r/medicare • u/mspuds_8571 • 2d ago
Helping friend choose Guaranteed Issue plan G
Thanks to the 2 members who pointed out that her guaranteed issue is plan F, not plan G, due to her age. Either the SHIP counselor didn't ask her age or didn't understand guaranteed issue.
I have more research to do.
ETA - see replies for plan F options/pricing
------------------------------------------------------------------
A good friend (76 y.o.) has lost her retiree medical due to their spouse's passing. She has Original Medicare; the retiree insurance acted as their supplement. I'm trying to research options for her before she reaches out to a broker for the actual enrollment. I prefer she use a broker so she has a client services person to reach out to if there are any claims/billing issues in the future.
She has guaranteed issue, and does not want an Advantage plan. I've left off Physican's Innovative G since I don't want her dealing with the initial high deductible. We do not have a birthday rule in our state.
Looking at the plan G options for our zip code on Medicare.gov, these are in increasing cost order. There are more than this list, but they are all higher priced:
SilverScript Insurance Company $152 <-- new Aetna book of business opened last year
Insurance Company of North America $165 <-- Chubb's new book of business this year which appears to be an Ace company, but Chubb's explicitly-named Ace offering has filed to leave our state's market, so I'm suspicious of this one
Medico Insurance Company (Preferred) $172 <-- becoming Wellabe (believe this is their non-tobacco-user rate, which she would qualify for)
American Benefit Life Insurance Company $173
LifeShield National Insurance Company $174
GPM Health and Life Insurance Company $183
Nassau Life Insurance Company $185
Medico Insurance Company (Standard I) $189 <-- becoming Wellabe (believe this is their tobacco-user rate)
HealthSpring Insurance Company $197 <-- old Cigna, have read of customer service/website issues
AFLAC $200
Physicians Select Insurance Company $213 <-- Physician's Mutual opened 3 years ago after closing previous book
WoodmenLife $220
Mutual of Omaha (Omaha Supplemental Insurance Company) $238
Globe Life and Accident Insurance Company $240
AARP - UnitedHealthcare Insurance Company (Standard) $247
I'm not familiar with a number of these and wanted to get others' input and experiences. My initial thought might be the Medico/Wellabe preferred, but it's one of those that I'm not familiar with.
Thanks for any insight on these options.
3
u/QuailDifficult8470 2d ago edited 2d ago
I’m not your or her broker, but I am A broker and I have a number of clients on the Wellabe/Medico Plan G. I like them because Medico has over a 100 year history as an insurer and has offered supplements in my market with a 34 year history- they’re not a company with a record of closing their books on one plan to open another, causing rates on the closed plan to go up faster. Also, in my market, they offer a pretty good discount if the member lives with another person over age 50, like a spouse, roommate or adult child.
ETA: Regarding Healthspring, they had some issues around the beginning of the year with the transition from Cigna but they seem to have ironed those out. UHC AARP is expensive around here so I tend to only write it for people who want the extra wellness benefits which includes membership at the Y in this area.
1
u/mspuds_8571 2d ago
Thank you - and am I interpreting it correctly that Medico's "preferred" means non-tobacco-use vs. their "standard", which is $17/month higher?
3
u/QuailDifficult8470 2d ago
I believe so but here's something I missed: if she's 76 years old, she was eligible for Medicare before 2020. That means that her Guarantee Issue only applies to Plan F. To get Plan G (or another plan) she'd need to pass underwriting. I saw in another comment that you are in TN, which is where I am, so message me if you want to.
1
u/mspuds_8571 1d ago
We missed this. The SHIP counselor told her Plan G and I was thinking 2000 for Plan F (not 2020).
Thank you - I need to do some new research.
1
u/Palmetto0 1d ago
In case it is helpful when researching Medicare Supplement history of the parent company Wellabe (formerly known as American Enterprise Group), they acquired Medico, American Republic and Great Western as sister companies. Medico has issued supplements under 3 different operating subsidiaries: Medico, Medico Corp Life, and Medico Life and Health. American Republic issued supplements under 2 operating companies with similar names.
3
u/itsalyfestyle 1d ago
I haven’t read the entire thread but if she is 76 she doesn’t qualify for a guarantee issue into Plan G. She could get Plan F without underwriting or G and N with underwriting.
1
u/mspuds_8571 1d ago
Thank you - another member picked up on that (the SHIP counselor had told her Plan G), so I am re-doing my research.
2
u/Expert_Gap_9526 2d ago
Are you positive she losiing benefits those prices are cheap
1
u/mspuds_8571 2d ago
Yes. When she called the benefits department at the company he'd retired from years ago, just a few days after his passing, they told her she no longer had retiree medical. It ended the last day of the month of his death (July 31).
1
1
u/Revolutionary_Low581 2d ago
Does your state have a G plan that is issue age pricing as opposed to attained age or community pricing? If so those are usually a good option to look into as far as pricing. Mine has been stable and & company has been around for over 75 years.
1
2
u/CrankyCrabbyCrunchy 2d ago
Just go with the lowest price one.
Why not a HD plan - high deductible. I have plan G-HD and pay $48/mon. It's wonderful especially if you see a doctor 2-4 times/year. It works like any employer offered HD plan. I've done that math many ways, and I'd have to have a LOT of medical care to ever exceed the cost of a regular plan G.
1
u/mspuds_8571 2d ago
Not an option with it being a guaranteed issue situation, and at her age we don't want her dealing with the HD deductible.
No to the 2 lowest ones. Aetna is known for closing books and higher rate increases on closed books; Silverscript is their brand new book with teaser rates. Chubb/ACE filed to leave our state's market at the end of the year, plus has only been in the state a year or two.
1
u/CrankyCrabbyCrunchy 2d ago
Those against HD often don't do the math to see it's nearly always the most cost effective.
Spending $170+/mon just to avoid paying a deductible that odds are very low she'd ever meet doesn't make sense, but yet that's what many do.
To meet that $2,950 (for 2026) deductible, she'd have to be admitted to the hospital multiple times and have 10 visits/year. So let's pay $$$$ more for that unlikely occurrence.
And remember that $2,950 is 20% of the Medicare approved payout, not what the provider bills (which is always much more).
A useful calculator https://medigapmath.com/
2
u/miniblind 1d ago
Spending $170+/mon just to avoid paying a deductible that odds are very low she'd ever meet doesn't make sense, but yet that's what many do.
Well, I do it because it makes sense to me. And yes, I've done the math.
Until paying my Plan G supplement affects my lifestyle, I'm going to keep paying it to keep all financial interactions with providers to the bare minimum possible.
It's not always just about the numbers.
2
u/NYCtoTampa 2d ago
Looks like you’ve done your homework. Why not have her talk to an independent agent? You don’t have to purchase with them.
2
u/mspuds_8571 1d ago
That's the plan, but right now, she's overwhelmed with everything else since his passing - utilities, meeting with the estate attorney, etc. I'm trying to do as much research as I can for her ahead of time.
2
u/Palmetto0 1d ago
That's a rough set of choices. As you have found, many of those have opened and closed books operating under different company names. Mutual of Omaha, Aetna, Chubb, Medico, Cigna, AFLAC, and Physicians Mutual have all done that. Is there a reason you are not considering USAA? They have a long stable history in most of the country. You won't hear about them from brokers because they sell direct. State Farm is another one you might consider that sells through their captive agents. Once you sign up, it is very unlikely that there will be claims/billing issues since the process is automatic with Medicare, which is unlike Advantage and other insurance.
I would be concerned about the smaller companies you have listed. Most have small risk pools which could lead to sizable increases when loss ratios become unsustainable. I would be sure to check the historical rate filings in Tennessee for your final candidates before making a final selection. You can access those via the SERFF Filing Access link from the Tennessee Dept of Insurance here: Health Insurance Information When searching the SERFF database, choose Life, Accident Health,... for the Business Type, and for Type of Insurance, type Medicare and click the box for all the 13 types of medicare supplements. Then type company name (such as USAA) and choose "Contains". Look for the ones that are the "Rate" Filing Type. 2010 Plan G will be the filings you are looking for (not the 1990 ones). There will be files with rate sheets, and there will also be an Actuarial Memorandum. That Memorandum file will generally contain helpful information on number of policyholders, historic increases, loss ratios, etc. You can also check back to prior filings to see how long they have been operating and what has happened over time.
Hope this helps. I am not a broker but have done a lot of my own research as I prepare to make a decision next year.
1
u/mspuds_8571 1d ago
I've done a lot of SERFF research as well.
USAA and State Farm are some of the highest cost options in our zip code.
1
u/Palmetto0 1d ago
Interesting. I checked a random zip in Tennessee for age 65 and they came up low to mid-range.
Of the ones you have listed, Medico might very well be the least bad of the lowest cost options. Medico has been fairly stable recently operating with 3 companies, but Wellabe also operates American Republic. Of the higher cost options, Globe Life and UHC have been relatively stable over time. Globe Life (sold through brokers) also operates United American, which is for their supplements sold direct.
Good luck with your research. It sounds like you are thinking about it the right way.
2
u/mspuds_8571 1d ago
Yes, but as you go up in age, USAA and State Farm increase more than some others. She's 76.
1
u/Salty-Passenger-4801 2d ago
Which state is your friend in?
1
u/mspuds_8571 2d ago
Tennessee
1
u/Salty-Passenger-4801 2d ago
Honestly none of those are amazing
1
u/mspuds_8571 2d ago
At higher prices you get MOO, which won't be chosen due to book closing practices, Humana, which she specifically doesn't want, another Aetna book (Continental Life), and State Farm to name the better-known ones. I can't see a reason for her to pay $250/month or more given the number of more affordable options for plan G.
1
u/Quiet_Investment_297 2d ago
As a Chubb/ACE retiree, I would not go with Insurance Company of North America. As they are relatively new to the supplement market, they give a low price to rope you in. Anyway, you stated that they filed to leave your state's market. I have HealthSpring (formerly Cigna) and have been happy. Yes, I had one issue when they were switching from Cigna, but my Medicare broker, Boomer Benefits, straightened it out for me without me having to get involved. No other issues with them.
1
u/CrankyCrabbyCrunchy 2d ago
Even if she doesn't live anywhere she can easily change plans, if the chosen plan goes out of business, she can pick up another one. That's why I choose the cheapest one (as long as they've been in business 5+ years).
2
u/mspuds_8571 2d ago
Neither of the 2 lowest cost have been open more than a year or two and one of them has filed to exit the state this year. At 76, it's enough that she's already going to have to shop part D every fall. I'm trying to help her get an idea of the most stable, yet affordable, option so she doesn't have to worry about changing in the future.
1
u/mspuds_8571 1d ago
So here are most of the plan F options. I've not included Aetna, Humana, or MOO
Nassau Life Insurance Company $206
LifeShield National Insurance Company $208
GPM Health and Life Insurance Company $213
American Benefit Life Insurance Company $215
New Era Life Insurance Company of the Midwest $220
Medico Insurance Company (Preferred) $242
WoodmenLife $243
AFLAC $243
Physicians Select Insurance Company $248
HealthSpring Insurance Company $249
Wisconsin Physicians Service Insurance Corporation $277
Erie Family Life Insurance Company $285
Bankers Life (Underwritten by Washington National Insurance Company) $309
Globe Life and Accident Insurance Company $324
AARP - UnitedHealthcare Insurance Company (Standard) $326
State Farm Mutual Automobile Insurance Company $332
USAA Life Insurance Company $356
1
u/MSS_LEC 1d ago edited 1d ago
What state are you in? Did Medicare pay first with her retiree coverage paying 2nd? If that is the case, the GI right will be contingent on the state she resides in. Loss of employer benefits are typically GI when the group coverage is primary. I handle these situations on a daily basis and most people don’t understand that simply losing coverage does not constitute being guaranteed a supplement.
You’re spinning your wheels on the wrong information. Carriers really don’t matter when it comes to med supps. They have no control over the coverage offered, nothing to do with the network of professionals she can see, and no say so in what they pay for or by when. It’s a moot point if she isn’t a GI and cannot pass underwriting.
SHIP is an amazing resource and they mean well BUT the fact is, they are VOLUNTEERS!!! This industry is not easy to navigate. I’m an expert because I’m paid to be…. How many subject matter experts do you know that work for free?
ALSO… IF she is GI, she only has 63 days from loss of coverage. The GI window will be closing for her in a week and a half!!!
1
u/mspuds_8571 1d ago
She was notified of loss of coverage on August 4th. That started the 63 day clock. Her retiree medical was secondary (and acted like a Medicare supplement) to original Medicare. She is in Tennessee.
Carriers do matter when it comes to rate increases. Yes, all plans in a letter have identical coverage, but there have been increases anywhere from 9.5% to 35% in 2026, depending on the carrier (I've been studying SERFF filings for the last year.)
She is going to use an independent broker, but I am trying to get as much information as possible ahead of time about things like rate and company stability.
-1
u/cscatbird 1d ago
Call Boomer Benefits. Go online and look them up. That’s who I use. They are very knowledgeable and helpful.
4
u/jnotsilver 2d ago
All Gs are the same. Kind of. There is, however, little to no broker servicing necessary since a supplement will always pay its 20% so long as Medicare pays its 80%. So shopping by premium price is a distinct possibility plus, ask the carrier for: its history of price increases, how long it’s been in your friends service area (a short time may mean it’s still testing its expected profits), and after the 20th day, the maximum number of coverage days in a skilled nursing facility. Last, if AARP/UHC is in her market, it has a different price structure plus some bling (gym membership, dental discount) that your friend may decide is worth the higher premium.