Potentially – I think in all states you can change if you are in good health, but in most states there could be an underwriting issue that would limit your ability depending on pre-existing conditions or health status. I think you can always change from Medigap to Medicare Advantage, and within one company you can always change to a different letter plan offering less comprehensive coverage (such as going from plan F to G or N). but yes, depending on where you live, you could potentially be stuck with a company charging higher rates down the line.
For those nearing the age, I would highly recommend going to the CMS website and looking at the information they put out. There is a booklet they produce every year called Medicare And You and it goes over the benefits and helps educate people on what is available.
I would also say, make sure to understand your supplemental plan so you know what you are getting for your money. Also, in some states, there are mandated benefits so there are some differences within the plans. For example, Wisconsin mandates that Supplemental plans cover Diabetic supplies, that is not true in all states.
Also, be cautions of the if Medicare pays, then the supplement carrier pays. That is not necessarily a true statement. For example, if you by a Plan F High Deductible plan then the supplemental plan will apply any payment against the deductible first until you meet it for the calendar year before paying out a benefit to the provider.
Also for those of you nearing the need, in 2020 MACRA is changing all supplemental plans and starting for newly eligible enrollee’s in 2020 Plan F and Plan C will no longer be allowed to offer the Part B deductible. If you already have it you can keep it but if you come of age after 2020 it won’t be available to you.
Sorry, as the other poster said, CMS.gov is Center for Medicare and Medicaid Services and there is also the Medicare.gov site. The Medicare site might be more user friendly where the CMS tends to have more technical documents.
The two sites are full of information for people looking to educate themselves on Medicare plans.
Each state has an executive Office on Aging connected with their Dept of Health. There should be a SHIP program in that office to help folks get Medicare questions answered. They provide unbiased info and are funded by the state and/fed govt, not insurers. I’d start with them. Your state insurance commissioner should also be able to answer questions about your state insurance laws.
And a supplement to dcolosi’s summary: IF you already have plan F (or C), or are thinking of joining one before 2020, we were cautioned that as the members age (and decrease, either by dying or simply because they are not offering new plans), the payments may rise for those plans. It is my understanding, that insurance companies are not allowed to raise rates, unless they do so for everyone across the board – but as the pool of recipients diminishes, it will be easier (and necessary) to raise premiums.
Plan F is going away in 2020. Plan N will still be there. Plan F will essentially be replaced by plan G – the only difference between Plan F and Plan G is that on “G” you still need to pay the Part B deductible (currently $183/year).
For every single rate sheet I have looked at, the difference in annual premiums for Plan F significantly exceed the Plan G Premium + Plan B deductible. So basically Plan G seems to always be the better value, unless you are in a situation where some third party is paying or subsidizing your Plan F premium. Maybe there’s an exception — but Plan F simply seems to be a system where you prepay your Part B premium plus give the insurance company a bonus for allowing you to prepay.
I like the idea of never having to worry about deductibles, but I will be signing up for Plan G unless someone gives me a very good reason not to. There just isn’t any possible value I can see in the F plan over the G.
@calmom thank you. Reg post #138, I am still not sure. What/Who is there to prevent a doctor who treats a patient as a cash cow and getting a patient to do all sort of tests? Say in my recent experience, the insurance company, I believe, correctly denied a screen visual assessment for my DD. But if it were for me, will medicare decide that the assessment is not necessary or will they just pay whatever the provider charges?
If I understand your post correctly, you are saying that medicare makes the decision but not the insurance company.
Medigap just pays whatever excess is not covered by Medicare For outpatient (part B) - there is a $183 deductible (which is waived for covered preventive services) – and Medicare pays 80% of charges beyond that.
A Medigap policy pays the other 20%. The F plan would also pay your deductible.
The Preventive services you are looking at are relevant to determine whether the deductible is waived. If I get a diabetes screening (no previous diagnosis) – it’s free; if someone with a previous diagnosis gets the same tests, the may have to pay their deductible.
So if your goal is that you pay premium, everything is covered – then you want Plan F because the insurer will pay the deductible. Whereas if you have Plan G, you could go to the doctor and end up with a bill for $183.
The bill would come from the provider, AFTER the claim was processed through Medicare. So let’s say you go for a service that includes $450 of billable services to Medicare. The doctor bills Medicare; Medicare pays $267. Then you get a bill from the doctor for $183.
am I correct in understanding that the California Birthday rule allows a Medicare enrollee to change a Medigap policy without medical underwriting? For example, if I sign up for the xx health plan F at $150 per month but next year it jacks up its prices 20%, then I can easily switch to the yy health plan F next birthday if its lower (or for any other reason)?
Does the birthday rule work for Part D, too?
With the BD rule, wouldn’t it make sense to just get the lowest priced plan every year? What am I missing?
If it matters, my BD is within 30 days of Jan 1, so I could change to a new plan every Jan 1?
That’s my understanding … but I’m new to this as well. I’m going to set up a phone conference with an agent soon… I hope next week – and It’s something I’m going to do my best to verify. But I think it works the way you describe- as long as you sign up at age 65 and stay on Medigap continuously, you can switch companies each year. And I think you are right-- lowest priced plan matching the letter coverage you want (let’s say, G)- would make sense.
But some companies do offer extra stuff — the plans are the same, but Blue Shield offers Silver Sneakers, 24/7 nurse help line, & a wide variety of “extras” -(some of which might really be upsells… its hard to tell which is which from their website). Plus they had a pretty low quote when I followed the link from their email… so I’m guessing that one thing a company can to retain customers is offer a variety of perks and then hope that in later years when the rates go up, hope their clientele doesn’t want to give up the perks.
Plus it can be a pain in the rear to have to shop for a new plan each year. So I’m guessing that most people probably don’t do it unless there’s been a sudden rate hike rather than a gradual creep. And in general older people are probably a change-averse clientele, so the insurance companies have that going in their favor.
I think Part D is guaranteed renewable (and switchable) for everyone in the open enrollment period, which would be different than your birthday month. But there’s a rate penalty if you delay buying into a plan.
Sounds like you and I are age-mates – I’ll be starting Medicare on Jan 1st.
yeah, those extras are hard to find. I just compared Plan G rates for my zip code and USAA was cheaper than United Heatlh (AARP plan, I think), by hundreds of dollars at ages 65, 70, & 75. Interestingly, the USAA plan is Age-rated and the UH plan is CR. I’m guessing USAA is just the basic Plan, but can’t tell of United Heatlh has extras buried into thier rates.
The AARP plan is community rated, but offers a steadily declining discount tied to age, so you pay less than the regular premium in the early years. Age related ratings means that we are now entering a market where we are the youngsters (rather than the $$$$ market we are leaving)-- so we can expect the age-rated policies to be the cheapest to start with… but down the line we would be hit with higher rates at a time when we can least afford them. So yes, the ability to switch once a year is advantageous. Unless you really hate junk mail…because something tells me that we are going to all be great targets for marketing, once a year, every year…
yeah, I get the difference between AA and CR, and that is why I looked up today’s rates for each insurer in those different ages. And I think I’ve read that the CR plan by ARRP offers a discount for each of the first five years.
Regardless, for example Plan G (my SoCal zip code)
For Ages 65, 70, 75
A - Attained Age-rated plan rates today: $1764, $1920, $2306
B - Community Rated plan rates today: $1841, $2273, $3596.
In other words a 75 year old under Attained Age would pay $2306 annually under insurer A, but would pay $3596 under insurer B (the CR rating). I would have expected that the numbers would have flipped by age 75…