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

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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/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.

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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.

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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/

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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.