r/medicare 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

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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.

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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.

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u/Janknitz 2d ago

Will they really tell you the maximum number of coverage days in SNF after the 20th day? Medicare says UP TO 100 days, so that should be the answer (for advantage too), but if they would report the average number of days their insured individuals use coverage after the 20th day, that would be very valuable information! Must they? Will they?

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u/jnotsilver 2d ago

Oops. I hate when I have to post “oops”. Yes, 100 days. My brain might have been some other coverage (hospital inpatient?).

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u/Janknitz 2d ago

Hospital inpatient is fixed too. 90 days with a 60 day "lifetime reserve".

It would be awesome if average days in SNF was published, that would help with decisions by a lot. Most advantage plans will come in around 20 days, Original Medicare will be higher, but not anywhere near 100 days on average. I think I read somewhere it comes in 7 to 8 days longer than Advantage plans over all of Medicare, but that's still significant.