297 Medigap

Oh how much fun I have been having learning about the so-simplified Medicare plans before I HAVE to go onto Medicare all-to-soon. Yes, the plans are now standardized. INTO Plans A-N. Hmmm...that's like FOURTEEN possibilities. Well, you are spared looking at 14, because your state or provider may limit the number of plans available to you in your state. Medicare.gov is a good place to start and you can get a listing of the plans and providers in your state. So, I did that. But the number of providers were too many for me to possibly review, PLUS you can't find 80-90% of the companies on the Internet or if they are there, any more detailed information about there company than on the Medicare.gov site. Another place to look is your state insurance regulatory site. To me it seemed that every financial company and every new venture looked at the standardization and assumed they could compete in the market. Some didn't even bother brushing off the dust collected in the closet before "highlighting" their success in the market -- yeah right. So how can you compare companies? Well, you CAN'T without getting an independent agent involved. Then, you need to assure you have one licensed in your state and dependable. Now your list of possibilities have escalated exponentially.

I located an independent as many other had. Google Medicare Supplement plans in your state and pick one of the specially highlighed ads from the resulting sites list. I was directed to ArborIF.com and Jonathan Brackin. I have never felt better about an independent agent (used one for pre-Medicare plans) than he. First let me qualify my knowledge in Medicare and plans -- close to expert before contacting him. The only thing I was seeking from him was a comparison of providers and some differences in plans. Here are some specifics of my experiences:

1. Advantage or Supplement plan? I had already ruled out Medicare Advantage plans in lieu of Medicare Supplement Plan. You'll have to make that decision first. Don't be enamored by the 0% premium of Advantage plans compared to $91-168 Supplement plans. You should know by now you get nothing for nothing. Co-pays and deductibles in Advantage plans add up. The bottom line in comparisons are Out-of-Pocket and Peace -of-mind. You can probably come up with some typical number of services you will need in a year, but you can never plan on the unexpected accident or major illness. PLAN for it -- it will "seem" more costly (premiums, that is), but the peace-of-mind and actual costs are what is important. For example, I am in excellent health and haven't even been to a doctor in over 6 years -- no expenses. Now I MUST join Medicare and see Part B be taken away from my operating income. Ignore that cost in comparisons -- you pay that regardless of Advantage or Supplement. So, when you see that your out-of-pocket could be as much as $3400 on a $0 premium Advantage Plan, is that better than a $0 out-of-pocket in addition to a premium of $150/month ($1800 per year). NOT in my book. If you want play the game of excellent health now and no chance of any major illnesses AND not go to the doctor when you, like it or not, are MORE MATURE (old will suffice in my mind), go for the Advantage plan. I'm going with a $91.91 first year monthly premium for a Supplement.

2. Let's talk Supplements: The state list is ridiculous, as are the number of different plans, A-N. Do you realize your rate increases are dependent on the provider's risk pool for a SPECIFIC plan? Jump into on that has higher-risk people and you'll see higher rate increases. Also beware, some of the plans now entice consumers with lower premiums + copays, once again competing at the Advantage plan level -- already discussed that briefly (want more info, enter a comment and I'll answer). So, if you use logical commonsense, you'll find a lot of people NEVER look at anything other than price -- almost like those who vote for a president base on his looks or grammar. My bet is these people are also the ones who have no clue on what the spend on health care and thus are the riskiest pool to be with. Just my theory -- but, I immediately ignored the L, N and similar low premium plans. Once again, I didn't want to have to micromanage my health counting co-pays and worrying about limits. So, I focused on the G and F plans. The difference? G=F except you pay the Part B deductible (around $162) yourself instead of the plan paying it. Surprisingly, the annual cost for the F plan is MORE than the G Plan plus the deductible. In other words, F is pushed and sucks in the not-so-clever consumers who can't do math. Well, I didn't want to be in that risk pool either. I secured a G Plan. In addition to these, there are also F and G SELECT plans, but SELECT plans limit you to a specific hospital(s) in a Network. For $6/month less I opted out on that. I had a hospital in that Network, but the other hospital here is the one that is known for its cardiology work and programs.

3. Now that a plan is decided on, which provider? If you haven't already heard of the company, avoid it now is my recommendation. It so happens that the company I chose is well known AND had the lowest rates offered. Let me qualify that. The agent selected did NOT have a complete list of all providers available in the state. None do! Some providers have their own agents too. It's a real zoo out there. Anyway from the list available to me, I narrowed it down quickly to just 2-3. Ratings were given, but they are NOT ratings of the provider's success in the health care business. Most were financial institutions that decided they could make a few extra bucks. Thus, take the ratings give with a grain of salt. Questions to ask: how long have they been in the Medicare Supplement business? How frequent and what were the rate increases for this plan and other plans in the last 3-5 years? Was there a reason for larger than normal increases that are viewed as exceptional rather than typical or normal? Do they have eServices on their Internet site? (Note: Most didn't even have a website that focused on their health plans, e.g., Gerber, Forethought). eServices I was looking for were the ability to look at my claims history and status along with prescriptions (if part D included), news re your plans, news beneficial to your health, easy direct contact, etc. Many more questions were asked -- above were ones that mattered the most.

Bottom-line: You have a 6-month window to select a Medicare Supplement plan at age 65. Only during this windos will you be able to obtain a plan WITHOUT underwriting nit-picking though you past medical issues. Here in Texas, insurance companies can look back TWO years for pre-existing conditions. BEWARE: Obamacare's implementation of pre-existing conditions does NOT take effect until 2014 except for this windows and for people under 19. Despite them not basing their selection during the window on questions to you about past health (they can't ask you on an application), they can review medical databases and come back and ask you and then DELAY coverage for pre-existing conditions. Usually this won't happen if you had creditable insurance before applying for Medicare Supplement. HOWEVER, if you miss the window or later want to switch to a different Supplement plan, you are back in the underwriting game as before!

Hopw this was helpful. I realize this is so-o-o high level. Do your homework and list your Peace-of-Mind requirements FIRST.