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Ariadne, first off, thank you so much for your time and effort in this forum. I haven't visited in over a year but see you are still going strong!
I'm trying to decide whether to look into switching my current Medigap policy with Aetna. I'm in Texas, and 72. I used an agent to switch to Aetna (plan G) in Jan 2018 switching from my original medigap with BCBS. There was underwriting. He and I were on the phone together with an Aetna nurse.
My current medigap premium is jumping from $148 to $170 in January. When I started in 2018 it was $114. Maybe this is reasonable but I am getting annoyed :-) I haven't contacted my agent as he is Aetna exclusive and I am assuming doesn't want to help me leave. (By the way, do they keep getting paid for bringing you in and as long as you are in, or just when you sign up??)
First question - if I wanted to downgrade to Aetna's plan N, would there be underwriting do you think? If I am with the same company but just changing plans?
Second question - I truly don't recall if Aetna is community pricing or issue-age or attained-age...do you? At this stage (me being 72) does it matter what type I get if I try to switch?
Third question - I read some good things about AARP United... any thoughts?
Fourth question - I just discovered Boomer Benefits website. Worth having them look into my options? I saw someone here reference them as a legit outfit, but really don't know. Generally I'm not keen on "agent will call" stuff, but if they really do want to help me, I'll try to get over it.
Fifth question - just stay where I am and shut up??
The recent AARP Bulletin did a big cover story on OM vs Med Advantage... the latter is tempting. But I had so much trouble with my (late) elderly mother's plan and getting her services I switched her to OM.That was over 13 years ago so maybe they're better now; they sure do seem to be popular. I guess for now I am willing to pay for the freedom of seeing whatever doctor I want. And as I have always suspected "there is no free lunch" I keep wondering what the catch is with the $0 premiums, $0 copays and free gym memberships of these med advantage plans!!
Anyway. Thanks for any thoughts! At least I have learned I don't have to figure this all out by Dec. 7!
PS - I'm in fairly good health, just on a low dose BP med. Have sleep apnea (have sleep doc and use CPAP). All my joints are starting to act up but I don't think there is anything "major" to report to underwriting. Not necessarily afraid of it just prefer not to have the hassle.
I'm sure she will be by soon.
I don't know your Aetna G plan. I looked into the AARP/UH G for my hub. It's attained age pricing which means it will go up for inflation, not age. You need to know if your Aetna plan goes up with age because that could be why yours went up, but then again, Medicare B went up too in 2022. I don't recall what my BCBS C plan raised me for 2022. I'm under 60, so different rules.
She may tell you to consider the AARP/UH high deductible plan since you're healthy.
The AARP/G plan is a great plan. Everyone here who has it is very happy. I've been reading 2 years to prepare for when my hub turns 65. He was uninsured most of the 2nd part of the last few years due to COVID. He now switched jobs, just got employer insurance so he changed the game plan on what I thought we were doing. Now I'll have to make a post in a few weeks to be sure I know what he has to do lol
I'm trying to decide whether to look into switching my current Medigap policy with Aetna. I'm in Texas, and 72. I used an agent to switch to Aetna (plan G) in Jan 2018 switching from my original medigap with BCBS. There was underwriting. He and I were on the phone together with an Aetna nurse.
My current medigap premium is jumping from $148 to $170 in January. When I started in 2018 it was $114. Maybe this is reasonable but I am getting annoyed :-) I haven't contacted my agent as he is Aetna exclusive and I am assuming doesn't want to help me leave. (By the way, do they keep getting paid for bringing you in and as long as you are in, or just when you sign up??)
First question - if I wanted to downgrade to Aetna's plan N, would there be underwriting do you think? If I am with the same company but just changing plans?
Second question - I truly don't recall if Aetna is community pricing or issue-age or attained-age...do you? At this stage (me being 72) does it matter what type I get if I try to switch?
Agents do get renewal commissions on Medigaps.
To answer your first question, UHC (last I heard) allows a downgrade to N w/o health underwriting. Probably not true for Aetna, although I don't know for sure.
Aetna is an attained-age policy. My sister had Aetna. Within five years, her premium was higher than the same plan with United Healthcare which is community rated. Avoid attained-age policies.
I would leave Aetna and either go to UHC (Plan G or N) or, because you're healthy, buy a High Deductible G Medigap for a fraction of the premium of a full Medigap. Many here have HD plans.
Quote:
Originally Posted by catfancier
Third question - I read some good things about AARP United... any thoughts?
See above. UHC is community-rated - which means an open risk pool, discounts premiums b/c of age until age 81, commands over 35% of the Medigap market for a reason..
Fourth question - I just discovered Boomer Benefits website. Worth having them look into my options? I saw someone here reference them as a legit outfit, but really don't know. Generally I'm not keen on "agent will call" stuff, but if they really do want to help me, I'll try to get over it.
I have no experience with any online Medicare "helpers." Some here say they are very helpful. Based on questions later posed here, my belief is they miss a lot. Never will they explain to you the importance of pricing b/c most of those reps have only cursory knowledge.
Quote:
Originally Posted by catfancier
Fifth question - just stay where I am and shut up??
Change - to either an HD plan or a UHC Plan G or N.
Realistically, your choices are:
G - 100% after payment of $233 deductible, includes excess fee coverage
N - 100% after payment of $233 deductible, up to $20 copay dr. visit, $50 ER; no excess coverage
HD-G - Medicare pays 80%, you pay 20% up to $2,490 deductible; thereafter plan pays 100%, includes excess coverage
Quote:
Originally Posted by catfancier
The recent AARP Bulletin did a big cover story on OM vs Med Advantage... the latter is tempting. But I had so much trouble with my (late) elderly mother's plan and getting her services I switched her to OM.That was over 13 years ago so maybe they're better now; they sure do seem to be popular. I guess for now I am willing to pay for the freedom of seeing whatever doctor I want. And as I have always suspected "there is no free lunch" I keep wondering what the catch is with the $0 premiums, $0 copays and free gym memberships of these med advantage plans!!
Anyway. Thanks for any thoughts! At least I have learned I don't have to figure this all out by Dec. 7!
PS - I'm in fairly good health, just on a low dose BP med. Have sleep apnea (have sleep doc and use CPAP). All my joints are starting to act up but I don't think there is anything "major" to report to underwriting. Not necessarily afraid of it just prefer not to have the hassle.
You shouldn't have any trouble with health underwriting for either an HD or coverage through UHC.
Your mother's experience with Advantage is very common. Some call them "dis-advantage" plans. You may want to read this.
Otoh, some MA's perform very well. For myself, I would only 'consider' a PPO MA from a local medical provider, not a national insurer with no local medical presence. Fortunately, in WI, we have many local medical providers throughout the state with investments in their communities who provide highly-rated MA's for their patients. In my immediate area, two very large Wisconsin-based health systems are now offering MAs.
Last edited by Ariadne22; 12-05-2021 at 02:07 PM..
My current medigap premium is jumping from $148 to $170 in January. When I started in 2018 it was $114. Maybe this is reasonable but I am getting annoyed :-)
Catfancier, are you sure it's your Medigap increasing by these numbers? The Medicare Part B premium is $148.50 in 2021, and is increasing to $170.10 in 2022. This is what Medicare charges, not the Medigap/supplement plans which are separate. Even if you change to a different Medigap, Medicare's $170.10 premium will still be deducted from your social security each month.
Catfancier, are you sure it's your Medigap increasing by these numbers? The Medicare Part B premium is $148.50 in 2021, and is increasing to $170.10 in 2022. This is what Medicare charges, not the Medigap/supplement plans which are separate. Even if you change to a different Medigap, Medicare's $170.10 premium will still be deducted from your social security each month.
Wow, good catch. I was asleep when I read this post, clearly.
Yes, catfancier, there isn't a thing you can do about increases in Part B. Like death and taxes.
Better take another look at your records to check actual premium of Aetna policy. Probably an automatic deduct from your checking. My sister's started at $148, ended up at $232 at her death four years later in 2019.
Wow, good catch. I was asleep when I read this post, clearly.
Yes, catfancier, there isn't a thing you can do about increases in Part B. Like death and taxes.
Better take another look at your records to check actual premium of Aetna policy. Probably an automatic deduct from your checking. My sister's started at $148, ended up at $232 at her death four years later in 2019.
Ariadne and Wildflowers, thanks for the question. It is just a little coincidence.
My Aetna jumps to $172.26 exactly. I had just rounded it off to $170 and realize now that's exactly what the the Part B increase will be. Sorry for any confusion.
I am going to switch for sure! My friend who got me into Aetna thru her agent is unhappy with him at this point as well. She is talking to a different local agent tomorrow and I will see what she has to say to my friend and perhaps speak with her as well. (I think this agent handles several carriers but I will check.) Because of this wonderful forum I was able to reassure my friend that she CAN change her Medigap after Dec. 7! She thought she had to make a decision by tomorrow.
Ariadne I am still a bit puzzled by the "excess" coverage with a Plan G, or lack thereof on N. What is a real-life example of this, when you have it or don't?
Ariadne I am still a bit puzzled by the "excess" coverage with a Plan G, or lack thereof on N. What is a real-life example of this, when you have it or don't?
Nonparticipating providers are allowed to charge 15% above their allowed Medicare reimbursement rate which is 95% of the allowed reimbursement for participating providers - effectively increasing their revenue 9.25%. Medicare will pay 80% of the 95% as follows, Medigap pays 20% of 95%, you pay the difference.
EX:
$100.00 - Medicare participating provider reimbursement
$..95.00 - Nonparticipating provider reimbursement
$..14.25 - Excess fee
$109.25 - Nonparticipating provider fee
$..76.00 - Medicare (80% of $95) $..19.00 - Medigap pays (20% of $95)
$..14.25 - Excess fee not paid by Plan N
Mayo Clinic, at one time, was a nonparticipating provider at all its locations, except for Minnesota residents at the Rochester location. Within the past year, it has changed that policy. Mayo is now a participating provider at all its locations.
One would hope that also applies to doctors/specialists who have privileges at Mayo, but I don't have the answer for that.
Most doctors/providers are participating providers so the lack of excess coverage isn't an issue. Those here who have Plan N and undergone expensive medical care have not mentioned an experience with a nonparticipating provider. In my area, any provider who accepts Medicare patients is a participating provider.
If you have or expect unusual or chronic health issues, it would be wiser to have excess fee coverage in the rare event you need it. Again, the HD-G does cover the excess fee once the deductible is met.
What is the real experience in forum about annual premium increase ?
There are many reports on this forum on HD increases on various threads. The increases are teeny or nonexistent. Maybe $1 or $2 a month - maybe. Some years no increase at all. I had an HD plan on which the premium actually went down. Medicare reimbursements are so low the carrier's 20% exposure is minuscule. The $2,490 HD deductible provides a significant buffer for the insurer against loss. If you're healthy, your plan may never pay. You would need to incur Medicare charges of $12,450 to reach that deductible. That means hospitalization, lots of tests, surgery. A frequent comment from those who have an HD plan is they're a paying a premium, but they're so healthy the plan never pays. But keep in mind, the premium is only $600/year (often less) - v. $1,800 or more for a regular Medigap. $1,200 is a lot of Medicare copays for the healthy.
HD plans are catastrophic insurance, imo. Like homeowners insurance. Hope you never need it, but it's there for the big stuff should that day come.
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