Age 72 Best First Medigap - G, HDF, or N

[LostDollar]

RE open enrollment period:

My understanding goes with what FRJ said. That my open enrollment is based on the Plan B start date. And I tried to be careful with the start date so I did not create issues with my Group Health Plan. As I understood it, the default start was going to be the first of the month I applied, but I had the option of selecting either the first of the following month or the first of the second following month. I chose the first of the following month which gave me seamless health coverage of one sort or another, but did not create any coordination of benefits issues with my Group Health Plan. (and finally got that approved in a social security office around 3 pm on the last business day of the month of July!!)

(Unfortunately, due to both the obtuseness and the business practice of Aetna I have not been able to avoid having to learn something about GHP/MEDICARE COB rules and explaining them to customer service representatives of an insurance company who should know them better than I do.)

Again my understanding--I would modify jdeasy's statement above to say

You cant just not take part B and then pick it up later WITHOUT PENALTY.
I turned down part B when I was first eligible at 65. I believe the default condition now, at age 72, is that I would pay a penalty addition to the base part B (not Medigap) premium for the rest of my life. I turned down Part B because I was covered by an employer health plan. Rose told me of a form which I had to have completed, in addition to my Part B app, to document Group Health Coverage. What I learned the hard way was that I had to get multiple copies of the form done, documenting all group health coverage I have had since I turned down Plan B at age 65. I got that done and have penalty free Plan B. (Well free from that penalty anyway. I have learned that I am part of a special and privileged group that gets to pay another plan B premium penalty.)

All that work did not carry over to plan D because I then received a letter from SilverScript indicating I was going to get to pay them a premium penalty unless I did xxxx. So I got their forms completed too and I suppose I will get to do it again in a few weeks for a new 2017 plan D carrier.

 

[GreenSky]

You really need to hook up with someone who specializes in Medicare rather than doing the yourself.

By the questions you are virtually lost and doing way too much research.

Rick

 

[LostDollar]

What does this mean:
"My journey:
MA KS SHICK said NO."

Journey:
Medicare confused me, so I did not learn anything about it in 7 years because I did not need to. I did not worry about it because I expected to have group health coverage for at least another 5 years. That expectation changed rather suddenly.

So, looking at the KS ins commissioners website and the medicare website, I thought - this cant be too hard, I'll just get one of those advantage plans because it's "free" and it looks like the group health ins I've had for all those years. ( And I've seen guys selling Coventry in the grocery store for the last 3-4 years. )

And from there to Medigap plans.

Abbreviations-Sorry-I guess you caught me trying to be part of the "in" group.
MA-Medicare advantage
KS-Kansas
SHIP-State Health Insurance Assistance Program
SHICK-Ks variant- Senior Health Insurance Counseling for Kansas
NO-as in That's a negatory Good Buddy!

I made an appointment with a counselor at the local state extension office and the first thing I heard about Medicare Advantage was the potential exposure to rather large annual cycles of deductible payments in the event of serious health crises. That did not match too well with social security income in my mind so I decided to discard that option.

That led to the other contacts I've talked about.

 

[kgmom219]

Based on what the OP said, he went on Part B effective 8/1, with no Late Enrollment Penalty, due to group coverage.

Assuming that it is accurate, he is in open enrollment.

Now he wants opinions on G vs HDF vs N

And everyone has a different one. Shocking.

My favorite is G, for a long term solution. HDF and N work when you are healthy and "alert". If you become uninsurable (and thus, sick), they stop working. Once the doc says "we need to get the cataract surgery scheduled," you are going to be uninsurable until its completed.

Its not always about the money. If you get diagnosed with a heart condition, you are going to have a problem moving. So when you are 95, you are going to be getting bills to meet the deductible on HD-F. Yuk.

Same as N. N works in your first 10 years. It stops working when you are at the point where you go to the doctor multiple times each month. In addition to the fact that at some point, writing checks and keeping up with everything may be an issue. I write N, ONLY if I get to meet or chat with the children who are going to take over when their parents get to that point.

(Guess who deals with her 90 year old Grandparents insurance?)

So the best plan for you at 72, may be HD-F or N. I don't think either one of those is the best plan at age 80ish. For anyone.

And the Excess Charges should not be a concern. 96% of the docs nationwide take Medicare assignment. They may not take new patients, but those are 2 different things. I have had ONE issue with Excess Charges. And that was for an oral surgeon who needed to re-build a jaw, post radiation/chemo. There was only one oral surgeon in TX who would do it and she had opted-out.

My two cents.

P.S. Take on Silver Script and get the late enrollee penalty removed. There's a form they should send you. And FYI, they got the late enrollee info from Medicare.

 

[LostDollar]

--> FRJ, thank you for taking the time to read what I posted and to ask questions. Thinking and writing takes me awhile, I will get answers to your other questions too--In the meantime one for you
What do you and your clients think of Term Life?
LD

----------
----> Rick
You really need to hook up with someone who specializes in Medicare rather than doing the yourself.

Rick,
Easy to say, hard to do. One would think I had done that already, but I don't think I'm getting quite the right results. I don't believe the compensation model expressed above gets me complete or unbiased results or gives me the moral right to ask all the questions I would like to ask of all the people I would like to ask them to. Although not the only reason, I believe one of the reasons 3 agents shut the door in my face when I asked about HDF is that I had used up all my question time and question goodwill with them asking about plan G.

An exchange with agent Rose (false name):
Rose:
[I made an edit to keep things anonymous]
You’re overthinking this and reading too much into it.
I treat my clients like I would want my parents treated, if this isn’t for you then I understand, however at the end of the day, ALL of these companies rates go up every year. The trick is to get in at the lowest rate, and have someone watch it for you annually so if you can qualify, you can always keep stepping down to the lower price. I have clients that switch every year with our [ annual review process ] because they understand the plan letter is the plan letter no matter who you get it from. At the end of the day, who is going to give you the plan you want for the least amount of money?
LD:
“… you are the only person with whom I have spoken that suggests Plan B supplements are a shoppable commodity annually. I seriously question the wisdom of embarking on a business relationship with a company that promotes that as a desirable course of action.
[Following some other remarks about Transamerica] I also do not like their rate table--in comparison with another. I would not recommend Transamerica to my parents.”
[I will respond to FRJ’s question about my opinions of Transamerica/Bankers Fidelity (in the KS market) in another post when I can get the answer worked out and written.]
Rose:
That’s why I’m the licensed agent. I would never have told you how to do your job as I would have hoped you were an expert in your field. I am the top paid agent at this brokerage and the best at what I do and I would recommend any of these companies to any of my clients and have done so with nothing but positive, economical and happy results.

----------

Or this with Broker Paul. From my viewpoint as an uninformed consumer, he seems to have a national presence in Medigap supplements, which seems to meet Rick’s suggestions. I cannot say more about Paul without destroying anonymity.

LD:
Given the potential restrictions on changing supplements on an individual by individual basis, considering only the lowest price seems like it has the possibility to have long term drawbacks.

Broker Paul:
The only restrictions would be poor health, but of course we'd want to make sure you'd be with an A rated reputable company offering the same standardized plan G as all the others. In this case I'd recommend Cigna that has the second best price available of all the companies in your area, they've been around for over a hundred years, and they have an excellent track record of low rate increases.

LD:
I was concerned because it [Cigna] is not listed on the KS Insurance Commisioners website.

Broker Paul:
I represent Aetna too,,,, but I'd much rather you go with the company that has the better price since they're both A rated.

More competition means lower prices for you, and if you want an agent who stays on top of all of this from the beginning … then I believe I'm your guy.

LD;
Do you represent Bankers Fidelity Life?

Broker Paul:
Yes we represent every company in the state

LD:
[Since he represented every company in the state, I requested a quote on HDF with Std Life (TX) ]
I understand if that is something you would rather not quote. I'd prefer to do it with you rather than Standard Life if you will quote it. Please just let me know one way or the other so I can keep the process going.


Broker Paul:
As a licensed Life and Health Insurance broker our job is to give the best available recommendation in your area.

No one is going to recommend Standard Life because you'd be miserable with that company, and no one is going to recommend HDF because it's simply paying an insurance company each month to self insure because the plan covers nothing until you meet the large deductible.

If you really like Standard Life that much and that plan that much for whatever reason you can possibly tell yourself, then by all means go for it, but our agency won't be a part of it. Our years of experience tell us, and it sounds like the other agents you spoke to are in agreement that you'd be miserable with that company and plan that's going away in 2019 anyway.

If you want the best value for your dollar with the company with the best track record than we can help with that, if you want an agent to serve as your advocate to give you the truth about the best value for your dollar after 65 then we're your people.

If you'd like to take insurance advice from your barber, we simply won't participate due to the fact that you'd be so miserable and upset with the company, the plan, and eventually us.

 

[WinoBlues]

>>"What do you and your clients think of Term Life?"

>>".......that I had used up all my question time ..."



.

 

[LostDollar]

From FRJ above:
Partly why you are getting flack from agents regarding HDF is that they/we make very little commission of those plans because they are so cheap. There's almost no way that an agent could stay in business if they solely sold HDF.
----------------------------------------------------------------------------------------
I am in no position to dispute what FRJ says. What I can speak to is a “normal” approach to consumers by Medigap supplement representatives. 3 examples below:
Agent Rose:
We provide a free service sponsored by the insurance companies to help you find the best Medicare supplement plan & pricing for your situation. You'll never pay a dime for our service, and we take an unbiased approach to helping you and the rates you'll get from us are the best available from the various companies.

Broker Sidney:
I have been in this industry since [a long time]. You don’t pay for my service, it comes with any product you purchase through me.

Agent Xavier:
I can give you all the information you need and my services are free of charge.

If salespeople want to make this type of approach to me, and then be distressed with me later because I have chosen to consider a plan in the basket that does not reward them as well as one of the others, I think they have shot themselves in their own foot (feet). I then take further exception to their sales approach when the ONLY justification they offer me for taking one of the plans they want me to take is the length of time they have successfully been selling Medicare supplements.

----------

Why bankers fidelity life
Kansas Insurance Department Medicare Supplement insurance shoppers guide: Mar 2015 and Apr 2016.
Plus Ks Ins Dept online pricing in Aug 2016.
I listed all the companies registered with Ks Ins to sell plan G in Aug 2016. I listed their annual premium for age 70. I then rounded the annual premium to the nearest $50 and did a Mean/Median/Mode review. Mean $2129. Median $1900. Mode $1800.
In Aug 2016 there were 32 companies listed to sell plan G in KS. Three of them had premiums less than $1600 per year. 2 of that 3 were Transamerica and Bankers Fidelity Life. The same 32 companies were listed in Apr 2016. At that time, 9 of them had annual premiums less than $1600. In 2015, not all of those 32 companies had registered. Of the ones that had, 6 had annual premiums less than $1600. From there, I am into my own speculations, in the absence of data from anyone else. What I see is a trend of premiums from $1550 toward $2000. The numbers suggest to me that most companies are starting to think they need a minimum of $1800-$1900 in KS for plan G in order to cover losses and make some level of profit.
Somewhere I got booklets for Transamerica and Bankers Fidelity Life and I put their annual premiums into a spreadsheet out to 105 or so. By age 80, transamerica’s premiums became higher than Bankers Fidelity, instead of lower. Transamerica’s premium went level at 95. Bankers Fidelity went level at 90. Over a life span I wanted to work with, Bankers Fidelity was cheaper. I think they are both doing loss leader pricing to get into the KS market. I like Bankers Fidelity’s actuarial philosophy better than Transamerica’s. So I would choose Banker’s Fidelity and hope that their premium increases will go slowly towards the $1800 level and that they can build G membership fast enough to be able to continue with the plan.
Broker Sidney was alone, not on HDF, but on G, to present me with some factual data to think about. A term he introduced me to was legacy policy holders. And he told me that often there could be substantial unknown legacy increases because those prices did not have to be reported. He recommended Aetna (and would not sell the other lower priced plans) because he believes it to be a more stable company in terms of rate increases. He provided me some data from a quoting engine that suggested that Aetna’s increases were around half those of Banker’s Fidelity. When I studied those numbers carefully though, I was confused and the numbers did not seem to match to his verbals about learning about changes at the legacy level instead of the initial enrollment year level. I went to the Ks Ins commissioners site and plugged in ages for G quotes one at a time for Bankers Fid and Aetna. I think I got exactly the same figures the quote engine was showing for annual increases. So while I saw an annual change comparison for the two companies, I don’t think I saw anything about legacy policy holder increases for either company. So Im just back to my speculations compared to someone else’s speculations. Given their premium level, starting in September, I think that Cigna is doing exactly the same thing in the Kansas market.
Up in the agent area there is a very long thread about Mutual of Omaha. There are a lot of things in it I do not fully understand like books and changing company names, but my layman’s take away is that if I take the long view – like 10 years or so- there may be an 80% or better chance that no matter what plan or company I choose, the company will take some kind of action that will place me in a pool of people to which new additions are no longer being made. I just hoped that maybe one of the things I could learn with this thread was a sense of history for the companies like Transamerica, Std Life (TX), Bankers Fid Life, Cigna, Aetna in regard to things like book changes, company changes and legacy rate changes. I know I am just one person (with a small commission) and I am in the swimming pool with a whole bunch of people who have to work together and work with all the companies for whom they sell, so I don’t know what is possible. All I can do is ask and see what happens.
LD

----------

I have been rereading answers I have been given.
Thinking in regard to G and N.

Excess charges have been addressed in posts above. I really appreciate that feedback.

What about the appearance that N does not have a cap. a) is that true? and b) if the only out of pocket charge is copays, will those add up to serious dollars in a given year, even with more serious medical conditions? I can't remember precisely now, but in experiences with Prostate Cancer, finger surgery, and kidney stones, I don't think a given event has required more than 5-8 dr visits. Only the kidney stones required emergency room visits.

Points made about recordkeeping were things I had not considered. However in relation to plan G and N, it looks to me like some record keeping is required for either. Are the plan N requirements really more difficult to keep up with than the plan G requirements?

Thank you. LD

 

[kgmom219]

I have been rereading answers I have been given.
Thinking in regard to G and N.

Excess charges have been addressed in posts above. I really appreciate that feedback.

What about the appearance that N does not have a cap. a) is that true? and b) if the only out of pocket charge is copays, will those add up to serious dollars in a given year, even with more serious medical conditions? I can't remember precisely now, but in experiences with Prostate Cancer, finger surgery, and kidney stones, I don't think a given event has required more than 5-8 dr visits. Only the kidney stones required emergency room visits.

Points made about recordkeeping were things I had not considered. However in relation to plan G and N, it looks to me like some record keeping is required for either. Are the plan N requirements really more difficult to keep up with than the plan G requirements?

Thank you. LD

N does not have cap.

My grandmother is 89 and has at least 1 appointment EVERY SINGLE DAY. Its ridiculous. And most of it is saline transfusions, to keep her blood pressure up. If I had put her on N, she would have $100 due in copays weekly. That's a lot of bills coming in the door for anyone to keep up with. Much less my grandma

With G, you pay the deductible. One time. (maybe more, depending on your personal claims). There's a cap, because its just deductible. After that, you are at 100%. You will pay copays, after the deductible is met, all 12 months.

Look at the premium differential between G and N, then do the math. How many copays do you need before G became a better deal? You said "chronic conditions" in an earlier post. How many visits does that require now? Are they degenerative? If so, you are going to have more visits in future years.

At this point, you've gotten advice from at least 25 agents. Some of whom have more than 20 years in the business. You need to pick a plan and a company..for the next 30 years.

Good luck!

 

[LostDollar]

Re: “You need to pick a plan and a company..for the next 30 years.” You are reading my mail. I figure there is a 98.5% chance of a major body system failure in the next 30 years. (I am giving myself a 1.5% chance to go for 50 instead of 30. )

Figuring your own play book is a problem. An uncle was found on his lawn beside his lawnmower. My father lived for 4 years with around 50% heart function. He was in his 70’s. A man who I am told was my father’s best friend during WWII lived to 92. I believe I have learned of another person with whom they both would have interacted, at least on a weekly basis, who is still going at 102.

Re: 25 agents (or brokers) - I think 12 or less including responses here.

Re: “ You really need to hook up with someone who specializes in Medicare rather than doing the yourself.” I thought I had done that, but……

Brokers Sidney and Paul: Each have their own agency, an internet presence and Medigap experience in excess of 15 years.

Broker Sidney terminated all contact when I mentioned Standard Life and Accident, Cigna and HDF in the same sentence.

Broker Paul teminated all contact when I mentioned Standard Life and Accident and HDF in the same sentence.

I believe the reasons go beyond agent/broker compensation. One of the reasons for this thread was to try and understand what those reasons might be, prior to finding a way to reengage in the process of solving the agent/coverage proposition.

 

[jdeasy]

Based on what the OP said, he went on Part B effective 8/1, with no Late Enrollment Penalty, due to group coverage.

Assuming that it is accurate, he is in open enrollment.

Now he wants opinions on G vs HDF vs N

And everyone has a different one. Shocking.

My favorite is G, for a long term solution. HDF and N work when you are healthy and "alert". If you become uninsurable (and thus, sick), they stop working. Once the doc says "we need to get the cataract surgery scheduled," you are going to be uninsurable until its completed.

Its not always about the money. If you get diagnosed with a heart condition, you are going to have a problem moving. So when you are 95, you are going to be getting bills to meet the deductible on HD-F. Yuk.

Same as N. N works in your first 10 years. It stops working when you are at the point where you go to the doctor multiple times each month. In addition to the fact that at some point, writing checks and keeping up with everything may be an issue. I write N, ONLY if I get to meet or chat with the children who are going to take over when their parents get to that point.

(Guess who deals with her 90 year old Grandparents insurance?)

So the best plan for you at 72, may be HD-F or N. I don't think either one of those is the best plan at age 80ish. For anyone.

And the Excess Charges should not be a concern. 96% of the docs nationwide take Medicare assignment. They may not take new patients, but those are 2 different things. I have had ONE issue with Excess Charges. And that was for an oral surgeon who needed to re-build a jaw, post radiation/chemo. There was only one oral surgeon in TX who would do it and she had opted-out.

My two cents.

P.S. Take on Silver Script and get the late enrollee penalty removed. There's a form they should send you. And FYI, they got the late enrollee info from Medicare.

When I commented on it might not be open enrollment the OP had not explained the reason for not taking part B at age 65.