Med Sup

[FLM2]

From the Medicare website about HDF:

Plan F also offers a high-deductible plan. If you choose this option, this means you must pay for Medicare-covered costs up to the deductible amount of $2,200 in 2017 before your Medigap plan pays anything


This is so clear it's ridiculous that there has to be an explanation.

'YOU MUST PAY FOR MEDICARE-COVERED COSTS UP TO THE DEDUCTIBLE AMOUNT OF $2,200 BEFORE THE MEDIGAP PLAN PAYS ANYTHING!

So, for Part B, the deductible must be met, then the policy holder pays 20% of all Part B charges up to $2,200 before the HDF pays any benefits. For Part A, the deductible must be paid as well as additional Part B charges (or multiple benefit period Part A deductibles) until the Medigap plan pays anything.

 

[LostDollar]

From the Medicare website about HDF:

Plan F also offers a high-deductible plan. If you choose this option, this means you must pay for Medicare-covered costs up to the deductible amount of $2,200 in 2017 before your Medigap plan pays anything


This is so clear it's ridiculous that there has to be an explanation.

'YOU MUST PAY FOR MEDICARE-COVERED COSTS UP TO THE DEDUCTIBLE AMOUNT OF $2,200 BEFORE THE MEDIGAP PLAN PAYS ANYTHING!

So, for Part B, the deductible must be met, then the policy holder pays 20% of all Part B charges up to $2,200 before the HDF pays any benefits. For Part A, the deductible must be paid as well as additional Part B charges (or multiple benefit period Part A deductibles) until the Medigap plan pays anything.

So why are you explaining it?

Plan F, for which HDF is an option, includes all the benefit options listed in the multicolumn table. Posters in this thread are trying to tell me that HDF is not plan F and they are trying to tell me that HDF requires one to pay the part B deductible even though plan F does not require it to be paid. Those are not true statements. What is true is what you posted in large red type-and that is a different thing. Those costs may include a part A deductible, they may include a part B deductible, they may be only part A, they may be only part B, they may be both. The plan requires only that the beneficiary pay the first X dollars of any benefit covered by the plan charged to the beneficiary's account in a given year. That is distinctly different from mandating that a specific benefit be paid by the beneficiary, as can be seen by comparing HDF to Plan L.

 

[FLM2]

So why are you explaining it? Plan F, for which HDF is an option, includes all the benefit options listed in the multicolumn table. Posters in this thread are trying to tell me that HDF is not plan F and they are trying to tell me that HDF requires one to pay the part B deductible even though plan F does not require it to be paid. Those are not true statements. What is true is what you posted in large red type-and that is a different thing. Those costs may include a part A deductible, they may include a part B deductible, they may be only part A, they may be only part B, they may be both. The plan requires only that the beneficiary pay the first X dollars of any benefit covered by the plan charged to the beneficiary's account in a given year. That is distinctly different from mandating that a specific benefit be paid by the beneficiary, as can be seen by comparing HDF to Plan L.

Every licensed agent who offers Medicare Supplements on this INSURANCE AGENTS GENERAL DISCUSSION FORUM understands EXACTLY how this plan works, which is that almost all of the time the Part B deductible will need to me paid first in the year, plus all of the other deductible and coinsurance charges, before the HDF will pay any benefits. The ONLY way this wouldn't happen is if 2 hospital admissions, with two separate benefit periods, took place before any outpatient charges for the year and that is essentially impossible because there are always follow up outpatient visits after an inpatient hospitalization. Your argument is such an uninformed, stupid one I had to rewrite this several times just to find a scenario where the Part B deductible wouldn't be paid.

You, the only NON-LICENSED individual participating in this thread, believes all of us are wrong.

You just don't get it and never will.

 

[sman]

That is not necessarily a true statement. It definitely does not jibe with CMS presentation of the plan parameters.

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Re Medicare-do you have suggestions, say 1 to 3 options, that won't cost me more than $300?

Experience is the best teacher. If you're considering getting licensed and plan to actually earn a living doing this, be prepared to spend much more than $300.

As for the Part B deductible, HDF covers it once you've met the $2,200 deductible. I can't put it more simple than that. Either way, a person on HDF will be spending money before their plan pays anything. Even on Part A expenses. This alone differentiates it from a traditional Plan F. That is why you should stop saying they are the same. Just because the outline of coverage shows both in the same column doesn't mean they are the same. As I said before, there's a reason they put an asterisk next to it.

Here's an outline for last year. I would hope that everyone can agree that NAIC is correct with their information:

http://www.naic.org/documents/committees_b_medigap_sg_exposure_chart_plan_f.pdf

 

[LostDollar]

Experience is the best teacher. If you're considering getting licensed and plan to actually earn a living doing this, be prepared to spend much more than $300.
]

Making a living selling medicare supplements is not likely to happen anytime soon. The question as written still stands if you want to offer any practical suggestions that fit within it.

As for the Part B deductible, HDF covers it once you've met the $2,200 deductible.

There, you've gone and said it. That is my point. The other posters in the thread are unwilling to say that and they are saying that I am incorrect and don't understand the plan for saying or implying it myself. They have gotten so caught up in the practical effects of the plans requirements which they have seen in 20 or 30 years of experience they are twisting the practical effects back to say they are the actual legal requirements of the plan, which is not true. You are approaching the situation in a rational manner and sticking to the language of the plan and arriving at a different result which is what I have been trying to say. They will listen to you because you are an agent.

That is why you should stop saying they are the same. Just because the outline of coverage shows both in the same column doesn't mean they are the same. As I said before, there's a reason they put an asterisk next to it.

I have not said they are the same. I have said they are both plan F. I have said they both cover the same insurance features or benefit options. I believe that is pretty clearly suggested in the document you linked.

The differential footnote you discuss relates to the modification of the beneficiary's payment option for the HDF plan. It does not change the features covered by the plan. If I could look at claims data for a batch of HDF plans for a year, I would not expect to see letter perfect matches in the beneficiary deductible payments by each beneficiary.

The the beneficiary's payment requirement and its cap, essentially self insurance to a limit, will be easily understood by anyone interested in self insuring a portion of their medicare costs through the medicare supplement HDF vehicle.

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Your argument is such an uninformed, stupid one I had to rewrite this several times just to find a scenario where the Part B deductible wouldn't be paid.
You just don't get it and never will.

Your effort supports my comment that HDF is a plan F with benefit coverages that include the Part B deductible.

You spoke to gollini about being unable to explain HDF even to your friends, your rant just above suggests that rather than using the simple, clear, easy to understand language of the plan which you presented to me, you are attempting to create some convoluted explanation of the the plan that matches your practical experience with it.

A person does not have to have visited the villages in FL or have sold insurance for 30 years to read and understand the explanations of F and HDF in "medicare and you" or the "Kansas supplement shoppers guide".

Also, FYI, there are experienced Medicare sales agents who believe that the premium differences between F and HDF are beneficial for some folks in markets other than FL.

 

[FLM2]

Once again you are so entirely off the mark it is ludicrous.

I have no problem explaining the HDF to my friends, the reality is that most of them who can afford Medicare supplements don't want the bother for the marginal money savings when an HDF is only $100 per month less than a Plan F and $60-$70 a month less than a Plan G so they just tune out.

My comments don't support anything you claim in all of your posts-your contention is something that can't possibly happen in real life ($2200 OOP reached without paying the Part B deductible).

I really don't give a crap what you think or what you say except you continue to say it as a non-licensed person within an agent community and your inaccuracies potentially hurt those of us who are not only licensed but have thousands of hours invested in our lifetime education on this subject as well what is probably 10's of thousands of total clients under our collective umbrella.

It's a good thing you won't be getting licensed because you wouldn't last 6 months in this business and would be giving out advice that is so bad it would undoubtedly lead to carrier terminations and potentially E&O claims.

 

[sman]

There, you've gone and said it. That is my point. The other posters in the thread are unwilling to say that and they are saying that I am incorrect and don't understand the plan for saying or implying it myself. They have gotten so caught up in the practical effects of the plans requirements which they have seen in 20 or 30 years of experience they are twisting the practical effects back to say they are the actual legal requirements of the plan, which is not true. You are approaching the situation in a rational manner and sticking to the language of the plan and arriving at a different result which is what I have been trying to say. They will listen to you because you are an agent.

I have not said they are the same. I have said they are both plan F. I have said they both cover the same insurance features or benefit options.

Saying they are both Plan F sure sounds like you are at the very least implying they are the same. You said in an earlier thread that you pay $55 per month for a Plan F. So someone who has a traditional Plan F, and is without knowledge of the differences between Plan F and a HDF, would assume they are overpaying for an identical plan. If you want to be taken seriously then differentiate between the two. Because there is a difference. You shouldn't go around telling people you have a Plan F that is $55 per month. You should be saying you have a High Deductible Plan F for which you pay $55 per month.

One could say, a HDF is identical to a regular Plan F once they've met the $2,200 deductible. But the way you say it, as I said, at the very least implies they are the same. And you really can't say they have the same benefits unless you also point out the $2,200 deductible. It's only after the beneficiary spends $2,200 out of their own pocket does the HDF benefits kick in and then becomes identical to a traditional Plan F.

When I come across someone who has Plan F and I am recommending Plan G, I will sometimes tell them that once they meet the Part B deductible, Plan G is identical to Plan F. In that regard, Plan G is closer to the benefits of Plan F than a HDF is based on out of pocket cost (in that the only difference in out of pocket cost is the $183 deductible for a Plan G whereas it's $2,200 out of pocket on HDF - we won't discuss premium difference at the moment).

The reason they aren't listening to you is because the way you say it is misleading. Especially to someone who doesn't know the difference. And quite frankly, disheartening to those of us who value doing things the right way for our clients.

In my zip code, rates for a 65 year old female are as follows (lowest rate for each):

Plan F - $139.41
Plan G - $110.66
HDF - $42.00

If I were to send out marketing pieces touting a Plan F for $42 per month, I can guarantee you that both the carrier who has that rate and the DOI would have a HUGE problem with it. So much so that the carrier may terminate my appointment and the DOI could (not saying they would) terminate my license. Again, this is why when you say you have a Plan F many of us view it as either you are willfully misleading or are ignorant (not meant in a derogatory way) to the factual way in which to present what you have. You say you want to learn, but you come across as arrogant and combative. This is why you are being met with such resistance.

 

[senior-advisor-indiana]

Making a living selling medicare supplements is not likely to happen anytime soon. The question as written still stands if you want to offer any practical suggestions that fit within it.

There, you've gone and said it. That is my point. The other posters in the thread are unwilling to say that and they are saying that I am incorrect and don't understand the plan for saying or implying it myself. They have gotten so caught up in the practical effects of the plans requirements which they have seen in 20 or 30 years of experience they are twisting the practical effects back to say they are the actual legal requirements of the plan, which is not true. You are approaching the situation in a rational manner and sticking to the language of the plan and arriving at a different result which is what I have been trying to say. They will listen to you because you are an agent.

I have not said they are the same. I have said they are both plan F. I have said they both cover the same insurance features or benefit options. I believe that is pretty clearly suggested in the document you linked.

The differential footnote you discuss relates to the modification of the beneficiary's payment option for the HDF plan. It does not change the features covered by the plan. If I could look at claims data for a batch of HDF plans for a year, I would not expect to see letter perfect matches in the beneficiary deductible payments by each beneficiary.

The the beneficiary's payment requirement and its cap, essentially self insurance to a limit, will be easily understood by anyone interested in self insuring a portion of their medicare costs through the medicare supplement HDF vehicle.

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Your effort supports my comment that HDF is a plan F with benefit coverages that include the Part B deductible.

You spoke to gollini about being unable to explain HDF even to your friends, your rant just above suggests that rather than using the simple, clear, easy to understand language of the plan which you presented to me, you are attempting to create some convoluted explanation of the the plan that matches your practical experience with it.

A person does not have to have visited the villages in FL or have sold insurance for 30 years to read and understand the explanations of F and HDF in "medicare and you" or the "Kansas supplement shoppers guide".

Also, FYI, there are experienced Medicare sales agents who believe that the premium differences between F and HDF are beneficial for some folks in markets other than FL.

When you go to the doctor for the first time this year, is your HDF plan going to pay your part B deductible?

 

[JimmyUt]

When you go to the doctor for the first time this year, is your HDF plan going to pay your part B deductible?

Since it is the same as Plan F, of course it will.

 

[GreenSky]

When you go to the doctor for the first time this year, is your HDF plan going to pay your part B deductible?

Ask your upline.

Or maybe someone without a license than posts here dozens of times a day.

Rick