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Old 06-11-2019, 10:48 AM
 
5,069 posts, read 5,408,985 times
Reputation: 11548

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Quote:
Originally Posted by PNW to NEPA View Post
It's just $12. You don't have to renew after the first time. No big deal.


Just making a statement of what I found... that was all.
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Old 06-11-2019, 02:06 PM
 
Location: Leesburg, FL
7 posts, read 5,724 times
Reputation: 56
Going through this now as I turn 65 in September. I live in Florida and was thinking about N due to price difference from F or G (F=$184/mo, G=$157, and N is $129 per month).

My concern is N does not cover excess charges from the doctor or hospital which "can be up to 15% beyond Medicare allowable costs"! Does anyone have any experience with this?

Also, any concern about the $185 deductible in Part B for G or N getting raised significantly once F is no longer available after 1/1/20?

This really gets complicated as we age and I will need to go through it again in 18 months when my wife turns 65!

Thanks for all replies.
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Old 06-11-2019, 05:30 PM
 
Location: Wisconsin
23,566 posts, read 50,229,019 times
Reputation: 18224
Quote:
Originally Posted by Dennis11003 View Post
Going through this now as I turn 65 in September. I live in Florida and was thinking about N due to price difference from F or G (F=$184/mo, G=$157, and N is $129 per month).

My concern is N does not cover excess charges from the doctor or hospital which "can be up to 15% beyond Medicare allowable costs"! Does anyone have any experience with this?

Also, any concern about the $185 deductible in Part B for G or N getting raised significantly once F is no longer available after 1/1/20?
$185 Part B deductible is set by Congress/CMS, not the insurer. Increases generally have been reasonable - we can only hope that will continue. Plan F policyholders are not immune to Part B deductible increases. Plan F will raise its premium to compensate for the additional cost. Plan F says it will pay the deductible, but it does not say "no matter the Part B deductible amount, your premium will not increase."

Further, in your example, the $27 difference between Plan F and G is $324/yr, $139 MORE than the $185 deductible. Not all insurance companies inflate their premiums to this extent. However, that differential is not there to cushion Part B deductible increases. It is charged because those with Plan F, knowing there will be no direct out-of-pocket cost, tend to doctor more often. This is why Congress is eliminating Plan F for newly-eligible Medicare recipients beginning in 2020 - hoping people will think twice before using their Medicare benefits if they know they will be incurring a $185 charge.

It makes no financial sense to consider a Plan F other than the convenience of paying $139 for the privilege of knowing the deductible will be paid. Further, because Plan F will no longer be available in 2020, the risk pool will be limited to an aging and more costly population. Thus, the greatest likelihood of higher percentage premium increases comes with a Plan F.

Plan G, on the other hand, will be more likely to implement a lower premium increase because the increase in Part B deductible means more cost-sharing on your part. Insurance companies love cost-sharing.

This is why Plan N is attractive - $20 copays for doctor visits, $50 for ER if not hospitalized. Yes, Plan N does not cover excess charges - but those are not a common experience for most people. With the number of aged in FL, most providers who accept Medicare patients would be participating providers.

However, know that in FL and AZ, the Mayo clinic and its doctors, are nonparticipating providers, and will impose an excess charge. If you are a patient at Mayo or similar nonparticipating providers which can be hospitals and some specialists, then you need Plan G.

How excess charges are calculated, here:

AARP/UHC vs. Aetna and Plan G vs. Plan N

Mayo will, as a courtesy, send bills to Medicare and your supplement, but is very clear you are responsible and will bill you, as well. Some supplements will pay Mayo directly, others will send payment to you for reimbursement to Mayo.

We've had only one poster on this forum who was a patient at Mayo in Jacksonville and that was a while back. The Jacksonville clinic is now limiting the number of Medicare patients it will accept. If you are not already a patient there, it is unlikely you will be. Mayo in AZ is also a nonparticipating Medicare provider, implementing excess charges. Mayo in MN, otoh, is now participating provider to both in and out-of-state patients, result being excess charges are no longer an issue there.

https://www.mayoclinic.org/patient-v.../insurance/faq

If you don't anticipate needing Mayo or some other specialty care, excess charges shouldn't concern you. I understand Shands in Gainesville is a very good facility and is a participating Medicare provider. I have a 78 y/o friend whose son works in IT at Shands. She much prefers the Shands doctors to others she's had in FL.

Last edited by Ariadne22; 06-11-2019 at 06:46 PM..
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Old 06-11-2019, 07:21 PM
 
Location: Leesburg, FL
7 posts, read 5,724 times
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Thank you Ariadne22. Very much appreciated. An easy to read, and understand, explanation. I read your response to my wife and she nodded in agreement. I think "G" makes more sense for us and something we budgeted for in our retirement plans.

I see you are listed as from Wisconsn. My wife and I retired to Florida three years ago after spending 60 years in Wisconsin. Loved Wisconsin but could not take cold, snow and ice for 4-5 months of the year anymore.
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Old 06-11-2019, 07:30 PM
 
Location: Wisconsin
23,566 posts, read 50,229,019 times
Reputation: 18224
Quote:
Originally Posted by Dennis11003 View Post
Thank you Ariadne22. Very much appreciated. An easy to read, and understand, explanation. I read your response to my wife and she nodded in agreement. I think "G" makes more sense for us and something we budgeted for in our retirement plans.
Yes, should the one-off happen, that 15% can become significant. Better to overinsure than be sorry later, especially if the cost isn't a hardship.

Quote:
Originally Posted by Dennis11003 View Post
I see you are listed as from Wisconsn. My wife and I retired to Florida three years ago after spending 60 years in Wisconsin. Loved Wisconsin but could not take cold, snow and ice for 4-5 months of the year anymore.
Born and raised here. Now 77 y/o. I can't stand heat and humidity, I could never live in FL. Truth be told, over the past 20 years even WI is getting a bit warm for me and I have generally always disliked summer, although this past winter was pretty bad with snow and ice - which becomes more onerous as one ages. I don't mind the cold, but dealing with the snow is an issue. My son who lived next door died a year ago, so I'm managing for now between dil and neighbors who do most of it. She and I may arrange with neighbor kids across the street to handle the snow next winter, because she's getting tired of it, too.
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Old 06-12-2019, 06:51 AM
 
3,563 posts, read 2,996,296 times
Reputation: 7214
Quote:
Originally Posted by Ariadne22 View Post
Depends on where he lives. Unless he lives in MA, NY, CT, CA, OR, ME or MO, he will almost certainly be required to undergo health underwriting if he later decides to switch. Circumstances for guaranteed issue vary by state, as outlined on this link:

https://www.medicareresources.org/states/

Otherwise, depending on his ailments, he may may not be accepted or charged a higher rate if his current policy becomes unaffordable.

His best choice now at age 65 is either an issue-age policy or a community-rated policy such as yours with AARP. Plan N might be a good choice - small cost sharing (Part B deductible, $20 per doctor visit, $50 ER if not hospitalized) which reduces the premium and still mitigation of rate increases because of community rating. Going forward, that small cost sharing should result in lower premium increases as well.

Issue age policies retain the same basic rate at the time one enrolls and increase premiums based on medical costs.

Community-rated
AARP discounts rates for those under 77, with age-based and rate-based premium increases each year. After age 77, only premium increases are due to rises in medical costs. Whether one is 77 or 97, because of community rating, the rate is the same.

Medicare on policy pricing, here:

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

He should avoid an attained-age policy - cheaper in the beginning - but rate increases continue with some insurers until age 85. It isn't unusual for an 80+ senior to have a Medigap premium of well over $400/mo. Again, unless in a guaranteed issue state or a state, bad health can preclude switching to a less expensive policy.

He could also consider a high-deductible F which caps his 20% at $2,300. High-deductible F plans are considerably less expensive and premium increases are modest. For the reasonably healthy person, an hd-F can be a very cost-effective choice. Many here have them.

Thank you!
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Old 06-17-2019, 06:20 PM
 
4,124 posts, read 8,077,872 times
Reputation: 3697
Quote:
Originally Posted by saralvr View Post
Yes. Both for my husband and my mom has used it for 30 years. Never a problem. Excellent customer service.

Thank You. We try. We are not always perfect, but we do our best.
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Old 06-17-2019, 06:24 PM
 
4,124 posts, read 8,077,872 times
Reputation: 3697
Quote:
Originally Posted by brava4 View Post
Just making a statement of what I found... that was all.


Correction: It is 12 dollars if you agree to have it automatically renewed by CC each additional year. If you only intend to sign up for 1 year the AARP membership is 16.00. There could be promotions thru AARP which UHC is not involved with and the company will not be able to match those promotions. Also if you are expecting a tote bag or another promotional item call the AARP # directly. UHC customer service cannot help with those inquiries.
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Old 06-17-2019, 06:29 PM
 
4,124 posts, read 8,077,872 times
Reputation: 3697
Quote:
Originally Posted by Dennis11003 View Post
Going through this now as I turn 65 in September. I live in Florida and was thinking about N due to price difference from F or G (F=$184/mo, G=$157, and N is $129 per month).

My concern is N does not cover excess charges from the doctor or hospital which "can be up to 15% beyond Medicare allowable costs"! Does anyone have any experience with this?

Also, any concern about the $185 deductible in Part B for G or N getting raised significantly once F is no longer available after 1/1/20?

This really gets complicated as we age and I will need to go through it again in 18 months when my wife turns 65!

Thanks for all replies.


No, if there are excess charges N does not cover.
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Old 06-17-2019, 06:32 PM
 
207 posts, read 118,504 times
Reputation: 1102
Quote:
Originally Posted by Dennis11003 View Post
Thank you Ariadne22. Very much appreciated. An easy to read, and understand, explanation.
Ariadne22 is the most helpful Medicare guru on these boards.
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