# Two questions about high deductible plan f.



## Erika (Nov 28, 2018)

Good morning,

   I'm hoping someone can answer a couple of questions I have about Medigap High Deductible plan F. The first is: I am in NYS,. Can you only renew the same plan and not upgrade to a higher coverage plan without medical underwriting?

  The second is if you have to go to the hospital say between December 29th and Jan 5th, does the whole high deductible start over again in the next year with the same hospital stay?  Any help would be appreciated as I need to make a decision soon. High deductible plan f seems to be the way to go but I just wanted clarification on these 2 things.

           Thank You, Erika


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## GreenSky (Nov 29, 2018)

New York has different rules and I'm not 100% sure of this but I thought you could get a supplement without medical underwriting pretty much anytime.  So if that's true you can "upgrade" your plan.

Your concern over two deductibles is valid.  Hospital admission 12/29 for cancer surgery.  You likely will hit the $2,300 deductible.  Chemo starting in Jan means you have another $2,300 deductible.  

Obviously that's not a typical scenario but certainly possible.  So be sure you can afford $4,600.

However, for most people HDF is the best value in a plan.  But too many are concerned about the deductible and fail to factor in the typical $1,200+ difference between HDF and (my favorite) Plan N.

Hope that helps a bit.

Rick


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## Erika (Nov 29, 2018)

Thank you GreenSky for your help. I read many of your posts last year when I was trying to decide what to get. It was a big help. As far as hospital stay I was really wondering about a continous stay of dec29th thru jan 5.  I have had high ded plan f  this year as it is so much cheaper than the n plan which I have for my husband. I really wanted to switch him to it as well. Planning on setting aside the deductible in emergency fund just in case. I called the agent I went thru last year with these questions but all I get is an answering machine. Could have been the storm. I know it's busy this time of year as well.


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## mathjak107 (Nov 30, 2018)

i have a high deductible f-plan in nys .  we have saved so much by having it .  we pay 91 a month for the humana plan . they participate in silver sneakers so  they pay my gym which i was paying 40 a month for directly .

together my wife and i  add up to about 500 bucks in stuff that would have been covered under a regular f plan . but we would pay almost 2k more a year each for that . so it is not worth it .

you can switch in ny only at enrollment time with no under writing. there are only a few states that offer no medical under writing but we pay very high premiums here in ny because we have no age based increases  and no  underwriting to switch . most of the country i s age based and require under writing .


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## Erika (Nov 30, 2018)

Thank You mathjak for your reply. My high deductible f plan will be $58.00 a month. No silver sneakers. No gym within 20 miles. I want to switch over my husband because he paid $150.50 per month for plan n and never went to a doctor so hopefully he/ we won't need to this coming year either. People complain about many things in NYS, but I am glad that there is no age based increase and no underwriting. It leaves you able to change to a different plan if you suddenly become unhealthy.


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## GreenSky (Nov 30, 2018)

Erika said:


> Thank You mathjak for your reply. My high deductible f plan will be $58.00 a month. No silver sneakers. No gym within 20 miles. I want to switch over my husband because he paid $150.50 per month for plan n and never went to a doctor so hopefully he/ we won't need to this coming year either. People complain about many things in NYS, but I am glad that there is no age based increase and no underwriting. It leaves you able to change to a different plan if you suddenly become unhealthy.



The drawback to community rating is that young people pay the same as 90 year olds.  It's great if you're 90; not so much if you're 65.

I'm making it my "quest" to change the law here in Nevada to allow for the same birthday rule that CA and OR have adopted.  It says if you have a current plan you can switch to the same or lesser on your birthday without medical questions.  It hasn't impacted rates much but allows people to get out of companies that have a habit of huge increases (are you listening Mutual of Omaha?).  When I talk to people in CA I don't even bother asking about their healthy until I know I can save them money (which is about 80-90% of the time).  Then if they have any issues my next question is "When is your birthday?"

It's a great system and allows someone to have "portable insurance".

Rick


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## mathjak107 (Nov 30, 2018)

GreenSky said:


> The drawback to community rating is that young people pay the same as 90 year olds.  It's great if you're 90; not so much if you're 65.
> i agree , it sucks that we are so high here , but the good thing is now we caNevada to allow for the same birthday rule that CA and OR have adopted.  It says if you have a current plan you can switch to the same or lesser on your birthday without medical questions.  It hasn't impacted rates much but allows people to get out of companies that have a habit of huge increases (are you listening Mutual of Omaha?).  When I talk to people in CA I don't even bother asking about their healthy until I know I can save them money (which is about 80-90% of the time).  Then if they have any issues my next question is "When is your birthday?"
> 
> It's a great system and allows someone to have "portable insurance".
> ...



i agree , it is more expensive , but the good thing is we have no under writing .


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## mathjak107 (Dec 1, 2018)

Erika said:


> Thank You mathjak for your reply. My high deductible f plan will be $58.00 a month. No silver sneakers. No gym within 20 miles. I want to switch over my husband because he paid $150.50 per month for plan n and never went to a doctor so hopefully he/ we won't need to this coming year either. People complain about many things in NYS, but I am glad that there is no age based increase and no underwriting. It leaves you able to change to a different plan if you suddenly become unhealthy.



however you have to hope it coincides with open enrollment to switch .  it was like my co-workers wife got breast cancer and they had to wait until open enrollment to switch so they had to eat the thousands in out of pocket on the advantage plan


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## Erika (Dec 1, 2018)

I just found this  https://www.dfs.ny.gov/consumer/caremain.htm  It seems you can enroll at any time in NYS but... there can be a wait of up to 6 months for a preexisting condition. So that protects ins. companies from people getting lesser plans until they get sick.


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## Erika (Dec 1, 2018)

GreenSky,   What is the average cost for high deductible plan f  and plan n there? The problem with rates going up as you get older is you are less able to afford them.


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## mathjak107 (Dec 1, 2018)

Erika said:


> GreenSky,   What is the average cost for high deductible plan f  and plan n there? The problem with rates going up as you get older is you are less able to afford them.



study after study shows  as we age , we go from the go go years early in retirement , to the slow go years where we no longer do or buy what we used to , to the no go years .

we tend to spend more in the go go years , then spending tends to fall off a cliff in the slow go years , in which case a lot of what goes up is offset by what we no longer buy or do . then spending  ramps up gain as medical goes up in the no go years .

studies show retirees spend a lot less than they think they will because we do tend to spend in a smile shape .


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## GreenSky (Dec 1, 2018)

Erika said:


> GreenSky,   What is the average cost for high deductible plan f  and plan n there? The problem with rates going up as you get older is you are less able to afford them.



Average cost depends on the area.  However, in the Los Angeles area a 65 year old can expect to pay about $32.  At 80 it is $67.  But that doesn't take into account potential annual increases that affect all plans.

Rick


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## Flyagent (Dec 18, 2018)

So far as a plan underwriting it depends on the the plan even if you up grade some plans you don't need to go there underwriting


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## Pauline1954 (Mar 16, 2019)

Thats a great idea for changing on the birthdate day.  I hope it works out.


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