Sunday, October 13, 2013

IBM Medicare More thoughts on Medigap Plans

Yesterday I spent about hour helping a friend understand more about how to pick replacement insurance plans to replace his IBM Medical and drug Supplemental plan that he had for himself and his wife.  After talking through the differences between a Medicare Advantage plan and Original Medicare - he decided he wants the flexibility of Original Medicare + a medigap + part D for both him and his wife.
First, we went to and looked at part D drug plans in his zip code.  He takes no drugs so it was easy to pick a plan for him.  He will buy the cheapest drug plan available.  Then we looked at a plan for his wife who has expensive prescriptions and picked a plan for her that covers her drugs.  We next looked at to see if both plans were offered by EH and they are which was great news!  That means he can buy at least two plans through Extend Health, qualify for his subsidy and is free to buy medigap plans from insurance companies with the cheapest premiums in his zip code.
We looked for insurance companies selling medigap plans in his zip code by going to  for the medigap policy finder at the top of the home page.Unfortunately, does not provided policy prices for each insurance company but they do give a price range for all the companies that sell a type of medigap policy in your zip code.  I asked him to get his "Medicare and You" book and we kept it open to the page that has the chart showing the different kinds of medigap plans and what is covered.  He decided to get the F high deductible plan as he rarely goes to the doctor but should something go wrong he will cap his medical cost.  Mostly, he likes that F-HD has the lowest premium.  Extend Health offers the cheapest medigap F high deductible plan available in his zip code, which is, again, great news, so he will also buy his medigap "F high deductible" plan through EH.
However, his wife needs different medigap supplemental coverage because she does have health issues.  He'd love to buy an F no deductible plan for her but the premium cost is too high -  the cheapest plan offered is $206/month premium. It wasn't any better getting an F high deductible plan because the "adjusted premium" of an F high deductible plan was even higher (adding $176/month to the F HD plan premium provided a premium comparison of about $209/month).
 He needed to find a cheaper medigap plan for her that provided "good" coverage.  We looked at other medigap plans with lower premium cost.  He decided the premium price for an "N" medigap plan was a better fit given the lowest premium price offering is $140/month and there is no deductible.  The things N doesn't cover are not important to her.  I told him to call the state SHIP (find your state SHIP by going to to find out exactly who sells the cheapest N policy.  Unfortunately, it's not the the N medigap plan offered by Extend Health.  
When he enrolls through Extend Health he will tell them exactly what part D plans and medigap plans he wants to buy. He knows he will buy 3 policies through EH. For the "N" plan he will ask EH if they sell the plan he wants and tell them the name of the insurance company.  If they can't sell it he will buy the "N" medigap directly from the insurance company.
This was a useful exercise for both of us.  I realized I should have offered more advice about picking the "right" medigap plan when premium affordability is an issue.  My friend is now ready for his call with Extend Health and no longer feels overwhelmed by the whole process.

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