General Question

Jeruba's avatar

Do you have any advice for me on the choice of a Medicare supplemental plan?

Asked by Jeruba (41917 points ) May 20th, 2012

Yes, that’s about where I am. And the amount of stuff I have to look at is pretty overwhelming.

If you’ve been there and done that, please share your experience and recommendations.

I thank you.

Observing members: 0 Composing members: 0

12 Answers

bkcunningham's avatar

@Jeruba, if you get an opportunity to read this brochure, it may help.

http://www.medicare.gov/publications/pubs/pdf/02110.pdf

gailcalled's avatar

My college class listserv, a smart group of about 120 women, discussed this at great length when we turned 65. The winner by a long shot was AARP medigap plan F.

Personally I have been very content with it..including a 6 day hospital stay after I fell off my porch in the dark, knocked myself unconscious, had no memory of the event, broke two ribs, tore a rotator cuff and had a subdural hematoma.

info

YARNLADY's avatar

It depends on what you need. In my case, I am covered by my husband’s policy and I don’t need the supplemental. My Mother-In-Law has Kaiser and she has signed her share over to them, which seems to work well for her.

My brother lives in Texas, and they seem to have some sort of state paid plan, so you just sign your supplemental over to them, and all your medical needs are covered, including in-home nursing visits.

bkcunningham's avatar

@YARNLADY, I was under the impression that each spouse has to have their own Medigap insurance. I didn’t think it covered a “family” so to speak.

Kayak8's avatar

@Jeruba I work with clients who select Medicare Part D/Advantage plans and the associated gap policies every day, then helped my Mom select hers. After all that, I still can’t offer a better choice than the one @gailcalled mentioned above. Of course, it all depends on any special needs you have. If you take a lot of medications, then you may want to ensure that your supplement plan covers anything that Medicare Part D doesn’t cover. Just know that there are some regional variations in plans—on the AARP website here, you have to enter your zip-code for the plans in your area.

Jeruba's avatar

I’m feeling better already! Thank you. Your response is especially helpful, @gailcalled, because it represents a tally of views of real people you know and trust.

@Kayak8, in what capacity do you have such clients? Or maybe what I want to know is—what kind of professional helps people make their selection? I am wary of anyone who has something to sell, and how do you know when you’re talking with someone who doesn’t?

YARNLADY's avatar

@bkcunningham My husband is still employed, and we are covered by his employee insurance.

bkcunningham's avatar

Ohhh, I understand now, @YARNLADY. I’m sorry, I misunderstood what you said before.

srmorgan's avatar

I sold Medicare Supplemental policies for about a year, working for Bankers Life and Colonial Penn.

Everybody’s F plan or N plan (the two that we sold the most of) are exactly the same. No company’s policy exceeded the benefits of anyone else’s. The Center for Medicare Studies regulates the plans and lists the specification that each plan must follow.
The only difference in Supplemental policies (used to be called Medigap) is price. AARP may charge $xx in Minnesota and charge $10 more in Tennessee or $15 less in Nevada.

A company bases its rates on its own “book of business”, its own experience with people born in a given year in a given state. Each company submits their rate request to insurance regulators in a particular state and the regulator will either approve or deny the rate request.

Not every company sells every plan in every state. There is no Medicare requirement that AARP sell an N plan in New Jersey. The company can opt out if it so chooses.

The thing to watch for is that the initial rate you are offered for the first year when you turn 65 is not a teaser rate. Some companies have an unofficial reputation for increasing rates in year 67 or 68 dramatically. You can get historical data from your state department of insurance. In North Carolina it is available on the Dept of Insurance website.

An illustration: The N plan was introduced only on 7/½010. This well-known company underpriced their premiums in order to get market share and they also allowed customers from other carriers to switch to this N plan without going through the health questions.

A year into it, this company raised rates over 23% and stopped writing the N plan in North Carolina due to having a 90% loss ratio. Standard loss ratio should be in the range of 75%.

Well OK you might ask why this is important. During your initial period of enrollment you can not be declined coverage for any reason by any company if you pay your premiums.
Once you are 90 days passed your 65th birthday, an insurer will ask you a health questionnaire and you could be turned down for coverage.

So if your premium gets jacked up when you turn 67 and you have had a serious illness you may not be able to switch companies.

So be careful. I can’t prove it but it seems to me that the larger carriers like AARP, Blue Cross Blue Shield, Colonial Penn among others will have larger pools of customers and that their rates will be more stable. On the other hand their initial rates are in the higher range than many other companies

SRM

srmorgan's avatar

One other thing, you really should consider the purchase of an N plan. It covers everything the F plan covers except for two features.
1. The F plan covers the full cost of physician visits and you don’t pay a nickel. Under the N plan you pay 20% of the office visit fee up to $20.
2. The N plan covers has the full medicare deductible of around $165. (It was $162 in 2011).

So you have to do a quick and dirty calculation to see if the Premium saving on the N plan exceeds the cost you might incur.

Medicare Advantage plans are a good deal however, many of them have high out of pocket costs, Last year Humana in North Carolina was $5900 and not every physician accepts them. So you have to make sure your doctors will accept the advantage plan from a particular company. They might accept Humana but not accept Mutual of Omaha for example.

As to the Part D plan for prescription drugs, be careful and make a good choice, there are a lot of plans out there. I used to recommend the $14 Walmart plan instead of our own plan if the customer was using only generics. If a customer was on a lot of Tier 3 drugs then our plan with a higher premium but tiny deductible proved to be better.

SRM

learning23's avatar

yes there are planty of choices for medicare supplemental plans. my mom used to tell me that if you want something, ask yourself why you need it in the first place. i kind of think this works. why you need the medicare in the first place. knowing exactly what is happening, go to someone with expertise and then you will find a perfect plan.

Kayak8's avatar

@Jeruba I work with HIV/AIDS patients who take a lot of Tier 3 drugs. I am a public service employee who was assigned (and now supervise those assigned) to help with folks getting their medication from any number of sources.

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