Medigap Plan F Woes

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Desmodronic
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Medigap Plan F Woes

Post by Desmodronic »

I was prompted by the recent thread regarding switching Medigap insurance providers (same Plan - Plan G to Plan G) to ask a related question.
My wife and I have been on a Medigap Plan F from the date we signed up for Part B coverage, many years ago. As of January 1, 2020, Plan F is no longer available to new enrollees, which makes it an "orphan" plan. As a result, Plan F participants will become an increasingly older and sicker cohort until the last one dies. This means that the premiums for Plan F participants will increase at a faster rate than those for other plans, and we have seen this ourselves with 20-25% increases the last couple of years (our plan premiums are issue - age rated).

If we seek to enroll in any other plan, say Plan G,we will be subject to medical underwriting, and being considerably older, may not be accepted.
So, it looks like we may be as they say, "attached to the substrate via the use of a screwdriver."

I would appreciate any thoughts on this.
cadreamer2015
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Re: Medigap Plan F Woes

Post by cadreamer2015 »

In California my DW was able to switch from Plan F to Plan G with the same insurer (Blue Cross) without medical underwriting. But this is probably state specific.

You could always move to a different state.
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cheese_breath
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Re: Medigap Plan F Woes

Post by cheese_breath »

My thoughts? You're spot on right.

There were multiple threads here discussing Plans C and F future closure some years ago. DW and I both had BCBS Michigan plan C at the time. I was healthy enough to leave BCBS and get a Transamerica Plan G. DW had many health issues and wouldn't have passed underwriting, but BCBS allowed her to downgrade to Plan N anyway.

Who's your insurer? Maybe they'd allow you to do the same thing.
The surest way to know the future is when it becomes the past.
mhalley
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Re: Medigap Plan F Woes

Post by mhalley »

You can always contact a broker like boomer benefits and see what’s out there. If you can switch, do so, if not, what can you do? But the longer you wait, the more likely you will develop a condition that will cause you to fail underwriting.
bberris
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Re: Medigap Plan F Woes

Post by bberris »

Have you tried switching plans? I don't think insurers expect perfect health. My guess is that if your previous plan payouts would allow them to profit they will take you.

I've been happy with the MSA plan. The premiums on a medigap plan would equal the plan deductible. They have guaranteed issue during open enrollment.
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Sandtrap
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Re: Medigap Plan F Woes

Post by Sandtrap »

Desmodronic wrote: Tue Nov 30, 2021 8:42 pm I was prompted by the recent thread regarding switching Medigap insurance providers (same Plan - Plan G to Plan G) to ask a related question.
My wife and I have been on a Medigap Plan F from the date we signed up for Part B coverage, many years ago. As of January 1, 2020, Plan F is no longer available to new enrollees, which makes it an "orphan" plan. As a result, Plan F participants will become an increasingly older and sicker cohort until the last one dies. This means that the premiums for Plan F participants will increase at a faster rate than those for other plans, and we have seen this ourselves with 20-25% increases the last couple of years (our plan premiums are issue - age rated).

If we seek to enroll in any other plan, say Plan G,we will be subject to medical underwriting, and being considerably older, may not be accepted.
So, it looks like we may be as they say, "attached to the substrate via the use of a screwdriver."

I would appreciate any thoughts on this.
Question:
Would it be worth paying the higher/rising premiums for "Part F" to get the better coverage?

j :D
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cheese_breath
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Re: Medigap Plan F Woes

Post by cheese_breath »

Sandtrap wrote: Wed Dec 01, 2021 9:45 am
Desmodronic wrote: Tue Nov 30, 2021 8:42 pm I was prompted by the recent thread regarding switching Medigap insurance providers (same Plan - Plan G to Plan G) to ask a related question.
My wife and I have been on a Medigap Plan F from the date we signed up for Part B coverage, many years ago. As of January 1, 2020, Plan F is no longer available to new enrollees, which makes it an "orphan" plan. As a result, Plan F participants will become an increasingly older and sicker cohort until the last one dies. This means that the premiums for Plan F participants will increase at a faster rate than those for other plans, and we have seen this ourselves with 20-25% increases the last couple of years (our plan premiums are issue - age rated).

If we seek to enroll in any other plan, say Plan G,we will be subject to medical underwriting, and being considerably older, may not be accepted.
So, it looks like we may be as they say, "attached to the substrate via the use of a screwdriver."

I would appreciate any thoughts on this.
Question:
Would it be worth paying the higher/rising premiums for "Part F" to get the better coverage?

j :D
Better than what? Plan G covers everything Plan F covers except the Part B deductible ($233 in 2022).
The surest way to know the future is when it becomes the past.
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Sandtrap
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Re: Medigap Plan F Woes

Post by Sandtrap »

cheese_breath wrote: Wed Dec 01, 2021 10:41 am
Sandtrap wrote: Wed Dec 01, 2021 9:45 am
Desmodronic wrote: Tue Nov 30, 2021 8:42 pm I was prompted by the recent thread regarding switching Medigap insurance providers (same Plan - Plan G to Plan G) to ask a related question.
My wife and I have been on a Medigap Plan F from the date we signed up for Part B coverage, many years ago. As of January 1, 2020, Plan F is no longer available to new enrollees, which makes it an "orphan" plan. As a result, Plan F participants will become an increasingly older and sicker cohort until the last one dies. This means that the premiums for Plan F participants will increase at a faster rate than those for other plans, and we have seen this ourselves with 20-25% increases the last couple of years (our plan premiums are issue - age rated).

If we seek to enroll in any other plan, say Plan G,we will be subject to medical underwriting, and being considerably older, may not be accepted.
So, it looks like we may be as they say, "attached to the substrate via the use of a screwdriver."

I would appreciate any thoughts on this.
Question:
Would it be worth paying the higher/rising premiums for "Part F" to get the better coverage?

j :D
Better than what? Plan G covers everything Plan F covers except the Part B deductible ($233 in 2022).
Yes.
DW and I were just going over this. Thus. . .my question.

Great info.
Thanks for the help.
j :D
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Topic Author
Desmodronic
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Re: Medigap Plan F Woes

Post by Desmodronic »

Thanks everyone for your thoughts and suggestions. I did a little research and found out why Plan F is no longer open to new enrollees. Congress decided in 2015 that it was "unfair" for some Medicare recipients to have any Medigap plan that paid all deductibles and co-pays (i.e. Plan F). Their solution was to simply close it to new enrollees in 2020. They also were scrounging for money to pay for the "doc fix" without directly raising Medicare premiums.

Is this fair to existing Plan F participants who have been with it for years and now find themselves trapped in a plan whose premiums are bound to increase at a more rapid pace than other plans? I guess I should have picked up on this back in 2015 and switched to another plan then, since I probably could have passed medical underwriting, but probably cannot now.

In any event, I plan to apply to my existing insurer to switch to Plan G, since they have all relevant information as to my medical status at hand, and are already carrying me under Plan F. Worth a shot. Meanwhile, if you are in a similar situation, you might want to think about switching to another plan while you are still medically able.
SuzBanyan
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Re: Medigap Plan F Woes

Post by SuzBanyan »

OP: I hope that your switch is allowed.

My husband is still on Plan F, but switched last year to a Plan F Extra policy with the same provider. The Extra included Silver Sneakers, some vision, dental and hearing aid benefits and a home monitor service. He doesn’t use any of the Extras right now, but switching saved about $50/month. Yes, it does appear to be a bait and switch to move people off the old standard Plan F, though I’m not sure what is in it for the insurer. I expect at some point he will move to Plan G, but he has open enrollment every year as a matter of state law and Plan G does not yet offer enough savings.
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cheese_breath
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Re: Medigap Plan F Woes

Post by cheese_breath »

Desmodronic wrote: Wed Dec 01, 2021 8:43 pm ... I did a little research and found out why Plan F is no longer open to new enrollees. Congress decided in 2015 that it was "unfair" for some Medicare recipients to have any Medigap plan that paid all deductibles and co-pays (i.e. Plan F)...
I thought it was because the subscribers were 'abusing' the Medicare coverage and going to doctors and emergency rooms for each and every little thing since it cost them nothing. Congress wanted them (us) to have some 'skin in the game' first to discourage this.

edit:

Old way... "Ouch I have a splinter in my finger. I'm going to the emergency room."

New way... "I have a splinter in my finger, but I have to pay that deductible before I can get medical help. Where are my tweezrers?"
The surest way to know the future is when it becomes the past.
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CRC_Volunteer
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Re: Medigap Plan F Woes

Post by CRC_Volunteer »

Sandtrap wrote: Wed Dec 01, 2021 10:52 am
cheese_breath wrote: Wed Dec 01, 2021 10:41 am
Sandtrap wrote: Wed Dec 01, 2021 9:45 am
Desmodronic wrote: Tue Nov 30, 2021 8:42 pm I was prompted by the recent thread regarding switching Medigap insurance providers (same Plan - Plan G to Plan G) to ask a related question.
My wife and I have been on a Medigap Plan F from the date we signed up for Part B coverage, many years ago. As of January 1, 2020, Plan F is no longer available to new enrollees, which makes it an "orphan" plan. As a result, Plan F participants will become an increasingly older and sicker cohort until the last one dies. This means that the premiums for Plan F participants will increase at a faster rate than those for other plans, and we have seen this ourselves with 20-25% increases the last couple of years (our plan premiums are issue - age rated).

If we seek to enroll in any other plan, say Plan G,we will be subject to medical underwriting, and being considerably older, may not be accepted.
So, it looks like we may be as they say, "attached to the substrate via the use of a screwdriver."

I would appreciate any thoughts on this.
Question:
Would it be worth paying the higher/rising premiums for "Part F" to get the better coverage?

j :D
Better than what? Plan G covers everything Plan F covers except the Part B deductible ($233 in 2022).
Yes.
DW and I were just going over this. Thus. . .my question.

Great info.
Thanks for the help.
j :D
Plan G will cover some of the cost if you are outside of the USA. Much better than Plan F.
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Doom&Gloom
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Re: Medigap Plan F Woes

Post by Doom&Gloom »

I'm stuck in Plan F hell. So far not too bad, but it seems destined to become hotter.

Better luck to you folks!
BetaTracker
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Re: Medigap Plan F Woes

Post by BetaTracker »

I know this doesn’t help you, but whew … I am so glad we read this forum before signing up my wife two years ago for Plan G! The broker we used tried to sell us on Plan F, but I told her about the warnings I’d read from Bogleheads … in the end, she couldn’t argue with the logic of steering clear of a plan that was closing. She did indicate that switching plans later wasn’t all that difficult and the underwriting wouldn’t be too bad. I don’t know how it might work in your state, but it might be worth a shot to check. You’d think there would be some way they could grandfather you into Plan G, or make it less onerous than someone new just joining up.
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chalet
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Re: Medigap Plan F Woes

Post by chalet »

BetaTracker wrote: Wed Dec 01, 2021 11:28 pm She did indicate that switching plans later wasn’t all that difficult and the underwriting wouldn’t be too bad.

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ModifiedDuration
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Re: Medigap Plan F Woes

Post by ModifiedDuration »

CRC_Volunteer wrote: Wed Dec 01, 2021 10:57 pm
Plan G will cover some of the cost if you are outside of the USA. Much better than Plan F.
Plan F and Plan G both provide the exact same coverage for emergency medical treatment outside the US.
ModifiedDuration
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Re: Medigap Plan F Woes

Post by ModifiedDuration »

Contact a reputable broker, like Medicare Nationwide or Boomer Benefits, and they can walk you through what the best options for someone with your medical history are to switch from Plan F to Plan G.

They will know which insurance companies would most probably accept your application, who has the best price, and the best long-term price stability.

No cost to you, as their commission is paid for by the insurance company.
bradinsky
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Re: Medigap Plan F Woes

Post by bradinsky »

Plans F & G are exactly the same, except with G you pay the deductible of $233 (2022) & you get a less costly monthly premium. Why not just call and ask your insurer about making the switch. At open enrollment, we are able to switch plans without any issue, as long as we stay with our current insurer. No broker required to do this. Changing to different insurer/provider entails medical underwriting & you might contact a broker if you attempt to do this.
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Doom&Gloom
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Re: Medigap Plan F Woes

Post by Doom&Gloom »

bradinsky wrote: Thu Dec 02, 2021 7:59 am Plans F & G are exactly the same, except with G you pay the deductible of $233 (2022) & you get a less costly monthly premium. Why not just call and ask your insurer about making the switch. At open enrollment, we are able to switch plans without any issue, as long as we stay with our current insurer. No broker required to do this. Changing to different insurer/provider entails medical underwriting & you might contact a broker if you attempt to do this.
This apparently varies by state as my insurer would not allow me to switch to their Plan G from Plan F without underwriting.
ModifiedDuration
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Re: Medigap Plan F Woes

Post by ModifiedDuration »

Doom&Gloom wrote: Thu Dec 02, 2021 10:13 am
bradinsky wrote: Thu Dec 02, 2021 7:59 am Plans F & G are exactly the same, except with G you pay the deductible of $233 (2022) & you get a less costly monthly premium. Why not just call and ask your insurer about making the switch. At open enrollment, we are able to switch plans without any issue, as long as we stay with our current insurer. No broker required to do this. Changing to different insurer/provider entails medical underwriting & you might contact a broker if you attempt to do this.
This apparently varies by state as my insurer would not allow me to switch to their Plan G from Plan F without underwriting.
It varies from insurance company to insurance company.

The Medicare Supplement rules guarantee no underwriting in certain circumstances, such as in the Medigap Open Enrollment Period, but if an insurance company wants to give you a policy without medical underwriting outside those guaranteed circumstances, such as if you are an existing policyholder, they can do so.
Last edited by ModifiedDuration on Thu Dec 02, 2021 12:27 pm, edited 1 time in total.
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xplorer
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Re: Medigap Plan F Woes

Post by xplorer »

When we switched from Plan F to Plan G we were told that going through medical underwriting was not necessary whenever downgrading the medicare plan. Matter of fact, we never were subjected to medical underwriting when switching from Plan F to Plan G two years ago. Paying the higher annual deductible was more than offset by the lower monthly premiums for us.
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Re: Medigap Plan F Woes

Post by bradinsky »

xplorer wrote: Thu Dec 02, 2021 12:18 pm When we switched from Plan F to Plan G we were told that going through medical underwriting was not necessary whenever downgrading the medicare plan. Matter of fact, we never were subjected to medical underwriting when switching from Plan F to Plan G two years ago. Paying the higher annual deductible was more than offset by the lower monthly premiums for us.
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Grasshopper
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Re: Medigap Plan F Woes

Post by Grasshopper »

BCBS of Arizona, let me switch from F to G without underwriting when F was closed a couple of years ago.
Chuckles960
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Re: Medigap Plan F Woes

Post by Chuckles960 »

cheese_breath wrote: Wed Dec 01, 2021 10:44 pm I thought it was because the subscribers were 'abusing' the Medicare coverage and going to doctors and emergency rooms for each and every little thing since it cost them nothing. Congress wanted them (us) to have some 'skin in the game' first to discourage this.

edit:

Old way... "Ouch I have a splinter in my finger. I'm going to the emergency room."

New way... "I have a splinter in my finger, but I have to pay that deductible before I can get medical help. Where are my tweezrers?"
That was probably the intent, but it is not all that different with Plan G. I don't think $203 ($233 next year) significantly discourages wasteful behavior. The deductible is used up very quickly unless you are extremely healthy, and after that everything is free again.
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Eagle33
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Re: Medigap Plan F Woes

Post by Eagle33 »

Grasshopper wrote: Thu Dec 02, 2021 5:11 pm BCBS of Arizona, let me switch from F to G without underwriting when F was closed a couple of years ago.
Looking quickly at What Are Medicare Supplement Plans in Arizona?, your medigap insurance company probably wanted to leave the AZ Plan F market because it was shrinking and that resulted in a Special Enrollment Period for medigap for that insurance company. I'm in another state and our SHIP person said that insurance companies can choose to stop offering a plan, or can decide to offer a plan in a area that they have not done so in the past, or just want to increase their market share in that area and they will eliminate underwriting requirements for a period of time. But there is no way to know this in advance.
water2357
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Re: Medigap Plan F Woes

Post by water2357 »

When the ACA was passed it should have gotten rid of medical underwriting for everyone, not just those under 65. It leaves the most vulnerable subject to medical underwriting the one thing that the ACA touted as getting rid of for everyone else. The insurance companies want to force everyone into Medicare Advantage which was set up specifically so the insurance industry would be paid an incentive to open these plans and so they could acquire more profit. The problem with Medicare Advantage plans are the often limited networks and the lack of coverage out of area. Providers drop out of these plans all the time.

An insurer will often let you down grade your Medicare Supplemental coverage without medical underwriting, that benefits the insurer. Some states have laws that allow more latitude to change Med Supp plans, i.e. upgrade or go to another insurer. Otherwise you are stuck with the federal regulations that only allow switching plans in very, very limited circumstances. And the Medicare open enrollment period each year really only applies to Medicare Advantage and Drug Part D plans, it means nothing for Med Supp. You can drop Medicare Advantage during that open enrollment, but you won't be able to ever get a Med Supp plan to go with your Medicare Part A and B, unless you can get through medical underwriting and also pay the much higher premium for not starting Med Supp coverage at age 65 during you one and only Med Supp open enrollment period based on federal regulations.

And if you do join a Medicare Advantage plan, be very wary of signing up for a separate Part D drug plan, as soon as you do it is assumed that you are dropping Medicare Advantage, The insurer will drop you and you revert to original Medicare Part A and B. And as stated above you are not going to be able to pick up a Med Supp (Medigap) plan without medical underwriting, if at all.
grok87
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Re: Medigap Plan F Woes

Post by grok87 »

water2357 wrote: Sat Dec 04, 2021 6:54 am When the ACA was passed it should have gotten rid of medical underwriting for everyone, not just those under 65. It leaves the most vulnerable subject to medical underwriting the one thing that the ACA touted as getting rid of for everyone else. The insurance companies want to force everyone into Medicare Advantage which was set up specifically so the insurance industry would be paid an incentive to open these plans and so they could acquire more profit. The problem with Medicare Advantage plans are the often limited networks and the lack of coverage out of area. Providers drop out of these plans all the time.

An insurer will often let you down grade your Medicare Supplemental coverage without medical underwriting, that benefits the insurer. Some states have laws that allow more latitude to change Med Supp plans, i.e. upgrade or go to another insurer. Otherwise you are stuck with the federal regulations that only allow switching plans in very, very limited circumstances. And the Medicare open enrollment period each year really only applies to Medicare Advantage and Drug Part D plans, it means nothing for Med Supp. You can drop Medicare Advantage during that open enrollment, but you won't be able to ever get a Med Supp plan to go with your Medicare Part A and B, unless you can get through medical underwriting and also pay the much higher premium for not starting Med Supp coverage at age 65 during you one and only Med Supp open enrollment period based on federal regulations.

And if you do join a Medicare Advantage plan, be very wary of signing up for a separate Part D drug plan, as soon as you do it is assumed that you are dropping Medicare Advantage, The insurer will drop you and you revert to original Medicare Part A and B. And as stated above you are not going to be able to pick up a Med Supp (Medigap) plan without medical underwriting, if at all.
thanks, that's helpful
RIP Mr. Bogle.
ModifiedDuration
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Re: Medigap Plan F Woes

Post by ModifiedDuration »

water2357 wrote: Sat Dec 04, 2021 6:54 am When the ACA was passed it should have gotten rid of medical underwriting for everyone, not just those under 65. It leaves the most vulnerable subject to medical underwriting the one thing that the ACA touted as getting rid of for everyone else. The insurance companies want to force everyone into Medicare Advantage which was set up specifically so the insurance industry would be paid an incentive to open these plans and so they could acquire more profit. The problem with Medicare Advantage plans are the often limited networks and the lack of coverage out of area. Providers drop out of these plans all the time.

An insurer will often let you down grade your Medicare Supplemental coverage without medical underwriting, that benefits the insurer. Some states have laws that allow more latitude to change Med Supp plans, i.e. upgrade or go to another insurer. Otherwise you are stuck with the federal regulations that only allow switching plans in very, very limited circumstances. And the Medicare open enrollment period each year really only applies to Medicare Advantage and Drug Part D plans, it means nothing for Med Supp. You can drop Medicare Advantage during that open enrollment, but you won't be able to ever get a Med Supp plan to go with your Medicare Part A and B, unless you can get through medical underwriting and also pay the much higher premium for not starting Med Supp coverage at age 65 during you one and only Med Supp open enrollment period based on federal regulations.

And if you do join a Medicare Advantage plan, be very wary of signing up for a separate Part D drug plan, as soon as you do it is assumed that you are dropping Medicare Advantage, The insurer will drop you and you revert to original Medicare Part A and B. And as stated above you are not going to be able to pick up a Med Supp (Medigap) plan without medical underwriting, if at all.
Excellent summary.

One additional point is that you have Trial Rights to try Medicare Advantage for up to 12 months and have a Guaranteed Right to switch back to Traditional Medicare with a Medigap within that 12 month period, with no medical underwriting and at the lower Guaranteed Issue premium.

You can either do this at age 65 or after you already have a Medigap plan (in the second case you have to go back to the original Medigap plan you had to avoid medical underwriting and get the lowest premium).

You only have Trial Rights to try Medicare Advantage once.

Some states have different (more lenient) rules.
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Re: Medigap Plan F Woes

Post by CRC_Volunteer »

ModifiedDuration wrote: Thu Dec 02, 2021 7:07 am
CRC_Volunteer wrote: Wed Dec 01, 2021 10:57 pm
Plan G will cover some of the cost if you are outside of the USA. Much better than Plan F.
Plan F and Plan G both provide the exact same coverage for emergency medical treatment outside the US.
The reason for my statement, is that the health insurance navigator (ViaBenefits) my former employer uses, this was one of the highlighted differences.
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ModifiedDuration
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Re: Medigap Plan F Woes

Post by ModifiedDuration »

CRC_Volunteer wrote: Sat Dec 04, 2021 8:44 am
ModifiedDuration wrote: Thu Dec 02, 2021 7:07 am
CRC_Volunteer wrote: Wed Dec 01, 2021 10:57 pm
Plan G will cover some of the cost if you are outside of the USA. Much better than Plan F.
Plan F and Plan G both provide the exact same coverage for emergency medical treatment outside the US.
The reason for my statement, is that the health insurance navigator (ViaBenefits) my former employer uses, this was one of the highlighted differences.

The Medicare website shows which Medigap plans offer emergency medical treatment outside the US, both plans F and G being among them.

80% coverage, up to a lifetime maximum of $50,000, with a $250 annual deductible.

https://www.medicare.gov/supplements-ot ... gap-travel
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CRC_Volunteer
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Re: Medigap Plan F Woes

Post by CRC_Volunteer »

ModifiedDuration wrote: Sat Dec 04, 2021 8:55 am
CRC_Volunteer wrote: Sat Dec 04, 2021 8:44 am
ModifiedDuration wrote: Thu Dec 02, 2021 7:07 am
CRC_Volunteer wrote: Wed Dec 01, 2021 10:57 pm
Plan G will cover some of the cost if you are outside of the USA. Much better than Plan F.
Plan F and Plan G both provide the exact same coverage for emergency medical treatment outside the US.
The reason for my statement, is that the health insurance navigator (ViaBenefits) my former employer uses, this was one of the highlighted differences.

The Medicare website shows which Medigap plans offer emergency medical treatment outside the US, both plans F and G being among them.

80% coverage, up to a lifetime maximum of $50,000, with a $250 annual deductible.

https://www.medicare.gov/supplements-ot ... gap-travel
Thank you.
"Let me explain. No, there is too much. Let me sum up." (Inigo Montoya) | | 65/30/05 | 53% VTSAX | 12% VTIAX | 30% VAIPX | 5% CASH
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