topic Re: Anyone know if other Medigap Insurance do mid-year increases like UHC? in Medicare & Insurance

Anyone know if other Medigap Insurance do mid-year increases like UHC?

Ghaeilge1975 — Fri, 12 Jul 2024 06:58:38 GMT

Hi,

Rather new to Medigap and have United HealthCare's Medigap Plan G. This is the second year I got the increase letter for mid-year and another increase in Jan 2025.. Do other Medigap insurance companies also do Mid-year increases? Thank you.

Re: Anyone know if other Medigap Insurance do mid-year increases like UHC?

GailL1 — Sat, 13 Jul 2024 23:49:56 GMT

IN GENERAL - not specific to any plan: It depends on the reason that your premiums are rising- for inflationary reasons, it is usually once a year but if you are getting a declining discount, that might be done at a different time like on your coverage anniversary. OR if the company uses attained age as a rating method, then as the beneficiary gets older, the premiums rise - usually around their birthday.

The Federal government does not get involved in the pricing of Medigap plans - they only design the coverage parameters for each of the letter identifying plans. Your state government (usually the dept of insurance or finance) can regulate Medigap plans and make them more lenient as to who can purchase one (like those who are on Medicare because of a disability and are younger than 65) or make it easier for a beneficiary to change or switch plans. Both of these reasons can make specific plans much more expensive. Some states review any increase in premium increase or at least ask the insurer to state their reasoning. OR if you have a community rated plan (which I think most AARP-UHC supplemental plans are) then the price you pay is the same for everybody - younger and older/ well and sick are just figured in with everybody to come up with the premium.

Medigap coverage is NOT medical insurance - it is more financial protection insurance since our Medicare program does not set an annual or lifetime out of pocket limit - so a Medigap plan protects a beneficiary’s financial exposure to Medicare covered expenses under Part A and Part B.

Since in recent years, insurers have been exposed to the conditions brought about by the Covid Pandemic, which is still ongoing with conditions of long-covid. and with new approved therapies for expensive treatments and monitoring for diseases like Alzheimers which is being covered by Part B - to name just a few - then you can look for Medigap premiums to rise with more utilization of traditional Medicare.

Remember Covid care was covered by the government during the Pandemic but now not so - Medicare utilization was also way down during the Pandemic - people just did not go to the doctor if it wasn’t absolutely necessary - mot so now, we are back to booking doc appointments - lots of specialist too because traditional Medicare has no rules on a required referral to a specialist.

Having a Medigap is not required for traditional Medicare - it may be required for your financial concern but many people do not have a Medigap plan - half of those on Medicare use a Medicare Advantage plan. Or they may have other coverage to pick up some or all of their part of their traditional Medicare out of pocket cost - like MediCAID or military/veteran coverage or something else.

Just remember that every beneficiary in the same Medigap pool with you will continue to get older and with that perhaps sicker - so they may use their Medicare benefit more and more as the years gos by - and with that . . . . . higher Medigap premiums. No way around it.

It is what it is - Would you rather have traditional Medicare establish an annual out of pocket limit so we could do away with Medigap plans or at least modify them. I read some study from a university a while back and it said this figure would be about $8500 a year currently.

I am a nobody - not an agent, just a beneficiary like you. I’ve just been around Medicare for a very long time - take what you want and leave the rest.

Re: Anyone know if other Medigap Insurance do mid-year increases like UHC?

Ghaeilge1975 — Sun, 14 Jul 2024 04:41:21 GMT

Gail, Thank you for the info.

Thinking about switching to another Medigap insurance during open enrollment.

This year my Plan G United Healthcare went up 12% for mid-year (Aug) and then in Jan 2025 goes up another 4.5%.

Re: Anyone know if other Medigap Insurance do mid-year increases like UHC?

GailL1 — Sun, 14 Jul 2024 19:20:03 GMT

@Ghaeilge1975

You don’t have to wait for the annual Open Enrollment to change a Medigap plan - Annual Open Enrollment is only for Medicare Advantage plans and/or Prescription Drug plans.

Medigap enrollment is always best during the initial enrollment period - That's called the Medigap Open Enrollment period - that’s when all beneficiaries have guaranteed issue rights. Past that period unless you live in a state that has expended these guaranteed issue right, you maybe subject to medical underwriting which would raise the premium charged for coverage. OR the sponsor insurance company could disallow coverage for a pre-existing condition for a specific amount of time. OR they could refuse to cover you at all -

So what I am trying to say is know the program and the state and federal rules dealing with it. And whatever you do, don’t cancel one until you have the new one finalized by paying your 1st premium and you have the new insurers’ Explanation of Benefits in hand - issued with your name. Some links for you - Also make sure you understand if there is anything special about a Medigap policy in the state where you reside especially IF they have broadened the definition of guaranteed issue rights at the state level.

Medicare.gov - Medigap- Get Started

Medicare.gov - Get Medigap Cost

Medicare.gov - Your Medigap Open Enrollment Period

Medicare.gov- Can I Change my Medigap policy ?

Medicare.gov- Medigap - Guaranteed Issue Rights - Get Ready to Buy

Good Luck ~ Let us know how it works out for you.

Re: Anyone know if other Medigap Insurance do mid-year increases like UHC?

mem2002 — Wed, 07 Aug 2024 19:48:34 GMT

Increasing rates is one hazard that seems unavoidable no matter which insurance company you go with, due to medical inflation, higher claims, and advancing age. But an even bigger hazard (and possibly avoidable) is mentioned in this thread:

https://community.aarp.org/t5/Medicare-Insurance/Does-AARP-s-branding-agreement-with-UHC-for-Medigap-plans/m-p/2565150#M9610

Some insurance companies are notorious for playing the game mentioned in this post.

Re: Anyone know if other Medigap Insurance do mid-year increases like UHC?

Ghaeilge1975 — Wed, 07 Aug 2024 20:19:22 GMT

Thank you - good info I didn't know about.

Re: Anyone know if other Medigap Insurance do mid-year increases like UHC?

GailL1 — Thu, 08 Aug 2024 23:34:21 GMT

The important word in your post is SOME -

Re: Anyone know if other Medigap Insurance do mid-year increases like UHC?

mem2002 — Fri, 09 Aug 2024 18:02:13 GMT

You may find the following links helpful in educating yourself about Medigap insurance companies and rate increases:

Medigap Shopping: Closing the Book & Rate Increases [Early-Retirement.org]

What Medicare Supplement Companies are Hiding! [YouTube.com]

Your Medicare Supplement Premium Will Increase! (This is why) [YouTube.com]

Plan Blocks Closing? [Reddit.com]

There are some interesting retiree anecdotal experiences over at Boggleheads.org as well if you search on these topics.

Re: Anyone know if other Medigap Insurance do mid-year increases like UHC?

GailL1 — Wed, 11 Sep 2024 16:01:27 GMT

@mem2002

After thinking about this “closed book” subject again - it dawned on me that the discontinuance of certain Medigap plans by CMS - like Plan F - has the same effect as a closed book plan.

That is to say that premiums will rise just because no new / younger / healthier beneficiaries are allowed into the discontinued plan to balance out the older and possibly sicker - thus as the discontinued plan marches on in time, those still in it will be affected by increasing premiums because the plan is now only filled with older and possibly sicker beneficiaries.

So closing of plans by CMS or closed book on a plan by the insurer really has the same effect on premiums. The dollar bleed has to be stopped and that what both of these entities are thinking about when they close a block (insurer) or a plan (CMS).