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Yes Big AL, anytime you see paid advertising such as your example of Joe Namah that you mentioned, you can be sure there is a profit motive.? However, most if not all Medigap companies advertise their products; the F, G, and N as well as many others are also a for profit business and those usually have changes each year; some offer plans outside the standard dozen or so defined by Medicare.? Here in Alabama one of the most popular plans is by Blue Cross and is called a Blue Cross C+ plan which is defined by Medicare as a "Select" plan. My wife and I have both used it although I am currently experimenting with an Alabama only Advantage plan that has worked perfectly for me this year with no premiums and only $25 for a Specialist visit and free for a PCP.? Meanwhile, I pay $206/month for my wife to have the Blue Cross C+ because she feels more comfortable knowing she has NO copays; i.e. I'm paying $2,400/yr for her to have no Copays; BC will probably pay less than $500/yr for her and pocket almost $2,000 in profit... Remember, Medicare pays 100% of some things, and 80% of the discounted rate on others leaving you or your Medigap plan responsible for the 20% of those that Medicare has to pay the 80% for.? Your Medigap provider is "secondary" meaning they make NONE of the medical coverage decisions and should have NO contact with your providers other than sending them a check for the difference between the 20% copay and your copay, if any.? You will encounter medical providers who say they don't accept certain providers; that is not their decision to make unless they are saying they won't accept Medicare.? Insurance is complex, and providers do a poor job of educating their staff who greet customers coming for service.
Huel? ??
Correct. The government, insurance companies, Joe Nameth, etc have been pushing and incentivizing people to go to Advantage.
Advantage plans are being unfairly subsidized to trick people into a privatized and FOR PROFIT Medicare. That's enough of a
reason for me to turn-and-run and stick with my plan G. Please read NLRN.org for lot more information. Do not trust IBM.
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I went with Plan G knowing I'd have no bills for life for whatever Medicare covers.? And I can go to any doctor that accepts Medicare throughout the USA.??
You can't "guarantee" this with any MA plan.? And now with the new $2000 cap and more positive changes for Part D drug plans, I am feeling a financial security I had not felt before.? Whatever you choose, it may be unlikely you can switch your plan later in life - especially as you age and become more frail. Those extra features in many MA plans are siren songs that are limited and/or extra premium costs.
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"I will certainly consider this United Advantage offering (I'm currently Aetna). But my wife has strict instructions that, should I become seriously ill, to switch me to a medigap as soon as possible."
Unfortunately, your wife is unlikely to be able to execute your instructions. Medigap insurers, are free to decline requests to join their plan(s), because you would not be profitable.
UHC has a large network, but it's much smaller than all of those that accept Medigap policies. In my case, UHC, does not accept my Doctor.
The definitions of Medigap plan types (e.g. Plan F, G, N ...) are all set by Medicare and are very stable. It's easy to shop because every supplier is offering the same thing. Medicare Advantage plans change frequently, and it's very difficult to compare suppliers.
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I thought any doctor that accepts Medicare is valid for UHC doesn't that also apply to hospitals?
Joe Rothengast
On Monday, October 10, 2022 at 12:45:01 PM EDT, hdttraveler@... via groups.io <hdttraveler@...> wrote:
"I will certainly consider this United Advantage offering (I'm currently Aetna). But my wife has strict instructions that, should I become seriously ill, to switch me to a medigap as soon as possible."
Unfortunately, your wife is unlikely to be able to execute your instructions.? Medigap insurers, are free to decline requests to join their plan(s), because you would not be profitable.
UHC has a large network, but it's much smaller than all of those that accept Medigap policies.? In my case, UHC, does not accept my Doctor.
The definitions of Medigap plan types (e.g. Plan F, G, N ...) are all set by Medicare and are very stable.? It's easy to shop because every supplier is offering the same thing.? Medicare Advantage plans change frequently, and it's very difficult to compare suppliers.
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"I thought any doctor that accepts Medicare is valid for UHC doesn't that also apply to hospitals?"
No. My doctor, who accepts Medicare, was not on UHC's list of acceptable doctors, when I checked it on Sept 17.
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Suggestion: Visit the Medicare site at:
Click on the Medicare Advantage Plan button on the right, and you will see that Medicare Advantage plans do not support:
"Use of any doctor or hospital that takes Medicare, across the U.S."
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Suggest you call your State’s Dept. of Insurance & refer to their website to see terms & conditions for Medigap plans that apply to your state. The only 2 ways you don’t need to go thru medical ?underwriting (where they can deny cov or charge higher rate) is at age 65 when you 1st become eligible for Medicare OR within 45 days of losing non Medicare cov, whichever is later. My understanding is that for those of us currently on Medicare, if we switch to IBM’s new UHC MAP & want to change back to a Medigap plan in the future, we’ll need to go thru medical underwriting unless our state offers plans that allow you to do that. In my state (CT), I can but there’s a waiting period & some plans have pre-existing conditions clauses.?
I’m on LTD so finding anyone that understands how this change effects us is next to impossible. The change to Via Benefits in 2014 was a nightmare because they specialize in plans for age 65+. I’ve had to shop & buy my own Medigap plan since then & submit a reimbursement form to access my HRA funding.?
Does anyone have info on how this effects IBMers on LTD? If so, can you post it in new a thread?
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Regarding not going thru underwriting.? Here's a link for the guaranteed issue conditions?
Key here could be the "trial right" of dropping your existing medigap policy to "try" a MAP FOR THE FIRST TIME and within 12 months you want to go back to the SAME medigap plan you left.
This brings to mind what happens if you switch to MAP but don't stop paying your Medigap supplement premiums.? Benefits aren't coordinated and the medigap insurer gets free premium with no risk of paying anything... so could you then drop the MAP after 12 months and as you never quit the supplement policy are you now covered again?? The drug plans automatically cancel, but cautions in some of the early reading material gave reminders to specifically cancel your supplement bringing to question what could happen if you don't.
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I would be most interested in the answer to the slightly altered question,? "so could you then drop the MAP after 60 months and as you never quit the supplement policy are you now covered again?"? My wife and I are both IBM 2nd chancers and we have a total of $80K in 2 HRA accounts.? Since those funds would go poof if we stay with original medicare,? we would not care if the funds are used to pay a medi-gap premiums without coverage.? ?Who can we contact to get an authoritative answer to this question?? If we could do that we would keep the "redundant" medi-gap policy and quit the MAP coverage when our HRA funds are about to run out.? ?
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The Medicare enrollment system would prevent you from having Parts A, B & D when you enroll in a Part C (MAP) since they combine all 3 of those. I’m inclined to stay w/Orig Medicare, medigap & a drug plan this first yr to see how this transition goes for everyone since it appears we can change to the IBM MAP in future yrs & get our $3k funding but if we transition now, we only have 1 chance to revert back within the first 12 mos.
My biggest concern is UHC can remove providers from their network whenever they want & do so AFTER Medicare enrollment ends so your Drs might be in network when you enroll, Jan 1 they’re not & then you’re stuck looking for new Drs willing to accept new Medicare patients. In 2014 UHC dropped 30,000 providers from their MAP network for no reason & many people found themselves in this very position.?
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On Wed, Oct 12, 2022 at 10:39 AM, nancy Spear wrote:
In 2014 UHC dropped 30,000 providers from their MAP network for no reason & many people found themselves in this very position.?
Here is coverage of the UHC action.?. And ignore the # in the headline. I don't know if 30,000 is the right number, but on reading the article it is obviously WAY more than hundreds.? dave?
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You cannot have more than one Medicare plan or supplement at one time.
Suggest you do some searching on Mediare.gov
toggle quoted message
Show quoted text
I would be most interested in the answer to the slightly altered question,? "so could you then drop the MAP after
60 months and as you never quit the supplement policy are you now covered again?"? My wife and I are both IBM 2nd chancers and we have a total of $80K in 2 HRA accounts.? Since those funds would go poof if we stay with original medicare,? we
would not care if the funds are used to pay a medi-gap premiums without coverage.? ?Who can we contact to get an authoritative answer to this question?? If we could do that we would keep the "redundant" medi-gap policy and quit the MAP coverage when our HRA
funds are about to run out.? ?
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Interesting read on 'e health insurance', but can it be trusted???? And should you just eat the extra premium cost? And what is the new procedure to file for reimbursement from FHA converted to HRA funds for basic Medicare premium (the new 2023 rate 164.90 vs the current 170.10) when ViaBenefits goes away?
https://www.ehealthinsurance.com/medicare/coverage/medicare-supplement-and-medicare-advantage-plan-at-the-same-time/
?
"If you enroll in a Medicare Advantage plan and keep your Medicare Supplement insurance plan, keep in mind that your Medicare Supplement insurance plan will not pay any of the Medicare Advantage deductibles, copayments or coinsurance. To keep your Medicare Supplement insurance plan, you will need to continue paying the monthly premium but you won’t be able to use it for health coverage, so it may make sense to drop your Medicare Supplement insurance plan when you begin Medicare Advantage plan.
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You do, however, have a legal right to keep your Medicare Supplement insurance plan after enrolling in a Medicare Advantage plan, even though the Medicare Supplement insurance plan will no longer provide you benefits. If you do cancel your Medicare Supplement insurance plan, you may not be able to get it back. Outside your Medicare Supplement Open Enrollment period, you may be subject to medical underwriting where current or past health problems could be grounds to deny you coverage."
Interesting... would like a definite answer for the basis of "legal right to keep"...
?
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Here's what Medicare has to say about concurrent Medigap and Advantage plans:
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Thank you.? There are those who started years back with Medicare Advantage, were not happy with the coverage but were able to change to a Medigap plan when IBM started up with Via Benefits.? Now IBM is dropping us again (so much for guaranteed retirement medical coverage), this time pushing us to Medicare Advantage.? If we take the MA option due to apparently "favorable"?coverage/cost, we will probably not have a new one time "trial period" even if the MA plan should change to be unsatisfactory.? This "double coverage" option might be worthwhile for those who can afford to maintain the cost of both plans (could be $1500 or more for the year).
Our Plan F has been very worthwhile, but the MA options as now defined would be financially helpful.??
Here's what Medicare has to say about concurrent Medigap and Advantage plans:
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This is really worth looking into! I am currently on Medigap Part G, and it seems to me judging by the verbiage in this document that I could sign up for the IBM Essential Plan at a 0 premium, and then use the freed-up HRA money to pay the Medigap premiums! I realize that I can’t use the Medigap plan while I am using the Advantage plan, but that seems like a small price to pay for freeing up my considerable HRA funds.
Anyone see a problem with this, or know of a rock-solid authority I can contact to get “permission” to do this in writing?
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Question:? With all of these companies fighting to sign us up, just how much do they receive from the federal government for eacg Medicare person they sign up, I guess it is also based on zip code.
Thanks
Joe Rothengast retired in 2011 Started in SBC'68 (NYC) IBM Time-Life Lab (NYC) VM Common System (Kingston) CAC Architect (Kingston) Network Lab Manager (Kingston) Usability (RTP) Router Dev. and Support (RTP) Lenovo (FPT Support)
On Thursday, October 13, 2022 at 12:25:11 PM EDT, Rich Beaudry <richpbg@...> wrote:
Thank you.? There are those who started years back with Medicare Advantage, were not happy with the coverage but were able to change to a Medigap plan when IBM started up with Via Benefits.? Now IBM is dropping us again (so much for guaranteed retirement medical coverage), this time pushing us to Medicare Advantage.? If we take the MA option due to apparently "favorable"?coverage/cost, we will probably not have a new one time "trial period" even if the MA plan should change to be unsatisfactory.? This "double coverage" option might be worthwhile for those who can afford to maintain the cost of both plans (could be $1500 or more for the year).
Our Plan F has been very worthwhile, but the MA options as now defined would be financially helpful.??
Here's what Medicare has to say about concurrent Medigap and Advantage plans:
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First, that happened in 2013. Some of the rules have changed since. Second, the MAPs being offered are PPOs. That allows you to go to doctors who are not in their network as long as they take medicare. If those people had been in a PPO instead of an HMO, there shouldn't have been a problem to continue seeing their doctor as long as the doctor was willing to continue accepting them. You just make a higher co-pay, which in my experience has been $5-$10 more.?
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JoeRoth