It’s open enrollment season for Affordable Care Act health insurance! Here are 11 things you need to know.

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Re: Plan F or Plan G

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Message 1 of 11

Keeping my plan F-AARP is $50/month more than my insurance company when I compared premiums.

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Bronze Conversationalist
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Re: Plan F or Plan G

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Everything will be done to get you off Plan F because they want to eliminate it. Personally I've been very happy with Plan G- it's cheaper and is $185 more in cost than F- I don't have to pay anything after that first $185 with G- so far other than that initial additional charge it seems to be the same as F. Still, if you can afford F it's WAY better than a Medicare Advantage plan. My advisors told me to stay away from the Part C plans unless I can't afford the premiums because of all the co-pays and deductibles.

 

Anybody else noticed how heavily the insurances are pushing the Advantage Plans this year? I've gotten LOTS more "invitations" to switch.

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Re: Plan F or Plan G

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Message 3 of 11

well I did get my pricing for plan F next year and it is 25% more than the price I paid in 2018-9 increase. I do plan to keep it as they say grandfathered in. where I worked they have a plan but they are all the advantage plans. they dropped plan F in 2017 on me and changed to the CALPERS insurance plans. since I do not live in the state where CALPERS is any more I am going to keep plan F and pay for prescriptions. I like plan F and the fact I can go anywhere to anyone any time. I did not like plan G when I looked at it.

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Re: Plan F or Plan G

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Message 4 of 11

@GailL1 Nobody can really say because we don't know who is keeping their old plan ( C or F) - how many people or their condition.

 

People try/want to change Medigap plans for only one reason.

 

The premium increased.

 

Previously discontinued plans, by the carrier or forced by Medicare, will  never have new entrants.

 

That is a fact.

 

Eventually most will want to change plans. Many of those with plan J would have liked to change but did not.

 

J offered 3 benefits not included in F. Otherwise the plans are identical.

 

J had a nominal drug benefit. Those who still have the J plan and want to enroll in a Part D plan will incur a late enrollment penalty.

 

J also had a preventive care benefit, with a $120 cap. No longer needed since the annual wellness exam is not subject to the B deductible, and generally covered at 100% with no cap.

 

And J had a $1600/year benefit for at home recovery.

 

Quite a few become attached to their Medigap plan for reasons that go beyond financial. Usually esoteric reasons such as "my plan always pays my claims".

 

ALL plans pay claims and the claims are normally paid within 5 business days of receipt of the claim from Medicare,

 

Over the last 40+ years I have seen a lot of carriers exit the market and/or discontinue plans, all with the same results.

 

Premiums increase at a higher clip vs plans that are still active. Economics of a closed block dictates rate increases. The closed block goes into a death spiral. The carrier raises premiums in hopes of driving off the remaining policyholders.

 

When Omaha dropped the N plan from the market in 2011 renewal rate increases were almost always double digit. In many situations the renewal N premiums were higher than current rates for the F plan.

 

While I can't say with absolute certainty what will happen or when with C and F plan renewals I have a pretty good guess. This is based on watching hundreds of plans with dozens of carriers over the last 40 years.

 

This isn't rocket science.


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Re: Plan F or Plan G

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Message 5 of 11

@easyed598 

I can only tell you what happened to my mother.

  • She had Plan J - a very popular plan; she had had it since she turned 65 in the late 80's  - it was discontinued by Medicare in 2010 to those newly eligible.
  • She kept the plan / grandfather - In 2010, her premium were $ 181.00 per month - I still have the records - Boy, do I need to start shredding.
  • She died in Fall, 2012 (age 88, almost 89) and her premiums for this plan at that time were $325.00.

Nobody can really say because we don't know who is keeping their old plan ( C or F) - how many people or their condition.

 

I could have changed my mother's plan back in 2010 or even before - but sometimes it is just as easy to keep what is familiar than to throw a curve ball to someone set in their ways, if you know what I mean.  Plus she had the money so that was not a concern.

 

Guess I can start shredding - I forgot it had been that long - time flies, don't it?!

* * * * It's Always Something . . . Roseanne Roseannadanna
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Re: Plan F or Plan G

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Message 6 of 11

Working in the Medicare space, there's no way any of us can know what will happen to Plan F premiums come 2020 for those grandfathered in. Some agents are trying to get your business by scaring you into switching to Plan G by telling you there WILL BE rate increases, but they don't know that information, none of us do.  But as you did, make sure to do the research! If you're outside your open enrollment period and don't have guaranteed issue, you will have to answer underwriting questions.

Lindsay Engle
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Re: Plan F or Plan G

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Message 7 of 11

Thanks-will probably stick with Plan F for time being because of good will and good service with current provider . Will be $26 /month more than G but when figuring $185 annual deductible it will only cost me about $11/ month more on a yearly basis. Current provider also provides several other financial  services so it is more convenient not to switch and is worth the extra cost for that reason.

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Re: Plan F or Plan G

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Message 8 of 11

re Medigap plans . . . it's your plan and your money. When you pay more you don't get more, you simply paid too much.

 

@easyed598 drug plans changed during open enrollment. Trump won't have a drug plan. Any changes come through Congress and CMS.

 

The proposal is a lot of fluff

https://www.hhs.gov/sites/default/files/AmericanPatientsFirst.pdf

 

Every time DC tries to fix something they make it worse. Part D is no exception. It is program designed by Congress (who will never USE the plan) and administered by insurance carriers.

 

What could possibly go wrong there?

 

Anthem has created a new PBM, IngenioRx, that arrived on the scene 3/2/2019. Allegedly "customer friendly" with rebates going to the consumer, not the PBM.

 

the new PBM will pass along rebates to customers at the pharmacy counter, the company said during an investor presentation. Critics have said that deep rebates on drugs help keep list prices high, which hurts patients who have to pay cash or a share of a drug’s total cost.

 

Medicare is pressuring PBMs including CVS Health Corp.’s Caremark unit, Cigna Corp.’s Express Scripts and UnitedHealth Group Inc.’s OptumRx to give the rebates they get from drug companies directly to patients at the pharmacy counter. Lawmakers have proposed legislation that would require a similar change in private health plans. - Bloomberg

 

Why does DC believe this move will lower prescription drug costs?

 

If you want a lower cost drug plan you will need to do a lot of prep work and be willing to constantly shop new and existing drugs. Look for lower prices with cash vs using your plan.

 

A GOOD insurance broker can help you on the front end (picking a plan). You still have to do the leg work during the year

 

 


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Re: Plan F or Plan G

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Message 9 of 11

Thanks Sumarco for info. --I can`t believe the difference in premiums each Insurance company quotes- I`m happy with my insurance company and Plan F even though they are a little higher than  most but cheaper than some other popular insurance plans. I would also like to get a cheaper Drug plan but will probably wait to see what trump comes with before switching.

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Re: Plan F or Plan G

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Message 10 of 11

@easyed598 Plan F (and C) are indeed going away in 2020 . . . but only for those who are new to Medicare as of 1/1/2020.

 

Existing F and C policyholders are grandfathered. They can keep their plan as long as they pay the premium on time.

 

Consider this.

 

Carrier blocks for plans F & C will be frozen to new entrants after 12/31/2019. Those existing blocks will have folks who are getting older and sicker. In most cases when that happens rates for the frozen class of policyholders generally increase at a higher rate than blocks that still allow new entrants.

 

For several years now most carriers have issued higher new business and renewal rate increases of F vs the next closest plan G. If G rates increased by 5% the F plan for that same carrier would increase by 7%.

 

When asked about why carrier X charges less for the same plan the agent or carrier often has no justification for their higher rate and will make a disparaging remark about the other carrier.

 

I don't know of a single carrier that has increased rates by 30% in a single year. My personal experience with rate history only goes back 10 years so there may have been someone with that kind of rate increase in the past. Every increase since 2010 have been single digit.

 

Most carriers active in the Medigap market for years have offered F as well as G. Some carriers just introduced G in 2018 and have showcased low rates. In almost every situation their F plan is priced in the middle to high.  Do you suppose those low G rates will someday be less competitive relative to the market?

 

Hard to say, but I am suspicious of carriers and agents who were ripping off policyholders for years by pushing a much higher priced F because G was not in their portfolio.

 

To me the most important issue in evaluating a carrier is longevity. How long has the carrier been active in the Medicare market under the same name?

 

In my state there are currently 50 or so carriers offering the G plan (including 3 that did not offer G prior to 2019). Five years ago the number of carriers here was closer to 25. Over the last 5 years we have had around 70 carriers enter and/or leave the market. That's a lot of turnover in a market that SHOULD be predicably stable.

 

At this time there are about a half dozen carriers that have been here at least 5 years under the same name.

 

I have encouraged clients who are healthy to switch from F to G. Almost everyone who could qualify medically have followed that advice and are enjoying the savings.

 

In your case, depending on the condition treated, the 12 month waiting period before you can apply for a new plan may only be with that particular carrier. Some conditions can be underwritten and approved the next month following the surgery. Others may require a 5 year waiting period.

 

And this . . .

 

Plan G has been available with most carriers at least 20 years. And with most carriers, G was ALWAYS a better value than F.

 

Most carriers and agents were too lazy to explain the difference in the two plans. Plus carriers and agents alike make more money pushing the higher priced F plan.

 

You are wise to check around but unless you understand the way the market works you may end up making a costly decision.


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Open Enrollment: Oct 15-Dec 7, 2019 Find resources to help you decide on the best healthcare insurance plans for you during Open Enrollment season

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