I used F-HD as a proxy for G-HD and the rates stayed rock solid over many years. So now I am leaning towards G-HD assuming it can perform the same.

Here are is one chart of several I will post tomorrow.

Image
Last edited by MrRE on Fri May 20, 2022 10:50 am, edited 1 time in total.
ModifiedDuration
Posts: 1058
Joined: Sat Dec 05, 2015 3:33 pm

Re: Medigap Provider Decision Help Please for 65 YO

Post by ModifiedDuration »

MrRE wrote: Tue May 17, 2022 9:39 pm Regarding my decision, I just collected a lot of rate history now that I figured out how to do it. I confirmed the numbers with SERFF Outline Of Coverage files. And I was very surprised at the result. I used F-HD as a proxy for G-HD and the rates stayed rock solid over many years. So now I am leaning towards G-HD assuming it can perform the same.

Here are is one chart of several I will post tomorrow.

Image
What you were just “very surprised at the result” about I had previously posted in a response to you in this thread:

“Also, you mention that you could use CSG Actuarial in the future when you have the eventual dramatic increase in premiums.

Well, that might not be the case with a G-HD. In my state, the Plan F-HD premiums by my carrier have not increased in 14 or 15 years. In fact, during that time period they have reduced premiums 4 times. The reason being that F-HD (and G-HD) plans have a built-in ‘increase’ each year in the form of a higher deductible.”
buckeye7983
Posts: 212
Joined: Fri Jun 27, 2008 12:35 pm

Re: Medigap Provider Decision Help Please for 65 YO

Post by buckeye7983 »

ModifiedDuration wrote: Wed May 18, 2022 3:58 amWell, that might not be the case with a G-HD. In my state, the Plan F-HD premiums by my carrier have not increased in 14 or 15 years. In fact, during that time period they have reduced premiums 4 times. The reason being that F-HD (and G-HD) plans have a built-in ‘increase’ each year in the form of a higher deductible.”
G-HD deductible is pegged to yearly increase in CPI-U, all items, U.S. city average, suggesting next increase will be quite high.

Historical deductible increases can be found here:

https://www.cms.gov/Medicare/Health-Plans/Medigap/FandJ
ModifiedDuration
Posts: 1058
Joined: Sat Dec 05, 2015 3:33 pm

Re: Medigap Provider Decision Help Please for 65 YO

Post by ModifiedDuration »

buckeye7983 wrote: Wed May 18, 2022 7:00 am
ModifiedDuration wrote: Wed May 18, 2022 3:58 amWell, that might not be the case with a G-HD. In my state, the Plan F-HD premiums by my carrier have not increased in 14 or 15 years. In fact, during that time period they have reduced premiums 4 times. The reason being that F-HD (and G-HD) plans have a built-in ‘increase’ each year in the form of a higher deductible.”
G-HD deductible is pegged to yearly increase in CPI-U, all items, U.S. city average, suggesting next increase will be quite high.

Historical deductible increases can be found here:

https://www.cms.gov/Medicare/Health-Plans/Medigap/FandJ
It’s based on the CPI-U increase from August to August.

So far, the increase from last August through April 2022 is 5.7%, so if inflation is zero from May 2022 through August 2022, the HD deductible amount would increase from the current $2,490 to $2,630 in 2023.

However, if inflation remains at the current rate through August 2022, the HD deductible amount would increase to $2,700 in 2023.
Topic Author
MrRE
Posts: 166
Joined: Mon Feb 19, 2018 6:15 pm

Re: Medigap Provider Decision Help Please for 65 YO

Post by MrRE »

ModifiedDuration wrote: Wed May 18, 2022 3:58 am
MrRE wrote: Tue May 17, 2022 9:39 pm Regarding my decision, I just collected a lot of rate history now that I figured out how to do it. I confirmed the numbers with SERFF Outline Of Coverage files. And I was very surprised at the result. I used F-HD as a proxy for G-HD and the rates stayed rock solid over many years. So now I am leaning towards G-HD assuming it can perform the same.

Here is one chart of several I will post tomorrow.

Image
What you were just “very surprised at the result” about I had previously posted in a response to you in this thread:

“Also, you mention that you could use CSG Actuarial in the future when you have the eventual dramatic increase in premiums.

Well, that might not be the case with a G-HD. In my state, the Plan F-HD premiums by my carrier have not increased in 14 or 15 years. In fact, during that time period they have reduced premiums 4 times. The reason being that F-HD (and G-HD) plans have a built-in ‘increase’ each year in the form of a higher deductible.”
ModifiedDuration, Thanks! You are absolutely right. Please forgive me. I meant to thank you in my previous post for many things:

- Alerting me about F-HD low rate history per your experience

- Suggesting I use F-HD as a proxy for G-HD history because G-HD is new starting Jan 1, 2020

- Suggesting a good place to get rate history is CSG and suggesting the trial subscription

- Suggesting using SERFF to get rate history and showing examples

What surprised me was:

- You weren't exaggerating about F-HD rates staying constant over many years!!!

- My state has a stable F-HD rate history too!

Here are rate history charts for comparison of F-HD, G-HD, and G:

Image

Image

Image

Image

I see the same trend in G-HD as F-HD (as you anticipated I would).

Then I looked at AARP-UHC over the same time period.


Image

From the charts above and my cost modeling, I think I would rather save money getting G-HD.

I can use the money I save with G-HD to get better Part D prescription coverage.

My modeling shows that even if I have medical claims over the high deductible every other year ongoing, G-HD still costs less than getting Plan G long term. That includes adding inflation for the high deductible.


HD seems more stable than non-HD!

With G, I see high rates going up long term.

With G-HD, I see low rates staying very stable.

So the big question is, how can HD rates stay so stable?

I think there are several reasons.
I think the high deductible creates a "virtuous cycle" situation that keeps the policy pools filled with healthier people.


1) The high deductible keeps away unhealthy people who:

- "Adverse select" Plan F and Plan G knowing their medical claims will be much higher than the premium

2) The high deductible keeps away healthy people who::
- Like going to the doctor a lot
- Get all kinds of unnecessary tests
- Want to get their moneys worth from their insurance
- Go often because they paid their premium and there's no deterrent other than the tiny Part B deductible

The high deductible makes people leave their F-HD or G-HD policy and switch to a G policy as the years go by:

- As people notice their health slowly starting to turn for the worse, they switch to a non-HD policy while they can still pass the underwriting questions probably

So what about the risk of small policy pools for G-HD in NJ as of now?

I'm tending to think the small G-HD policy pools in NJ may not be risky given the extremely stable long term rate history of F-HD as proof.

How about the Loss Ratio predictions for F-HD and G-HD? What do the actuaries say about the outlook long term?

To get that answer, I found that in SERFF one can sometimes find uploads of the "MEDICARE SUPPLEMENT REFUND CALCULATION FORM".

That form shows a good overall picture of all policies individually, including the number of "life years" in a particular policy, like Plan F or G for example.

Unfortunately, I couldn't find any uploads that included F-HD or G-HD. Perhaps they lump HD with non-HD for loss ratio calculations.

How about inflation increasing the deductible amount?

I too think that inflation isn't a concern for G-HD. Inflation will probably impact G premiums as much as it does G-HD deductible costs.

I also think because the government controls the high-deductible based on the rate of inflation, that is totally fair.

So, overall, at this point in time, I think I'd rather be in the G-HD pool than the G pool.

Please forgive any typos above. Edited spelling typos in charts.
Last edited by MrRE on Fri May 20, 2022 6:51 am, edited 1 time in total.
ModifiedDuration
Posts: 1058
Joined: Sat Dec 05, 2015 3:33 pm

Re: Medigap Provider Decision Help Please for 65 YO

Post by ModifiedDuration »

An outstanding analysis of the High-Deductible plans!

A few thoughts:

First, I know this is implied throughout your analysis, but one reason the HD plans have such stable premiums is that the “increase” is in the annual Part B deductible and the HD deductible increases.

Since those increase each year, the premiums for many HD plans have not had to.

By the way, I much prefer the HD deductible increases being objective and just tied to CPI, rather than the way they do the Part B deductible increases in a black box (and that resulted in an almost 15% increase in 2022).

CMS’s explanation on the Part B increase doesn’t tell you anything:

“Rising prices and utilization across the health care system that drive higher premiums year-over-year alongside anticipated increases in the intensity of care provided.”

CMS also mentioned that a factor in the 2022 increase was the anticipated costs for Aduhelm, but I dislike that the calculation for the Part B deductible increase is opaque to us.

Second, I agree that perhaps the major factor in the HD premiums being so low is that it is a self-selecting pool, only healthy people sign up for an HD plan. I think that makes a big difference in the relative attractiveness of G-HD vs. G from a premium point of view.

Third, it appears that many people just decide on Plan G because it would involve less paperwork and would be easier (and possibly because they do not understand the G-HD plan), but they not do a cost/benefit analysis and actually look at the difference in cost between G and G-HD over the long term. How much are they paying for the convenience of having less bills to pay?

The people I know who have actually taken pen to paper (or used a spreadsheet) to do a long-term cost analysis of the two plans usually end up with G-HD, as they realize the large cost savings outweigh any inconvenience of having to pay more bills over the years.

When I did a spreadsheet and developed different medical cost scenarios (hospitalized once every three years until age 80 and then every other year thereafter, etc.), I was coming up with savings of at least $20,000 with G-HD.

I’m glad that you took the time and effort to do your own spreadsheet analysis.

Fourth, it looks like you are coming down to picking a G-HD plan primarily based on low cost and price stability over the long term. Sounds like a good plan.

Fifth, I regret to admit that once I actually did stumble across data that discussed how many people in different age brackets actually exceed the HD deductible each year (for example, 15% of HD plan holders age 65-70 exceed the HD deductible in a given year, etc.), but I didn’t bookmark it and have not been able to subsequently find it. I know that is something both of us would like to see.

Finally, fair warning: you will either have to do a simple Part D analysis, based on cost and what prescriptions you are currently taking, or be prepared for your head to explode if you try and do a detailed analysis like you did here. It would be very difficult to determine what prescriptions you should be concerned about and which insurers include those prescriptions in their formulary.

However, within the past year here, someone did do an analysis of about 10 very expensive cancer drugs.

If I remember correctly, each of the about 20 Part D plans in his zip code covered all the drugs and the range of low to high total cost for a default dosage for all 10 drugs was much smaller than you would think, about 10%.

Just keep telling yourself that your Part D choice is not an irrevocable decision, that you can change to a new Part D plan each year.
Topic Author
MrRE
Posts: 166
Joined: Mon Feb 19, 2018 6:15 pm

Re: Medigap Provider Decision Help Please for 65 YO

Post by MrRE »

Thank you ModifiedDuration and everyone else too. :happy

My status is "still stuck" because:


1) Still deciding which of the poor G-HD choices to pick that remain on my list after eliminating the "shell gamers" based on history data:

- Humana is back on my "Maybe List"
- Humana might not be playing the shell game; I learned it is offering "Value" priced Medigap just to certain "channels"; so that's why I can't get a price for it
- Humana is a big stable company but something seems iffy with their 3 Medigap "channels", each with different pricing, yet only 1 that will give me a quote

- United American is back on my "Maybe List" even though it has a very small number of policy holders in my state
- UA has a very stable rate history with F-HD and G-HD so far

- Philadelphia American is back on my "Maybe List" even though it has a very small number of policy holders in my state
- PA has a very stable rate history with F-HD and G-HD so far

I omitted Mutual of Omaha (because rumored to be "shell gamer" on the web in many places and it has an F-HD history that goes up unlike the others above so their G-HD trend might be similar in the future)


2) Unable to find a broker I trust yet:

- I'd rather not use a broker and just get the policy from the insurance company's website
- The only company above that has web sign-up is Humana
- Unfortunately some companies don't offer that option and they make you use a broker/agent

- So I'm now reviewing posts on Bogleheads on picking a broker like this
viewtopic.php?t=367450

- I've been vetting brokers I'm considering very carefully first before calling them
- I don't want to give out my personal information to people I don't know on the internet or on toll free numbers
- I don't want to get called or emailed or US Mailed by brokers
- I don't want to get put on a T65 list (so far I haven't received any junk mail and or calls, so my strategy is working)

So I'm...
- Finding what internet site brokers real company names are
- Checking real company names with BBB
- Checking real company names with Google Maps Google Reviews
- Although I am very suspicious because most are 5 star reviews
- I read that reviews on the internet are known to be fake often and can be bought
- See investigation on fake reviews link here from TV channel WTHR
https://www.wthr.com/article/news/inves ... dfcada43fa
- I like that I can check certain insurance agents on some web sites company pages or the agent's linkedin page; it's really nice to be able to see the agent's work history, education, etc

Brokers I considered so far:
- boomerbenefits: doesn't cover my insurance co. choices

- insurify aka ehealthmedicare (is one of the few websites that lists many quotes immediately w/o having to give email or phone info)

- my.viabenefits.com (also gives quotes immediately w/o having to give email or phone info but only half as many quotes as insurify ehealthmedicare (16 vs. 34))

- medicareseminars.org
- medicarenationwide.com
- medicare65quote.com
- healthcareradar.com
- medicareonvideo.com
- seniorsavingsnetwork.org
- Aon Retiree now owned by Retiree Alight
- Checked other websites too

I haven't found any local agents that seem worth calling.

What really bothers me about these brokers/agents is:

- They seem mainly interested in getting the policy sold and after that you may not get much help from them so you might have to switch agents
- They may become your AOR - Agent Of Record - for your policy
- They may have access to your personal health information
- You may become part of their "Book of Business" and they may get a commission from your insurance company for many years even though they might not need to do anything
- If they switch brokerage firms, I think they may get to keep you depending on the deal they have with the firm and ins. co.
- If you get the policy yourself on a website, you may get assigned a captive agent working for the insurance company
- Want to be able to "vet" the agent before talking to them or giving anyone my information

I'm tempted to just go with Humana
- If it turns out they start to raise their rate structure, I suppose I can switch

But I'd rather go with the lower cost Phil. American but they seem iffy.

Image
Please forgive any typos above.
ModifiedDuration
Posts: 1058
Joined: Sat Dec 05, 2015 3:33 pm

Re: Medigap Provider Decision Help Please for 65 YO

Post by ModifiedDuration »

I don’t know if you saw the other post, that the Medicare website now has prices by Medigap plan, by zip code, by insurance company.

I don’t know if that helps you, as you have already done so much research and I don’t know how it would help with Humana prices:

viewtopic.php?t=378299
Agent 99
Posts: 302
Joined: Wed May 25, 2016 6:44 pm

Re: Medigap Provider Decision Help Please for 65 YO

Post by Agent 99 »

I don’t know if I provided the full file serff # for the UA plans or just one file from the folder. I’m still learning the system despite having decided.

You may find some more pros and cons with UA HDG in these files. AMLC-132989531. UA has only 5790 over 65 enrollees nationwide. So it’s not big in your state - it’s not big anywhere. I think you remarked about their predictions for premiums going up that was described in one of the files. If you haven’t seen the other documentation in this folder it may be helpful or not.

Regarding brokers - I called each company directly rather than an agent. I felt it was the only way I could control my info dissemination. Given the research I did a broker didn’t seem to be necessary either only to find out they don’t rep the company, etc. And I’m sure you will find you are more knowledgeable given your research than anyone who is not specifically working for one company. Heck, the agents I spoke with at each insurance co couldn’t believe the questions I asked. They were impressed! Thanks to your and others quest for info.

AARP immediately inundated me with email so I just unsubscribed. Then I got an email to notify me that I unsubscribed!

Good luck!
ModifiedDuration
Posts: 1058
Joined: Sat Dec 05, 2015 3:33 pm

Re: Medigap Provider Decision Help Please for 65 YO

Post by ModifiedDuration »

Agent 99 wrote: Tue May 24, 2022 1:43 pm You may find some more pros and cons with UA HDG in these files. AMLC-132989531. UA has only 5790 over 65 enrollees nationwide. So it’s not big in your state - it’s not big anywhere. I think you remarked about their predictions for premiums going up that was described in one of the files. If you haven’t seen the other documentation in this folder it may be helpful or not.
Plan G-HD has only existed for two years, that is why there are so few policyholders. However, Plan F-HD has been United American’s bread and butter for many years.

As far as projected increases, that’s just conservative actuaries being conservative.

I looked up the UA actuarial projection for Plan F-HD from 2012. It’s projections were based on future annual premium increases of 5.0%.

In actuality, there were no prices increases in the ensuing 10 years in my state, in fact there were two price decreases.

I would put more credence in the fact that UA, for example, in my state has not had a Plan F-HD increase since September 1, 2006 - almost 16 years ago.
Agent 99
Posts: 302
Joined: Wed May 25, 2016 6:44 pm

Re: Medigap Provider Decision Help Please for 65 YO

Post by Agent 99 »

I keep forgetting about that. A little above 50,000 enrollees in HDF nationwide.
cashmoney
Posts: 525
Joined: Thu Jun 29, 2017 11:15 pm

Re: Medigap Provider Decision Help Please for 65 YO

Post by cashmoney »

MrRE wrote: Tue May 24, 2022 1:01 pm Thank you ModifiedDuration and everyone else too. :happy

My status is "still stuck" because:


1) Still deciding which of the poor G-HD choices to pick that remain on my list after eliminating the "shell gamers" based on history data:

- Humana is back on my "Maybe List"
- Humana might not be playing the shell game; I learned it is offering "Value" priced Medigap just to certain "channels"; so that's why I can't get a price for it
- Humana is a big stable company but something seems iffy with their 3 Medigap "channels", each with different pricing, yet only 1 that will give me a quote

- United American is back on my "Maybe List" even though it has a very small number of policy holders in my state
- UA has a very stable rate history with F-HD and G-HD so far

- Philadelphia American is back on my "Maybe List" even though it has a very small number of policy holders in my state
- PA has a very stable rate history with F-HD and G-HD so far

I omitted Mutual of Omaha (because rumored to be "shell gamer" on the web in many places and it has an F-HD history that goes up unlike the others above so their G-HD trend might be similar in the future)


2) Unable to find a broker I trust yet:

- I'd rather not use a broker and just get the policy from the insurance company's website
- The only company above that has web sign-up is Humana
- Unfortunately some companies don't offer that option and they make you use a broker/agent

- So I'm now reviewing posts on Bogleheads on picking a broker like this
viewtopic.php?t=367450

- I've been vetting brokers I'm considering very carefully first before calling them
- I don't want to give out my personal information to people I don't know on the internet or on toll free numbers
- I don't want to get called or emailed or US Mailed by brokers
- I don't want to get put on a T65 list (so far I haven't received any junk mail and or calls, so my strategy is working)

So I'm...
- Finding what internet site brokers real company names are
- Checking real company names with BBB
- Checking real company names with Google Maps Google Reviews
- Although I am very suspicious because most are 5 star reviews
- I read that reviews on the internet are known to be fake often and can be bought
- See investigation on fake reviews link here from TV channel WTHR
https://www.wthr.com/article/news/inves ... dfcada43fa
- I like that I can check certain insurance agents on some web sites company pages or the agent's linkedin page; it's really nice to be able to see the agent's work history, education, etc

Brokers I considered so far:
- boomerbenefits: doesn't cover my insurance co. choices

- insurify aka ehealthmedicare (is one of the few websites that lists many quotes immediately w/o having to give email or phone info)

- my.viabenefits.com (also gives quotes immediately w/o having to give email or phone info but only half as many quotes as insurify ehealthmedicare (16 vs. 34))

- medicareseminars.org
- medicarenationwide.com
- medicare65quote.com
- healthcareradar.com
- medicareonvideo.com
- seniorsavingsnetwork.org
- Aon Retiree now owned by Retiree Alight
- Checked other websites too

I haven't found any local agents that seem worth calling.

What really bothers me about these brokers/agents is:

- They seem mainly interested in getting the policy sold and after that you may not get much help from them so you might have to switch agents
- They may become your AOR - Agent Of Record - for your policy
- They may have access to your personal health information
- You may become part of their "Book of Business" and they may get a commission from your insurance company for many years even though they might not need to do anything
- If they switch brokerage firms, I think they may get to keep you depending on the deal they have with the firm and ins. co.
- If you get the policy yourself on a website, you may get assigned a captive agent working for the insurance company
- Want to be able to "vet" the agent before talking to them or giving anyone my information

I'm tempted to just go with Humana
- If it turns out they start to raise their rate structure, I suppose I can switch

But I'd rather go with the lower cost Phil. American but they seem iffy.

Image
Please forgive any typos above.
cashmoney
Posts: 525
Joined: Thu Jun 29, 2017 11:15 pm

Re: Medigap Provider Decision Help Please for 65 YO

Post by cashmoney »

MrRE wrote: Tue May 24, 2022 1:01 pm Thank you ModifiedDuration and everyone else too. :happy

My status is "still stuck" because:


1) Still deciding which of the poor G-HD choices to pick that remain on my list after eliminating the "shell gamers" based on history data:

- Humana is back on my "Maybe List"
- Humana might not be playing the shell game; I learned it is offering "Value" priced Medigap just to certain "channels"; so that's why I can't get a price for it
- Humana is a big stable company but something seems iffy with their 3 Medigap "channels", each with different pricing, yet only 1 that will give me a quote

- United American is back on my "Maybe List" even though it has a very small number of policy holders in my state
- UA has a very stable rate history with F-HD and G-HD so far

- Philadelphia American is back on my "Maybe List" even though it has a very small number of policy holders in my state
- PA has a very stable rate history with F-HD and G-HD so far

I omitted Mutual of Omaha (because rumored to be "shell gamer" on the web in many places and it has an F-HD history that goes up unlike the others above so their G-HD trend might be similar in the future)


2) Unable to find a broker I trust yet:

- I'd rather not use a broker and just get the policy from the insurance company's website
- The only company above that has web sign-up is Humana
- Unfortunately some companies don't offer that option and they make you use a broker/agent

- So I'm now reviewing posts on Bogleheads on picking a broker like this
viewtopic.php?t=367450

- I've been vetting brokers I'm considering very carefully first before calling them
- I don't want to give out my personal information to people I don't know on the internet or on toll free numbers
- I don't want to get called or emailed or US Mailed by brokers
- I don't want to get put on a T65 list (so far I haven't received any junk mail and or calls, so my strategy is working)

So I'm...
- Finding what internet site brokers real company names are
- Checking real company names with BBB
- Checking real company names with Google Maps Google Reviews
- Although I am very suspicious because most are 5 star reviews
- I read that reviews on the internet are known to be fake often and can be bought
- See investigation on fake reviews link here from TV channel WTHR
https://www.wthr.com/article/news/inves ... dfcada43fa
- I like that I can check certain insurance agents on some web sites company pages or the agent's linkedin page; it's really nice to be able to see the agent's work history, education, etc

Brokers I considered so far:
- boomerbenefits: doesn't cover my insurance co. choices

- insurify aka ehealthmedicare (is one of the few websites that lists many quotes immediately w/o having to give email or phone info)

- my.viabenefits.com (also gives quotes immediately w/o having to give email or phone info but only half as many quotes as insurify ehealthmedicare (16 vs. 34))

- medicareseminars.org
- medicarenationwide.com
- medicare65quote.com
- healthcareradar.com
- medicareonvideo.com
- seniorsavingsnetwork.org
- Aon Retiree now owned by Retiree Alight
- Checked other websites too

I haven't found any local agents that seem worth calling.

What really bothers me about these brokers/agents is:

- They seem mainly interested in getting the policy sold and after that you may not get much help from them so you might have to switch agents
- They may become your AOR - Agent Of Record - for your policy
- They may have access to your personal health information
- You may become part of their "Book of Business" and they may get a commission from your insurance company for many years even though they might not need to do anything
- If they switch brokerage firms, I think they may get to keep you depending on the deal they have with the firm and ins. co.
- If you get the policy yourself on a website, you may get assigned a captive agent working for the insurance company
- Want to be able to "vet" the agent before talking to them or giving anyone my information

I'm tempted to just go with Humana
- If it turns out they start to raise their rate structure, I suppose I can switch

But I'd rather go with the lower cost Phil. American but they seem iffy.

Image
Please forgive any typos above.

When you use an agent that has a direct contract with the insurance carrier to sign up with they will be your Agent of Record and will be paid renewals for the service commitment agreement they have with the carrier to provide customer service after the sale.This is a good thing because if there is a problem you have someone on your side with a vested interest in getting your problem resolved.With almost all the carriers now using off shore customer service it can really help to have an agent that may have a quick access line to speak to stateside customer service reps.The insurance carrier does not pay renewal commissions for policyholders accounts without an agent of record (" orphaned accounts")

If you do decide to use a broker do not go with the one of the big call center agencies like Ehealth,Go Health,Selectquote etc because those agents number one are usually very new/inexperienced and number two because they are employees agents they do not earn renewals therefore they do not have the same service commitment agreement as agents with direct contracts.This means most likely you will never talk to them again.This is also true if sign up directly with the insurance carriers telesales agents or direct to consumer online channel.The biggest thing I would look for in an agent is how long they have been in the business and of course if they represent the carriers you are interested in.For example with UHC you can google UHC medicare agents near me or go to www.myuhcagent.com and they will list UHC agents in your area with a bio.Look for Platinum Producer agents.Humana has something similar medicareagent.humana.com were you search local captive humana marketpoint agents

disclaimer licensed agent
Topic Author
MrRE
Posts: 166
Joined: Mon Feb 19, 2018 6:15 pm

Re: Medigap Provider Decision Help Please for 65 YO

Post by MrRE »

cashmoney wrote: Wed May 25, 2022 1:18 am
When you use an agent that has a direct contract with the insurance carrier to sign up with they will be your Agent of Record and will be paid renewals for the service commitment agreement they have with the carrier to provide customer service after the sale.This is a good thing because if there is a problem you have someone on your side with a vested interest in getting your problem resolved.With almost all the carriers now using off shore customer service it can really help to have an agent that may have a quick access line to speak to stateside customer service reps.The insurance carrier does not pay renewal commissions for policyholders accounts without an agent of record (" orphaned accounts")

If you do decide to use a broker do not go with the one of the big call center agencies like Ehealth,Go Health,Selectquote etc because those agents number one are usually very new/inexperienced and number two because they are employees agents they do not earn renewals therefore they do not have the same service commitment agreement as agents with direct contracts.This means most likely you will never talk to them again.This is also true if sign up directly with the insurance carriers telesales agents or direct to consumer online channel.The biggest thing I would look for in an agent is how long they have been in the business and of course if they represent the carriers you are interested in.For example with UHC you can google UHC medicare agents near me or go to www.myuhcagent.com and they will list UHC agents in your area with a bio.Look for Platinum Producer agents.Humana has something similar medicareagent.humana.com were you search local captive humana marketpoint agents

disclaimer licensed agent
Thank you cashmoney

I had already tried https://medicareagent.humana.com
but had no luck getting Humana (Value) quotes or Humana (Achieve) quotes.
(I only have Humana rate data from OOC files and my state SHIP pdf and CSG.)

But I just now stumbled across two amazing agent-search resources !!!


The first is easier to work with but not as informative as the second:


https://secure.utah.gov/agent-search/search.html

With the agent & insurance company search engine above, I was able to find TONS of independent agents that cover the small insurance companies I am looking at (Philadelphia American and United American).


Here is an example:

https://secure.utah.gov/agent-search/or ... 7J0pnqABAm


The second search engine is here and it lists a lot more details than the one above about the agents/brokers:


Note: the text below was edited because my first posting had a link that "timed out" eventually.

Here is the generic search link. Registration is not required.

https://www.sircon.com/ComplianceExpres ... nonSscrb=Y

It doesn't seem to matter which state I pick if I'm just searching for an agent or broker or insurance company in general. It seems to find them nationwide.

The caveat is: the results are probably what the agent is/was licensed to sell in the relevant state.


For example, to check the agent who founded medicarenationwide.com:

Pick any state, like Georgia.

Pick Individual (radio button).

Enter:
Last name: Edwards
First name: Jackson

Click submit.

Results are on the bottom.

So you can see which insurance companies the agent/brokerage covers now and covered in the past.

Although the accuracy might be questionable, but at least it provides some information for vetting an agent/broker before calling them.



Using the above, I can find an agent in my state and "vet" them before calling!


What I like about the search engine just above in particular is:

- Shows the current insurance companies that a broker/agent handles
- Shows past insurance companies a broker/agent was writing policies for, but no longer and when it expired



So now, I have a great way to find agents/brokers that cover insurance companies and I can see all of the other companies they cover also and I can "vet" the agent/broker before calling them so I know in advance who I am talking to (for safety reasons).

Please forgive any typos above.
Last edited by MrRE on Wed May 25, 2022 6:12 pm, edited 3 times in total.
tj
Posts: 6853
Joined: Wed Dec 23, 2009 11:10 pm

Re: Medigap Provider Decision Help Please for 65 YO

Post by tj »

I can't get the Sircon to work - did you have to register an account?
Topic Author
MrRE
Posts: 166
Joined: Mon Feb 19, 2018 6:15 pm

Re: Medigap Provider Decision Help Please for 65 YO

Post by MrRE »

tj wrote: Wed May 25, 2022 4:33 pm I can't get the Sircon to work - did you have to register an account?
Unsure what is meant by "can't get the Sircon to work".

Registration is not required.


Here is the generic search link.

https://www.sircon.com/ComplianceExpres ... nonSscrb=Y


For example, to check the agent who founded medicarenationwide.com:

Pick any state, like Georgia.

Pick Individual (radio button).

Enter:
Last name: Edwards
First name: Jackson

Click submit.

Results are on the bottom.

So you can see which insurance companies the agent/brokerage covers now and covered in the past.

Although the accuracy might be questionable, at least it provides some information for vetting an agent/broker before calling them.

The caveat is: the results are probably what the agent is/was licensed to sell in the relevant state.
Last edited by MrRE on Wed May 25, 2022 6:12 pm, edited 1 time in total.
tj
Posts: 6853
Joined: Wed Dec 23, 2009 11:10 pm

Re: Medigap Provider Decision Help Please for 65 YO

Post by tj »

MrRE wrote: Wed May 25, 2022 4:46 pm
tj wrote: Wed May 25, 2022 4:33 pm I can't get the Sircon to work - did you have to register an account?
Unsure what is meant by "can't get the Sircon to work".

Registration is not required.


Here is the generic search link.

https://www.sircon.com/ComplianceExpres ... nonSscrb=Y


For example, to check the agent who founded medicarenationwide.com:

Pick any state, like Georgia.

Pick Individual (radio button).

Enter:
Last name: Edwards
First name: Jackson

Click submit.

Results are on the bottom.

So you can see which insurance companies the agent/brokerage covers now and covered in the past.

Although the accuracy might be questionable, but at least it provides some information for vetting an agent/broker before calling them.
The links you provided previously did not work -they appeared to be temporary links that had timed out. but this link worked.
Topic Author
MrRE
Posts: 166
Joined: Mon Feb 19, 2018 6:15 pm

Re: Medigap Provider Decision Help Please for 65 YO

Post by MrRE »

tj wrote: Wed May 25, 2022 4:49 pm
MrRE wrote: Wed May 25, 2022 4:46 pm
tj wrote: Wed May 25, 2022 4:33 pm I can't get the Sircon to work - did you have to register an account?
Unsure what is meant by "can't get the Sircon to work".

Registration is not required.


Here is the generic search link.

https://www.sircon.com/ComplianceExpres ... nonSscrb=Y


For example, to check the agent who founded medicarenationwide.com:

Pick any state, like Georgia.

Pick Individual (radio button).

Enter:
Last name: Edwards
First name: Jackson

Click submit.

Results are on the bottom.

So you can see which insurance companies the agent/brokerage covers now and covered in the past.

Although the accuracy might be questionable, but at least it provides some information for vetting an agent/broker before calling them.
The links you provided previously did not work -they appeared to be temporary links that had timed out. but this link worked.
Thanks. I had tested the links multiple times and they seemed to work long term. But as you said, they eventually "timed out".

So I updated my original text above so it has the generic link and instructions. Thank you!!!
Topic Author
MrRE
Posts: 166
Joined: Mon Feb 19, 2018 6:15 pm

Re: Medigap Provider Decision Help Please for 65 YO

Post by MrRE »

Here is another agent search tool that seems to show the same data:

https://oci.georgia.gov/agent-individual-search

Follow similar instructions:

Enter first name: Jackson
Enter last name: Edwards

Then pick from the links to see the results on which companies they cover now and in the past.

The caveat is: the results are probably what the agent is/was licensed to sell in the relevant state.
buckeye7983
Posts: 212
Joined: Fri Jun 27, 2008 12:35 pm

Re: Medigap Provider Decision Help Please for 65 YO

Post by buckeye7983 »

MrRE wrote: Tue May 24, 2022 1:01 pm 1) Still deciding which of the poor G-HD choices to pick that remain on my list after eliminating the "shell gamers" based on history data:

- Humana is back on my "Maybe List"
- Humana might not be playing the shell game; I learned it is offering "Value" priced Medigap just to certain "channels"; so that's why I can't get a price for it
- Humana is a big stable company but something seems iffy with their 3 Medigap "channels", each with different pricing, yet only 1 that will give me a quote

- United American is back on my "Maybe List" even though it has a very small number of policy holders in my state
- UA has a very stable rate history with F-HD and G-HD so far

- Philadelphia American is back on my "Maybe List" even though it has a very small number of policy holders in my state
- PA has a very stable rate history with F-HD and G-HD so far

I omitted Mutual of Omaha (because rumored to be "shell gamer" on the web in many places and it has an F-HD history that goes up unlike the others above so their G-HD trend might be similar in the future)
MrRE-

Don't know if this is helpful, but in my state, United American has the most aggessive age increases for G-HD:

66 yo- 5.9%
67 yo- 8.3%
68 yo- 2.6%
69 yo- 2.5%

:sharebeer
Topic Author
MrRE
Posts: 166
Joined: Mon Feb 19, 2018 6:15 pm

Re: Medigap Provider Decision Help Please for 65 YO

Post by MrRE »

buckeye7983 wrote: Wed May 25, 2022 6:22 pm
MrRE wrote: Tue May 24, 2022 1:01 pm 1) Still deciding which of the poor G-HD choices to pick that remain on my list after eliminating the "shell gamers" based on history data:

- Humana is back on my "Maybe List"
- Humana might not be playing the shell game; I learned it is offering "Value" priced Medigap just to certain "channels"; so that's why I can't get a price for it
- Humana is a big stable company but something seems iffy with their 3 Medigap "channels", each with different pricing, yet only 1 that will give me a quote

- United American is back on my "Maybe List" even though it has a very small number of policy holders in my state
- UA has a very stable rate history with F-HD and G-HD so far

- Philadelphia American is back on my "Maybe List" even though it has a very small number of policy holders in my state
- PA has a very stable rate history with F-HD and G-HD so far

I omitted Mutual of Omaha (because rumored to be "shell gamer" on the web in many places and it has an F-HD history that goes up unlike the others above so their G-HD trend might be similar in the future)
MrRE-

Don't know if this is helpful, but in my state, United American has the most aggessive age increases for G-HD:

66 yo- 5.9%
67 yo- 8.3%
68 yo- 2.6%
69 yo- 2.5%

:sharebeer
Thanks for the info. I have plotted above United American's rate history and rate increases by age for my state for F-HD and G-HD for as long as they have offered the policies in my state. They are extremely stable and they have a flat section of the curve so a person in that age range would not have had any rate increase! Please see the United American plots I posted above and plots that have multiple insurance companies too.

I have rate data for all of the Medigap insurance companies and plans for my state and also all of their rate histories. It was very difficult to piece it together but I now have a very clear view of rate history and increases as age goes up also.

Thanks again.
Topic Author
MrRE
Posts: 166
Joined: Mon Feb 19, 2018 6:15 pm

Re: Medigap Provider Decision Help Please for 65 YO

Post by MrRE »

Here is the NAIC version that allows you to search an agent to see if they are licensed to sell a particular insurance company in your state:

https://sbs.naic.org/solar-external-lookup/

Note: you might not be able to save the search result URL with NAIC searches because NAIC's search links usually don't work later because they "time out".

Here's the search results I just did for New Jersey, Licensee, Jackson Edwards :

https://sbs.naic.org/solar-external-loo ... seType=PRO

If the link above has timed out, you can replicate the search as explained just above the link.
Topic Author
MrRE
Posts: 166
Joined: Mon Feb 19, 2018 6:15 pm

Re: Medigap Provider Decision Help Please for 65 YO

Post by MrRE »

-
Here are ways to make your own Medigap rate graphs for your local rates.


Why bother?

Current rate graphs can help you make better Medigap decisions.

You can see how companies change their rate structure for different ages.

You can see if the first few years have no increase.


History rate graphs show how they raised (or sometimes lowered) their rates over time.

Recently created plans will not have much history (like G-HD).
But you can use F-HD as a proxy because the plans are essentially identical except for the Part B deductible and the Plan deductible.


There are many ways to get the latest rate data.
History data is more work to get.


First try your state Department of Insurance or whatever they call themselves.

Also try your state SHIP or SHIIP or OSHIP or SHIBA or whatever they call themselves.

See if they have rate data and rate history.

They may have a rate tool and/or rate files.


If they don't have the latest data, you can get the latest data from a variety of sources.


Medicare.gov has a rate tool here:

https://www.medicare.gov/medigap-supple ... 22&lang=en

- Enter your zip code, etc.

- Pick the plan for which you want prices.

- Copy results and paste it in a file.


Change the age and repeat.



Plot the rate data for each company by age.



You don't need data for every age to get a rough plot.

- You can just pick 65, 70, 75, 80, 85, 90 etc. to get a rough view of the curve.

- Note: When using just a few ages for data points, the curve might not show the exact age that the curve tilts or goes flat.


Another way to get current rate data is to search for OOC files (Outline Of Coverage) in SERFF for your state for each company.
But that's a lot of work.


SERFF is where insurance companies are told to post files that show their new rates (for most states, not all).

- You can see current rates (most recent file posted).

- You can also search for past rate files for history (older files posted).


Here is the free link for SERFF (no login required):

https://www.serff.com/serff_filing_access.htm

- Pick your state.
Then you will get to your state's insurance website.

- Then you will see a link for your state's SERFF access.
It will look something like this except it will have your state abbreviation instead of NJ:
https://filingaccess.serff.com/sfa/home/NJ


To search for rate data using SERFF can be a lot of work if you are looking for a lot of different data (companies, years).

- You have to select Business Type (health ins).
- Enter the Type of Insurance (check box everything that begins with M for Medicare).
- Enter the company's NAIC code.
- Enter the date range so you see the files of interest.
Rate files are often uploaded in the last quarter of the year for the next year.
But rates can change at any time of the year.

Look at the search results:
- When you see a rate file or OOC file, that will usually have ALL of the rates for ALL plans and ALL ages at that point in time.

The files are usually PDF files.
- If the PDF file allows it, you can select the data and copy/paste it into a spread sheet.

- That's how I got most of my data.

- There are websites that will take a PDF file and convert it for free into a spreadsheet.


Another way to get current rate data is to get a free trial Medigap subscription (Silver level) to CSGacturial.com


If you already had a free trial period or your trial days ran out, then you would need to get a 1 month subscription to get more data.


The advantage of CSGactuarial.com is you can get a lot of data quickly.


But you have to piece it all together to make plots.

By doing just 1 quote, you could get data for one age for ALL plans, all at one time.



The way to get the data is to do the one quote, for one age, for one plan.

- Then when you get the result, click the export button.

- Then you get a "rate sheet" file with ALL possible plans for the age you selected.


But if you want other ages, you need to do other quotes.

Piecing all the data together is a lot of work and prone to making mistakes.


You can get history from CSGactuarial.com by using CSG as a time machine and selecting an "effective policy start date" that is in the past.


But the history data caveats are:

- History data from a CSG quote is just a snapshot at that point in time.
So if a company changed its rates after your selected quote date, you would not know it from a single CSG quote.
- If a company just recently started offering a plan in your region, then there won't be any history for that plan for that company for your region.
- Rates in a region depend on the size of the pool of policy holders and the medical claims and commissions and so on.
- So it can be tricky interpreting rate history.


Overall I found that using Medicare.gov link (explained earlier above) is good enough for plotting current rates for ages of interest.

History is easier to get from CSGactuarial.com.

But by the time I figured that out, I already got the data I needed from SERFF for the few companies and plans I was interested.

The good thing about using SERFF is it's official data.

With CSG data, I would always check it against SERFF data to make sure it was correct.

Please forgive any typos above.
RobotsRock
Posts: 11
Joined: Tue Sep 15, 2020 10:14 pm

Re: Medigap Provider Decision Help Please for 65 YO

Post by RobotsRock »

This thread has a good amount of great analysis and things I hadn't considered like the 'shell game'.

I'm trying to make a decision for my dad, and we're set on Plan G-HD for NJ as well as he's already had his life-changing surgeries and isn't a major user of medical services now that everything's been checked out - except for very high prescription costs. I can't see any reason to go with anyone else but Philadelphia American given the overall age-attained cost structure which is significantly lower than competitors, especially until age 82. Predicting increases for one provider versus another seems like playing the lottery, which is not a Bogglehead characteristic per sae.

Philadelphia American / New Era Life's credit rating was also upgraded to A- just last month: https://news.ambest.com/newscontent.aspx?refnum=241362

Is there anything I'm missing in this decision? Colonial Penn is slightly more expensive if the size of the pool would really matter, but I think Philadelphia American has been around even if not as recognized brand wise.

Any agent recommendations for NJ would be appreciated - though I have a preference to go direct due to security concerns instinctively, though I understand most insurers still require an agent.

PS for those with a combined income of less than $45k in NJ, you may qualify to have your Part D premium paid for by the state, and to limit prescription copays to less than $10. The 'good' thing about this is that since the copay is the same regardless, the Part D plan is selected by the state program based on the prescriptions and preferred pharmacy you choose - one less decision to make or optimize :) My family just applied yesterday: https://www.state.nj.us/humanservices/d ... ices/paad/

There's another program if you're slightly above that income threshold which still provides copay savings: https://www.state.nj.us/humanservices/d ... eniorgold/
bberris
Posts: 2114
Joined: Sun Feb 20, 2011 8:44 am

Re: Medigap Provider Decision Help Please for 65 YO

Post by bberris »

InMyDreams wrote: Sat May 07, 2022 10:22 am
bradinsky wrote: Sat May 07, 2022 6:44 am +1 Our daughter has been an infusion RN for 15 years. Stories of $25K per month chemo shots are frightening!
Only $25k? Maybe, per type of chemo, after MCare makes its reduction to contractual price.

I would hang two or three brand name drugs in a treatment, plus any drugs to pre-treat against side effects. Repeat every three or four weeks, depending on regimen. One drug was 6-digits per dose cost, tho it was only given twice.

Yes, those drugs were covered under Part B.

There are oral chemo drugs that are brand name and quite expensive. I believe they are covered under MCare Part D.

My MCare Part D coverage is $6.90 per month. Keeps my foot in the door at a reasonable cost, while giving me a resemblance of protection from unexpected crazy drug costs.
One month of IgG home infusion was billed to Medicare part B $81,000. Medicare paid 4,800, no copay because home infusion using durable equipment is Part B.
InMyDreams
Posts: 1502
Joined: Tue Feb 28, 2017 10:35 am

Re: Medigap Provider Decision Help Please for 65 YO

Post by InMyDreams »

bberris wrote: Thu Jun 16, 2022 1:27 pm
InMyDreams wrote: Sat May 07, 2022 10:22 am
bradinsky wrote: Sat May 07, 2022 6:44 am +1 Our daughter has been an infusion RN for 15 years. Stories of $25K per month chemo shots are frightening!
Only $25k? Maybe, per type of chemo, after MCare makes its reduction to contractual price.

I would hang two or three brand name drugs in a treatment, plus any drugs to pre-treat against side effects. Repeat every three or four weeks, depending on regimen. One drug was 6-digits per dose cost, tho it was only given twice.

Yes, those drugs were covered under Part B.

There are oral chemo drugs that are brand name and quite expensive. I believe they are covered under MCare Part D.

My MCare Part D coverage is $6.90 per month. Keeps my foot in the door at a reasonable cost, while giving me a resemblance of protection from unexpected crazy drug costs.
One month of IgG home infusion was billed to Medicare part B $81,000. Medicare paid 4,800, no copay because home infusion using durable equipment is Part B.
Wow! Things have changed with MCare and the world of IV Therapy.
https://wellsky.com/blog/2021/02/09/new ... s-benefit/
ModifiedDuration
Posts: 1058
Joined: Sat Dec 05, 2015 3:33 pm

Re: Medigap Provider Decision Help Please for 65 YO

Post by ModifiedDuration »

RobotsRock wrote: Thu Jun 16, 2022 12:18 pm This thread has a good amount of great analysis and things I hadn't considered like the 'shell game'.

I'm trying to make a decision for my dad, and we're set on Plan G-HD for NJ as well as he's already had his life-changing surgeries and isn't a major user of medical services now that everything's been checked out - except for very high prescription costs. I can't see any reason to go with anyone else but Philadelphia American given the overall age-attained cost structure which is significantly lower than competitors, especially until age 82. Predicting increases for one provider versus another seems like playing the lottery, which is not a Bogglehead characteristic per sae.

Philadelphia American / New Era Life's credit rating was also upgraded to A- just last month: https://news.ambest.com/newscontent.aspx?refnum=241362

Is there anything I'm missing in this decision? Colonial Penn is slightly more expensive if the size of the pool would really matter, but I think Philadelphia American has been around even if not as recognized brand wise.

Any agent recommendations for NJ would be appreciated - though I have a preference to go direct due to security concerns instinctively, though I understand most insurers still require an agent.

PS for those with a combined income of less than $45k in NJ, you may qualify to have your Part D premium paid for by the state, and to limit prescription copays to less than $10. The 'good' thing about this is that since the copay is the same regardless, the Part D plan is selected by the state program based on the prescriptions and preferred pharmacy you choose - one less decision to make or optimize :) My family just applied yesterday: https://www.state.nj.us/humanservices/d ... ices/paad/

There's another program if you're slightly above that income threshold which still provides copay savings: https://www.state.nj.us/humanservices/d ... eniorgold/
Philadelphia American sounds good, as long as you compared the long-term price difference with United American.

It looks like Philadelphia American is less expensive until the early 80s and then United American is less.

If you have done the analysis and decided on Philadelphia
American, go for it.

About using an agent: an agent can answer questions and provide insights from his/her experience now and during the application process and, perhaps more importantly, can help you further down the road if you have any questions or problems with your Medigap insurer.

Privacy shouldn’t be an issue with an insurance agent.
RobotsRock
Posts: 11
Joined: Tue Sep 15, 2020 10:14 pm

Re: Medigap Provider Decision Help Please for 65 YO

Post by RobotsRock »

ModifiedDuration wrote: Thu Jun 16, 2022 2:01 pm
RobotsRock wrote: Thu Jun 16, 2022 12:18 pm This thread has a good amount of great analysis and things I hadn't considered like the 'shell game'.

I'm trying to make a decision for my dad, and we're set on Plan G-HD for NJ as well as he's already had his life-changing surgeries and isn't a major user of medical services now that everything's been checked out - except for very high prescription costs. I can't see any reason to go with anyone else but Philadelphia American given the overall age-attained cost structure which is significantly lower than competitors, especially until age 82. Predicting increases for one provider versus another seems like playing the lottery, which is not a Bogglehead characteristic per sae.

Philadelphia American / New Era Life's credit rating was also upgraded to A- just last month: https://news.ambest.com/newscontent.aspx?refnum=241362

Is there anything I'm missing in this decision? Colonial Penn is slightly more expensive if the size of the pool would really matter, but I think Philadelphia American has been around even if not as recognized brand wise.

Any agent recommendations for NJ would be appreciated - though I have a preference to go direct due to security concerns instinctively, though I understand most insurers still require an agent.

PS for those with a combined income of less than $45k in NJ, you may qualify to have your Part D premium paid for by the state, and to limit prescription copays to less than $10. The 'good' thing about this is that since the copay is the same regardless, the Part D plan is selected by the state program based on the prescriptions and preferred pharmacy you choose - one less decision to make or optimize :) My family just applied yesterday: https://www.state.nj.us/humanservices/d ... ices/paad/

There's another program if you're slightly above that income threshold which still provides copay savings: https://www.state.nj.us/humanservices/d ... eniorgold/
Philadelphia American sounds good, as long as you compared the long-term price difference with United American.

It looks like Philadelphia American is less expensive until the early 80s and then United American is less.

If you have done the analysis and decided on Philadelphia
American, go for it.

About using an agent: an agent can answer questions and provide insights from his/her experience now and during the application process and, perhaps more importantly, can help you further down the road if you have any questions or problems with your Medigap insurer.

Privacy shouldn’t be an issue with an insurance agent.
Thanks! Enrollment was easy in under 5 minutes with the agent for Philadelphia American. For other folks in NJ wondering, I did a last comparison with Colonial Penn, as that was missing from MrRE's graph. Colonial Penn if paid annually was slightly cheaper than Philadelphia American until age 67, but on a cumulative premium-paid basis, Philadelphia American was cheaper for G-HD if you live between age 69 and 89. Beyond that, Colonial Penn was better on a cumulative premium basis, but who knows what rates would be by then anyway. The max cumulative premium difference between the plans is $561 at age 81 in favor of Philadelphia, so not a major difference regardless.
aum
Posts: 128
Joined: Wed Jan 30, 2013 1:27 pm

Re: Medigap Provider Decision Help Please for 65 YO

Post by aum »

RobotsRock: I am helping my brother and sister-in-law for medigap policy in NJ(both are 68 years old). Please share details of an agent if you used one in your Dad's case.

Here is their situation:

Bother is enrolled in medicare part A and part B and pays monthly medicare premium(He didnt have to sign up for part-b as my sis-in-law works and he is also covered on her plan. too late and unfortunate as I was not involved)

Sister-in-law still works, signed up for Part A last year and currently covered through her employer insurance.

She is retiring this year in June on her 69th Birthday. Will she be able to sign up(since she never enrolled for part b) for high deductible plan-F without going through underwriting process?

Will my brother(Already enrolled in medicare at age 65) be able to sign up for high deductible plan-F without going through underwriting process?
mudd
Posts: 83
Joined: Fri Mar 11, 2016 2:06 pm

Re: Medigap Provider Decision Help Please for 65 YO

Post by mudd »

Great thread!

My wife has been with Aetna for Medigap Plan G for 2-3 years now. Her premium went from 119 to 126 this year.
Completely satisfied with Aetna and not concerned about this shell game folks mentioned as we are in Illinois and from what I understand can switch out if it gets out of line. Someone mentioned the Birthday rule which allows to switch to the same plan elsewhere without underwriting I think.
I have another 2-3 years before I can joinng medicare and we hope to get a discount if we are with the same company.
NotWhoYouThink
Posts: 3465
Joined: Fri Dec 26, 2014 3:19 pm

Re: Medigap Provider Decision Help Please for 65 YO

Post by NotWhoYouThink »

Bookmarking a great thread.
ModifiedDuration
Posts: 1058
Joined: Sat Dec 05, 2015 3:33 pm

Re: Medigap Provider Decision Help Please for 65 YO

Post by ModifiedDuration »

NotWhoYouThink wrote: Tue Jan 24, 2023 4:56 pm Bookmarking a great thread.
The wiki on Medicare is also very helpful.

It had a complete re-write done last year.

https://www.bogleheads.org/wiki/Medicare
Jack_R2
Posts: 38
Joined: Tue Sep 02, 2008 11:52 pm

Re: Medigap Provider Decision Help Please for 65 YO

Post by Jack_R2 »

Question. State of Missouri allows Medigap plans to be switched once a year (without underwriting). But the plan can only be switched to another plan with same letter. Does anyone know if plan G and plan G High Deductible are considered the same for Missouri's rule?
Post Reply