Buying Medigap G, what're your thoughts? AARP plan G plus opinions wanted

[Puff TMD]

I will turn 65 in June of 2024 and plan to start the enrollment process on March 1st of that year. My wife will turn 65 in August of 2025 so we will have a little over a year of fairly high insurance premiums.

I plan to go with a MediGap Supplement Plan G and Plan D.

The Plan D is an easy choice, my broker plugged in my meds and came up with Wellcare Value Script as having the best overall cost when premiums and co-pay amounts are factored in for the meds I take, all of which are generic and have been around many years now.

The Plan G is a bit more of a bugaboo.

Humana Achieve comes in with the best price but of course it does not come with gym membership or any other enhancements. It just meets the requirements of a Plan G product and nothing more, nothing less. I would get a separate dental plan for about $34.00/month.

AARP/UHC has two Plan G products. One is the same as the Human in benefits but the other has enhancements such as gym membership, dental and vision discounts and a 24/7 nurse line. The dental discount is their Dentegra program and the vision is through LensCrafters.

The difference in premiums is about $45.50, about what gym membership costs but with no sign up fee attached. However if the dental discount program works I would not need to buy a separate dental policy, and the typical policy has a $1,000.00 annual benefit limit.

Has anybody got any personal experience with the AARP/UHC product I have described and how has the dental/vision part of the plan worked for you?
Have you used the 24/7 nurse line and was it of any benefit?

 

[HoneyNut]

I have an AARP UHC supplement G plan but I don't think mine has any dental or vision benefits. Maybe I just chose the cheapest that was available the year I started it, or possibly different states offer different versions.

The plan did send me a nurse 24/7 phone number magnet, which I have stuck onto my refrigerator but never used. In the past my employer plan had that feature and my daughter and I had called it sometimes, but every time the advice given was to go get checked out by a doctor.

As far as I can see we can't change once we've started with one, so I guess just be sure it is something you want for the rest of your life.

 

[perplexed]

I have an AARP UHC supplement G plan but I don't think mine has any dental or vision benefits. Maybe I just chose the cheapest that was available the year I started it, or possibly different states offer different versions.

The plan did send me a nurse 24/7 phone number magnet, which I have stuck onto my refrigerator but never used. In the past my employer plan had that feature and my daughter and I had called it sometimes, but every time the advice given was to go get checked out by a doctor.

As far as I can see we can't change once we've started with one, so I guess just be sure it is something you want for the rest of your life.

Do you live in US? I always thought you could change any plan during open enrollment (Oct 7th through Dec 7th) or if you move to another state.How can they make you stay with a plan? That is just odd to me.Maybe part G is different but I know people that have changed.

 

[Puff TMD]

In Oklahoma if you have a MediGap Supplement you can change providers around your birthday with no prequalifications. You can only switch to a plan that is equal or less in value, you cannot upgrade to a better plan.

 

[perplexed]

In Oklahoma if you have a MediGap Supplement you can change providers around your birthday with no prequalifications. You can only switch to a plan that is equal or less in value, you cannot upgrade to a better plan.

Wow that is so wrong to me! So your stuck if you don't like your plan and want to upgrade?

 

[Knight]

You asked abou UHC. Best way to answer is to show you why with our good health using Medicare advantage works for us. We take generic scripts that have zero cost to us. We have them mailed OptumRx calls our doctor ahead of time to refill. No stress for us about running out of our meds.

Review your plan changes
Compare this year to next year to see if any changes to your current plan don't suit your needs for next year.

Your plan name may be changing, but these are the benefits you can count on in the upcoming year.

Change indicator
Your plan
This year
Next year
Plan name
AARP Medicare Advantage Walgreens Plan 1 (HMO-POS) 2023
AARP Medicare Advantage Walgreens from UHC NV-0005 (HMO-POS)2024
Monthly plan premium
$0
$0
Primary care provider
You pay
$0
copay
You pay
$0
copay
Specialist
You pay
$0
copay
You pay
$0
copay
Medical deductible
$0
in-network
$0
in-network
Medical out-of-pocket maximum
$900
in-network
$900
in-network

Your additional benefits
Change indicator
Your benefits
This year

Dental maximum benefit
$3,000
per year
Next year
$4,000
per year
Eyewear allowance
Up to
$300
every year
$300
every year

Hearing aids
You pay
$175
to-
$1,225
copay per device

Next year
You pay
$99
to-
$1,249
copay per device
2023
Fitness program
Renew Active, which includes a free gym membership, plus online fitness classes and brain health challenges.
2024
Renew Active, which includes a free gym membership, plus online fitness classes and brain health challenges.

Over-the-counter (OTC) allowance
2023
$105
per quarter
2024
$75
per quarter

 

[Teacher Terry]

Do not take Medicare advantage. In many states you have to be able to pass medical underwriting if you want to return to a medigap plan and many seniors can’t pass. Most medigap plans cover the same things. Advantage plans have limited networks and I know 2 people only still alive because they could go out of state for the best care. Advantage plans also are allowed to do step therapy and by the time you get to the step you need it’s too late for it to work or you are dead.

There’s some advantage plans that are employer specific for their company’s retirees and those tend to be better. Plus with a serious illness you can end up paying more out of pocket. MA puts money into the insurance company’s pocket by denying care to patients.

 

[stretch5881]

I turned 65 this year. I had found an independent agent to answer my questions. The agency she works for carries dozens of insurance companies.
I went with a plan G also. From what I was told, all companies with this plan are the same. The only difference is that each company charges a different premium.
It's difficult to choose a plan on your own, and everyone chooses a plan with their own reasons in mind. I decided on the one that I did for the low deductible. When something major happens to me, we won't lose the farm. It's a higher premium up front of course.
Advantage plans have a bunch of stuff added that I wouldn't use anyway.

 

[Knight]

Do not take Medicare advantage. In many states you have to be able to pass medical underwriting if you want to return to a medigap plan and many seniors can’t pass. Most medigap plans cover the same things. Advantage plans have limited networks and I know 2 people only still alive because they could go out of state for the best care. Advantage plans also are allowed to do step therapy and by the time you get to the step you need it’s too late for it to work or you are dead.

There’s some advantage plans that are employer specific for their company’s retirees and those tend to be better. Plus with a serious illness you can end up paying more out of pocket. MA puts money into the insurance company’s pocket by denying care to patients.

I don't think a blanket statement of do not take Medicare Advantage is warranted. Advising to check what Medicare plan would work best for an individual in the state they live in makes sense to me.

Except for a $90.00 hospital emergency room visit if needed zero out of pocket cost to my wife & me works because we get fantastic health care service.
The Op asked for info about UHC. I provided actual coverage info, not input about what someone heard about someone not getting care of some kind.

Being on this site has provided me with info/stories about lack of care in some instances in Canada & the UK. No system is 100% perfect.

Example

debodun said:
The last two doctors I've had appointments with used to do a hands-on physical examination. Now it's just an interview style visit. I think they could be missing some important issues doing that.

When my dad started losing weight, my mom would take him to the doctor and the doctor would say, "How are you feeling?" and my dad would say, "Okay." and that was the visit. By the time it was found out what the problem was, he had terminal renal carcinoma.

hollydolly's post #8 in response to Deb's post
welcome to the world of the NHS...

I'm not promoting Medicare Advantage, just pointing out that due diligence is needed to find what works for each individual.

 

[Puff TMD]

Do not take Medicare advantage. In many states you have to be able to pass medical underwriting if you want to return to a medigap plan and many seniors can’t pass. Most medigap plans cover the same things. Advantage plans have limited networks and I know 2 people only still alive because they could go out of state for the best care. Advantage plans also are allowed to do step therapy and by the time you get to the step you need it’s too late for it to work or you are dead.

There’s some advantage plans that are employer specific for their company’s retirees and those tend to be better. Plus with a serious illness you can end up paying more out of pocket. MA puts money into the insurance company’s pocket by denying care to patients.

Yes, the Advantage plans are no advantage to me due to a pre-existing condition.

 

[HoneyNut]

The Plan G is a bit more of a bugaboo.

Have you checked the past price-increase-behavior of the choices you are considering? I think when I was choosing last year, the SHIP office provided a page of info that included an analysis of historical price increases of the various choices, and that was useful to know.

 

[Teacher Terry]

I don't think a blanket statement of do not take Medicare Advantage is warranted. Advising to check what Medicare plan would work best for an individual in the state they live in makes sense to me.

Except for a $90.00 hospital emergency room visit if needed zero out of pocket cost to my wife & me works because we get fantastic health care service.
The Op asked for info about UHC. I provided actual coverage info, not input about what someone heard about someone not getting care of some kind.

Being on this site has provided me with info/stories about lack of care in some instances in Canada & the UK. No system is 100% perfect.

Example

debodun said:
The last two doctors I've had appointments with used to do a hands-on physical examination. Now it's just an interview style visit. I think they could be missing some important issues doing that.

When my dad started losing weight, my mom would take him to the doctor and the doctor would say, "How are you feeling?" and my dad would say, "Okay." and that was the visit. By the time it was found out what the problem was, he had terminal renal carcinoma.

hollydolly's post #8 in response to Deb's post
welcome to the world of the NHS...

I'm not promoting Medicare Advantage, just pointing out that due diligence is needed to find what works for each individual.

There’s many documented cases of people losing their lives because of lack of care due to having advantage plans. Insurance companies get rich while their patients die. The word needs to spread because in many states people can’t switch back to regular Medicare and still be eligible for a medigap plan.

 

[Knight]

There’s many documented cases of people losing their lives because of lack of care due to having advantage plans. Insurance companies get rich while their patients die. The word needs to spread because in many states people can’t switch back to regular Medicare and still be eligible for a medigap plan.

My point is & has been to research what works best for each individual.

This site is about regular medicare & provides info on deaths while using medicare.

Department of Health and Human Services
OFFICE OF
INSPECTOR GENERAL

ADVERSE EVENTS IN HOSPITALS:
NATIONAL INCIDENCE AMONG
MEDICARE BENEFICIARIES
https://oig.hhs.gov/oei/reports/oei-06-09-00090.pdf

This site doesn't cite deaths but denial of claims. I couldn't find a site that gave factual info about the amount of deaths due to denial of a claim.

Rural areas seem to be the thrust of this & other articles about Medicare Advantage. Could be my situation is different because population here exceeds 650k

'Deny, deny, deny': By rejecting claims, Medicare Advantage plans threaten rural hospitals and patients, say CEOs
Medicare Advantage plans "are taking over Medicare and they are taking advantage of elderly patients," said the CEO of one Mississippi facility.

By denying claims, Medicare Advantage plans hurt rural hospitals, say CEOs

I don't think condemning either is in anyone's best interest. I think researching how plans work & what to expect for coverage is needed. It's probably possible to find horror stories about both Medicare & Medicare advantage plans.

Maybe everyone posting back & forth will generate interest by those that want to know to actually research.

 

[RandomName]

You asked abou UHC. Best way to answer is to show you why with our good health using Medicare advantage works for us. We take generic scripts that have zero cost to us. We have them mailed OptumRx calls our doctor ahead of time to refill. No stress for us about running out of our meds.

Review your plan changes
Compare this year to next year to see if any changes to your current plan don't suit your needs for next year.

Your plan name may be changing, but these are the benefits you can count on in the upcoming year.

Change indicator
Your plan
This year
Next year
Plan name
AARP Medicare Advantage Walgreens Plan 1 (HMO-POS) 2023
AARP Medicare Advantage Walgreens from UHC NV-0005 (HMO-POS)2024
Monthly plan premium
$0
$0
Primary care provider
You pay
$0
copay
You pay
$0
copay
Specialist
You pay
$0
copay
You pay
$0
copay
Medical deductible
$0
in-network
$0
in-network
Medical out-of-pocket maximum
$900
in-network
$900
in-network

Your additional benefits
Change indicator
Your benefits
This year

Dental maximum benefit
$3,000
per year
Next year
$4,000
per year
Eyewear allowance
Up to
$300
every year
$300
every year

Hearing aids
You pay
$175
to-
$1,225
copay per device

Next year
You pay
$99
to-
$1,249
copay per device
2023
Fitness program
Renew Active, which includes a free gym membership, plus online fitness classes and brain health challenges.
2024
Renew Active, which includes a free gym membership, plus online fitness classes and brain health challenges.

Over-the-counter (OTC) allowance
2023
$105
per quarter
2024
$75
per quarter

Knight, great synopsis. Easy to read and understand. Thanks.

I never heard of Walgreen's having a MA plan. It looks cheaper than my plan, which is a CapBlueCross HMO.

Have you used your plan yet for anything? No surprises?

 

[Knight]

Knight, great synopsis. Easy to read and understand. Thanks.

I never heard of Walgreen's having a MA plan. It looks cheaper than my plan, which is a CapBlueCross HMO.

Have you used your plan yet for anything? No surprises?

Typically for yearly exams & exams every 4 months as routine follow up to stay on top of any thing that might be of question. Zero cost

In 2018 with the same coverage I had cervical spinal surgery. Surgery room at the hospital, hospital stay, 3 weeks rehab, surgeons fee & meds needed at the time. My total out of pocket was $50.00

This year I had gall bladder pain. $90.00 copay for emergency room visit. The surgery for the gall bladder removal & subsequent discovery of A-fib meant 8 days in the hospital. The gall bladder surgery, the cardiologist fees, the meds, the private room & follow up with both my PCP & cardiologist were zero cost to me.

I understand there are some issues with Medicare Advantage in other places. But for me $140.00 total for two medical needs that were addressed immediately for the amount of care I needed I have no complaints.

I can't express it any other way than to advise people to check what works for them where they live.

 

[HoneyNut]

for the amount of care I needed I have no complaints

I don't have any experience with the Medicare Advantage options, but when I was young (20s, 30s) I had an HMO (Kaiser Permanente, which sounds to me similar to what Advantage is) and I thought it was great while I was young and healthy but as soon as I started needed medical care that wasn't plain vanilla cheap things, the HMO was worse than useless. Luckily (unlike with Medicare), I could switch to a PPO plan.

IMO, only people who have enough money to pay for private treatment should gamble on health programs like HMOs or Medicare Advantage.

 

[Knight]

I don't have any experience with the Medicare Advantage options, but when I was young (20s, 30s) I had an HMO (Kaiser Permanente, which sounds to me similar to what Advantage is) and I thought it was great while I was young and healthy but as soon as I started needed medical care that wasn't plain vanilla cheap things, the HMO was worse than useless. Luckily (unlike with Medicare), I could switch to a PPO plan.

IMO, only people who have enough money to pay for private treatment should gamble on health programs like HMOs or Medicare Advantage.

Are you on a Medicare plan now?

 

[Knight]

I checked with our advisor about plan G. No way we go from zero cost with the kind of excellent coverage we have to something like this.

Plan G is a medicare supplement plan. Meaning that it pays 100% of Hospital part A services and 100% of Hospital Part B services after a $240 medical deductible in 2024. At your age of 82, the monthly premium would be well over $200/mo plus we would need to add a separate prescription plan as Plan G does not help with prescriptions. Nor does it cover extra benefits like dental, vision, hearing, etc. Does that help answer your question?

 

[Michael Z]

I went with plan N that is plan G with a small copay for office visits but a lower premium. I have so few office visits so this was a better deal for me. Also plan N does not cover overcharges, but my agent checked all my doctors and this also was not an issue. For plan N and a separate prescription plan, I pay less than $100 a month. I used United Medicare Advisors to set this all up.

If you go with an Advantage plan, make double sure it is a good one!

 

[Liberty]

Get a good independent agent and go with an economical plan G provider. You probably will need to change providers every few years. We changed this year as our current provider was jacking up the costs.

 

[Michael Z]

Here are some things I learned:

• If you initially go with a Medigap plan, you can always switch to an Advantage plan in the future.
• If you initially go with an Advantage plan, you can not switch to Medigap in the future without underwriting (checking medical history).
• All Medigap plans of a given type without dental and prescription are 100% the same! Your insurance agent does not have to tell you that their plan costs twice as much for the same coverage.
• Often, people have problems with Advantage plans that drop doctors. Nobody ever complains about a Medigap plan other than the increase in premium with age. With Medigap, you see any doctor that accepts Medicare.
• An independent agent can quickly shop around for you to get the best plan at the best rate.

 

[Knight]

Here are some things I learned:

• If you initially go with a Medigap plan, you can always switch to an Advantage plan in the future.
• If you initially go with an Advantage plan, you can not switch to Medigap in the future without underwriting (checking medical history).
• All Medigap plans of a given type without dental and prescription are 100% the same! Your insurance agent does not have to tell you that their plan costs twice as much for the same coverage.
• Often, people have problems with Advantage plans that drop doctors. Nobody ever complains about a Medigap plan other than the increase in premium with age. With Medigap, you see any doctor that accepts Medicare.
• An independent agent can quickly shop around for you to get the best plan at the best rate.

Good info Michael Z.
That's the kind of info people need to be checking before they pick a plan. The state & area of a state might make a difference, rural vs. urban. Quantity of doctors, hospitals all might make a difference. Income might make a difference.
A lot of factors play into making the best choice for an individual. I can't express this enough
research what you think will suit you best.

 

[Jackie23]

I went with plan N that is plan G with a small copay for office visits but a lower premium. I have so few office visits so this was a better deal for me. Also plan N does not cover overcharges, but my agent checked all my doctors and this also was not an issue. For plan N and a separate prescription plan, I pay less than $100 a month. I used United Medicare Advisors to set this all up.

If go with an Advantage plan, make double sure it is a good one!

I also changed plans this year...from plan F to plan N....plan F premium went through the roof...I've also used an agent for the last 4 years.

 

[Knight]

I also changed plans this year...from plan F to plan N....plan F premium went through the roof...I've also used an agent for the last 4 years.

I just looked up

What is Medigap insurance.


What's Medicare Supplement Insurance (Medigap)?

Medicare (.gov)
Welcome to Medicare | Medicare › health-drug-plans › medi...
Medicare Supplement Insurance (Medigap) is extra insurance you can buy from a private health insurance company to help pay your share of out-of-pocket costs ...
‎Get Medigap Basics · ‎Switching Medigap policies · ‎Get ready to buy

I must be very lucky to live where I live to get the kind of excellent care I get at zero cost, except a $90.00 copay IF I need to go to a hospital emergency room. My post #6 shows detailed factual numbers.

I didn't mention that for something other than an emergency there are a lot of urgent care centers that are free for us to use. Those are staffed by board certified doctors.

Can someone explain what the advantage of paying for health care coverage via medigap is.

 

[Michael Z]

Can someone explain what the advantage of paying for health care coverage via medigap is.

With Medigap, you can see any doctor that takes Medicare. No networks. Also, if you start with Medigap, you can switch to an Advantage plan with no medical checkup but once you are on an Advantage plan, you can not switch back to Medigap without disclosing your medical history.