Deciding on a United health Care Supplemental ? (medical, plan, doctor)

[Rickcin]

I am soon to start on Medicare Part B and just started investigating all of the AARP supplemental or gap plans that they offer through United Healthcare.

There are 7 different plans that range from minimal to maximum coverage and as they say, what is your risk tolerance and spend as much as possible for the highest level of coverage that you can afford.

I am having trouble deciding and wondering if there are any statistics that would help a person to decide on a plan? Almost like trying to predict the future. Any thoughts out there?

[Ariadne22]

Because you are in NY (or so it appears from your profile), you can switch plans at any time. You could choose a less expensive plan, for now, if your health is good. Should you encounter issues, you can switch without health underwriting. You are very fortunate.

That said, most people usually consider either purchasing a Medigap F/G or high-deductible F.

Medigap F/G's are more costly but, generally, your medical costs are limited to the premium.

The high-deductible F is less expensive, Medicare pays 80%, you are responsible for 20% of Medicare expenses up to $2,180 in any one year. Your cost for an hd-F is, therefore, the premium plus the potential $2,180. Keep in mind you need to accrue a lot of medical expense ($11,000) in order for copays to reach $2,180.

I had an hd-F for two years, cost $900/yr. It never paid anything because I don't doctor. I now have a Medicare Medical Savings Account with the same potential out-of-pocket exposure for zero premium, same provider flexibility - i.e.,no networks - anywhere in the country. MSA's are not available in every state.

Fyi- this is the Guaranteed Issue info from the State of NY. Again, uniike most states, you won't be locked into any plan should your health change. Posted two years ago, verify with whomever you dealing with on NY insurance:

Originally Posted by Never2L8

re: picking a Medigap, are a non-problem because I happen to live in NY State.

In NY, the Guaranteed Issue Rights (aka "full protections") apply regardless of when you apply for any Medigap plan. The six-month initial open enrollment period doesn't exist in NY: A person can apply, switch plans, whatever, at any time. There are also some protections regarding the length of the waiting period in the 6-month lookback.

Because of the "permanent guaranteed issue rights", it sounds as if I will be able to start coverage with a lower cost Medigap plan (because my income in 2014 and 2015 will be abysmally low) and then upgrade to a better plan when I can afford it... or price-shop Medigap policies every year if I want to... without ever having to worry about being either denied coverage or charged more for it because of my (pretty bad) medical history or present health.

From the NYS Dept of Insurance website (bolding mine):

“New York State law and regulation require that any insurer writing Medigap insurance must accept a Medicare enrollee’s application for coverage at any time throughout the year. Insurers may not deny the applicant a Medigap policy or make any premium rate distinctions because of health status, claims experience, medical condition or whether the applicant is receiving health care services.”

“Federal and state law allow Medigap policies to contain up to a six (6) month waiting period before pre-existing conditions are covered. (Federal HIPPA law at 42 USC 300gg). A pre-existing condition is a condition for which medical advice was given or treatment was recommended or received from a physician within six months before the effective date of coverage. However, under New York State regulation (11 NYCRR 52.20), the waiting period may be either reduced or waived entirely, depending upon your individual circumstances. Medigap insurers are required to reduce the waiting period by the number of days that you were covered under some form of "creditable" coverage so long as there were no breaks in coverage of more than 63 calendar days. Coverage is considered "creditable" if it is one of the following types of coverage:

a. A group health plan;
b. Health insurance coverage;
c. Medicare -- In New York, credit for Medicare coverage is only given if you apply for a Medigap policy before or during the first six months after you turn 65 and are enrolled in Medicare;
d. Medicaid;
e. CHAMPUS AND TRICARE health care programs for the uniformed military services;
f. A medical care program of the Indian Health Service or of a tribal organization;
g. A State health benefits risk pool;
h. Federal Employees Health Benefits Program;
i. A public health plan;
j. A health benefit plan issued under the Peace Corps Act; and
k. Medicare supplement insurance, Medicare select coverage or Medicare Advantage plan (Medicare HMO Plan).

New York’s Open Enrollment and Portability provisions protect you whether you are Medicare eligible by reason of age or disability. The provisions also apply to Medicare beneficiaries with end stage renal disease. Again, not all of these protections are nationwide. New York's protections are more generous than those required by federal law, which only apply to those who applied for Medigap during their initial open enrollment period (within 6 months of turning age 65 and enrolling in Medicare Part B).

[SCGamecock]

Not all insurance companies offer all plans. For example, the popular 'G' and high-deductible 'F' are not offered by AARP/UHC in NY so you should consider other companies as well. You can see which companies offer the different Medigap plan options and their rates at the website below.

Information for Medicare Beneficiaries

Another good thing about NY is that Medigap premiums are community rated. Also, remember that Medicare and Medigap plans do not include self-administered drug coverage so you may want to research Part D plans as well. Good luck.

[Ariadne22]

Originally Posted by SCGamecock

Information for Medicare Beneficiaries

That's a great link! Wish more states did this.

[Robyn55]

Originally Posted by Ariadne22

That's a great link! Wish more states did this.

You can do the same on the medicare.gov website (find out which companies sell which plans in your zip code):

https://www.medicare.gov/find-a-plan...igap-home.aspx

FWIW to the OP - everyone in our family (parents - us) has had AARP UHC Medigap policies. No problems in North Carolina or various parts of Florida. My husband and I have (discontinued) Plan J/Plan F. Among other things - the policies pay for "excess Medicare charges" (important for us since some of our providers don't "accept" Medicare). Also - here in Florida - we can "trade down" when it comes to policies - but we can't "trade up" without medical underwriting. So it made sense for up to buy the most comprehensive policies during our guaranteed enrollment period. Robyn

[Ariadne22]

Originally Posted by Robyn55

You can do the same on the medicare.gov website (find out which companies sell which plans in your zip code):

https://www.medicare.gov/find-a-plan...igap-home.aspx

Medicare.gov does not provide $$ premium cost by company - only a range - which is not helpful when one wants to examine which company is charging what.

Otoh, clicking on the NYS website link for any of the lettered plans brings up a page w/rates by company for a designated zipcode. No guarantees that information is completely up to date, either. Nonetheless, a much more helpful comparison and better starting point.

Further, I've found medicare.gov info can be inaccurate. I called two companies (BCBS & Central States) listed on medicare.gov as providing hd-F's during open enrollment two years ago and was told they no longer offered that policy in WI. In fact, Central States didn't know what I was talking about. Those two providers are still not offering hd-F's in WI and yet are still listed on medicare.gov today - and one excellent provider (Standard Life & Accident of Texas) offering hd-Fs and Fs is still not listed as an hd-F provider - even though it was included in the the download from the WI OIC website a year ago. I then spoke to a Standard Life rep who sent me both F and hd-F rate quotes for WI. So, medicare.gov info can be quishy.

Fwiw, the only way I can get specific rate info in WI without calling each company is to - long after the fact, usually March of the following year - go to WI Insurance Commissioner website and download and scroll through the filings which is how I discovered Standard Life was licensed in WI to provide hd-F - with better rates to boot.

[Robyn55]

Originally Posted by Ariadne22

Medicare.gov does not provide $$ premium cost by company - only a range - which is not helpful when one wants to examine which company is charging what. Clicking on the NYS website link for any of the lettered plan brings up a page w/rates by company for a designated zipcode. A very interesting comparison. The only way I can get specific rate info in WI without calling each company is to - long after the fact - go to WI Insurance Commissioner website and download and scroll through the filings. NY really provides a neat shortcut with that link.

Thanks for clarifying that.

FWIW - our prior experiences with 4 parents who had AARP UHC Medigap policies were so positive that we didn't "price-shop" elsewhere (we handled a lot of their Medicare/Medigap billing ourselves - so it wasn't just a "word of mouth" thing). OTOH - we did consult with a local insurance agent before we bought - just to make sure UHC was as good here as elsewhere (at the time - a few years ago - he thought that one or two companies were as good as - but not better than - UHC).

And - to the original poster - no harm getting an insurance agent who represents a lot of companies involved - if you can find a good one. You're going to pay the same with or without an agent. Our agent was particularly good since both he and his wife were on Medicare and his wife has lots of medical issues. So not only did he speak as an experienced agent - he spoke as a policy holder too. Robyn