The 2025 High Deductible limit for 2025 has been officially released and it is $2,870 as you can see here from the CMS announcement: www.cms.gov/files/document/cy2025-medigap-high-deductible-options-fjg.pdf This is inline with the typical annual increase to this deductible that we mentioned in the video
@@GiardiniMedicare Thank you. Right now I have HDG in FL but I may move to WA. Not sure it’s good idea to have HDG in WA. Ideal is N, isn’t it? So I’m thinking I should try to change to Plan N before I get sick (right now pretty healthy). I wish I could change when I move there. If it is possible to change to Plan N when I move, my problem will be solved, is there any way to do that?
@@めぐ-n6mCan't think of why having the HDG in Washington would be worse than having it in Florida, but Plan N is always a good plan to consider. In Washington, you are able to change to a different Plan B through N with guaranteed issue, if you are already already enrolled in another Plan B through N. However, we aren't licensed in WA, so we don't know if this applies to changing from the HDG once you move. Here is a good link to a Washington Medicare Supplement guide: www.insurance.wa.gov/sites/default/files/documents/what-you-need-to-know-medigap-plans_4.pdf
Excellent analysis and presentation. Three years ago I signed up for Plan G high deductible thinking of only Hospital costs. This year I was diagnosed with Wet Age Related Macular Degeneration and I go to the Retina Specialist for an injection in the eye every 4 weeks and the injection itself is 2000 dollars each time plus doctor and lab charges costing me $ 420 out of pocket each visit. Contrary to my planning now I have to first meet the 2800 dollar deductible ( ever increasing ) every year. My advice to those who can afford it, just take the Medigap plan G ( the regular one) and be happy.
I really appreciate you sharing your experience! What is described is often overlooked by many when it comes to choosing the high-deductible G. If you are willing to share, do you happen to know the actual billing code for the injection? Would like to include it in future examples if possible.
Cameron, this video is the BY FAR the best compilation of G-vs-GHD-vs-N stats ever; it pulls together information that would've required watching multiple other videos by you and others (which I already have!). It's strange how the "Medicare and You" book practically hides GHD. BTW my spouse and I have chosen N for New York.
Thanks for the feedback! It took me longer than I would like to admit to make this video, so I appreciate it. The HDG is a good value, but you are right that it is somewhat of a "hidden" plan. Medicare certainly barely mentions it, and both brokers and insurance companies don't love selling it.
I really appreciate how honest you are about commissions and explains why it was harder to find a policy. With a well funded HSA, HDG was the way to go for me but many tried to steer me away from it. Being in WA state, I can switch to another medigap plan without a penalty.
Thanks for the informative video. My wife and I live in NYS and are currently on a Medicare Advantage Plan. For a number of reasons, we are planning on switching back to Medicare + a Medigap policy. Given the very high Plan G and N costs in NY, we are currently planning on utilizing the HDG plan. I have done my own 20 cost analysis and it seems that the HDG plan will almost certainly save us a significant amount of money over that 20 year period. As you showed in one of your tables, in NYS, the worst case HDG year (premium + full deductible) essentially is the same as the normal Plan G year right now. And, since the Plan G premiums will likely increase faster than the HDG premiums and deductible, over time it looks as though the worst case HDG yearly costs will become increasingly cheaper than the normal Plan G costs.
Cameron, as with the SERFF video that you did earlier in the year, this video was excellent, excellent!!! Thank you SO much for putting all of this together. If I lived in NY or FL, I'd definitely go with the HDG plan. The analysis in your video confirmed for me that I made the right decision to go with Plan N here in Texas. Again, thank you SO much!
I gave Cameron's summary graph (at around 20:00 into the video) some more thought. All else being equal, two plans that end up at the same cumulative cost in inflation adjusted money by age 90 are not equal cost wise because they have different time values of money.
This was an exceptionally good video. I appreciate the time and effort that must have been required to generate some quantitative examples. It is valuable, even with all the understandable caveats.
So when I go to my primary doctor with a High Deductible Plan G I owe them nothing at the time of the visit. They must bill Medicare first and then they will bill me for the balance of the alloted Medicare amount and I pay that untill I hit the deductible ? Seems like a better deal by far than what I have had all my life as I have always paid for Health insurance for me and my family as a small businessman and the deductibles were a heck of alot higher than that. Thank you for taking the time to put this together, you did a great job, not just a sales pitch like so many others.
Correct. The doctor sends the bill to Medicare, and they pay their portion, if any. Then the Bill goes to the Supplement company, and they pay the amount (if any) they are obligated to pay. If there is still a balance left after all that, then the doctor bills the patient for the remainder. With High-Deductible G, you will pay 20% of Medicare-approved charges, after satisfying the annual Medicare deductible. then if your 20% hits the HD-G deductible ($2800 for 2024), then the Supplement pays 100% for the rest of the year. The HD-G deductible is really an annual maximum out-of-pocket.
@@g0989 This was very helpful and concise! To confirm I'm understanding, the statement "Then the Bill goes to the Supplement company, and they pay the amount (if any) they are obligated to pay. If there is still a balance left after all that, then the doctor bills the patient for the remainder." The remaining balance would be whatever I have yet to pay to my deductible if in HDG plan (or, I suppose, any non-Medicare covered charges). I, too, am in FL and looking at the HDG plan.
Thank you, thank you. There is a dearth of information on the High Deductible plans, so this analysis was much appreciated. It seems to me that a patient who lives in a State where it is easy to change Medigap plans at any time of year without underwriting requirements (eg. New York, or Washington) would be the most attractive places for a healthy person to use a High-DG plan to save on premium costs for un-used coverage, yet still provide a cap on one's exposure to unlimited costs in a bad year.... Saving $100+ per month, per person, in premiums adds up quickly for healthy people, but I can see how the paperwork burden could get ugly if you start actually going to see doctors. Add that to juggling at least three other policies for Part D, Dental and Vision, the whole Original Medicare / Supplement approach is quite complex and very expensive when compared to a good Advantage plan.
Totally agree! Thanks for watching and for providing your detailed thoughts on the HDG debate. I don't think there will ever be a clear answer between the HDG and Medicare Advantage route
Thanks for the straight talk about HDG. The pie chart showing just 6.3% enrollment was a good fact to have included. I started on BCBS Medex, Core plan, when I lived in MA. They allow you to keep that plan if you move, so long as you were a MA resident when you signed up. 2025 premium is $130; Medicare deducs $1676, 257). I'm in NY now, considering the HDG ($60; $2870 deduc). Living nicely but a very tight budget (Soc Sec + a small inheritance). Ridiculously healthy (running 5x/week for 43 years; labs all good), rare MD visits, 70+ year old; won't be that way forever but ... Switch to NY's HDG or keep BCBSMA Medex? Would so appreciate your thoughts to add to my own.
Cameron it would be amazing if your full Florida projection at 19:40 could be made available with the ability to plug in values to project for other states such as NY.
First, excellent presentation providing many details and nuisances of how this works. Thank you ! Next, I have a question about the graphs that project the costs under the various plan choices. Are they expenses only or do they take into account the differences in premiums ? For example, Plan G appears to be the most costly, with N being less and HDG being even less. So when graphing plan HDG is the cost line reduced by the amount of savings from premiums that are lower than G ? I apologize if that was information was specified and I missed it, but I couldn't seem to find that information when I replayed a few parts of the video. Thank you ! (P.S. - I live in Florida).
Thanks for watching, and good question! The projections I ran include the premiums (as well as estimated premium increases) AND estimated out-of-pocket spending for the different plan letters
GHD has the incentive to stay healthy to avoid medical costs and the horrible medical industry. I worked for a hospital complex for 22 years before retiring.
That's an interesting perspective, but I will say that I don't think people can just choose to be healthy because they have a financial incentive to be.
@@GiardiniMedicare They can choose to be healthy by eliminating processed sugar and processed carb foods and other junk including alcohol. Eat nutrient-rich foods, exercise, and take nonsynthetic supplements. Being healthy requires effort.
@@GiardiniMedicare Physician here. I cannot help but chime in.. There is a subtle point here. No one can "choose" to be healthy, but anyone can choose to reduce risk, and people who have a lifetime of a healthy lifestyle have a risk adjusted incidence for just about all the common morbidities of about 1/3 of average. The HDG plan lets these people monetize their lifestyle. If only a HD Part B also existed !
@@ericgold3840I still go by the: "you're healthy until you're not" mantra.. In 2020 my healthy 74 year old brother lost an eye to a freak accident AND then was diagnosed with acute myeloid leukemia IN THE SPAN OF 30 days. No cancer in our family on either side. Yep, he could have worn eye protection, but it was just a few seconds to use the drill. The bit hit something, broke off, and hit his eye. He could have lived with that. The leukemia expense was profound. They had enough insurance etc so their money wasn't drained when he died a year later, which was good. His wife was part way in to her dementia diagnosis and subsequent memory care facility residence. In the blink of an eye both lives were irreparably changed. So, yes, you are healthy now, taking steps to prevent illness, but what will tomorrow bring?
One thing I don't think you mentioned is if you have an HSA. HSA can't be used towards medigap premiums, but can be used towards the deductibles. If you have a sufficient size HSA, you could avoid the large premiums of a full G and use the HSA to cover the deductibles of the HDG.
I did mention it briefly in the "pros/cons" section at the 26:18 minute mark in the video, but thanks for the comment so it is highlighted for people who don't reach the end of the video!
That's what I do... HDG with HSA. My HSA is well funded and I have the funds invested for continued growth. So I can pay the deductibles (and Part B premium if I want to) tax free. It works great... the high deductible is much lower than my high deductible group health plan that I had during my working years. Furthermore, my premiums are quite low and even lower than the retiree Medicare Advantage plan that my company offers, and gives me the freedom to go anywhere, even to the best hospitals, for health care.
Could you please do a comparison of plan G and plan L. I am leaning to L because of low premiums and that is pays 75% of the 20% part b co ins AS YOU USE IT, so it helps right away up to its max out of pocket
We are publishing a video about Plan K and Plan L at the end of the month, so good timing! However, as you will see, you should likely consider Plan N instead of Plan L.
Hi Cameron, I've been waiting for this video ever since you mentioned it was in the pipeline. Thanks ! I analyze it a bit differently, but your approach is sound. My take home conclusion is that depending on health utilization, HDG may be as expensive as G in the worse case, or progressively cheaper as utilization decreases. HDG simply saves healthy people money. I cannot speak to 'psychological' considerations or cash flow since neither affect me. I would certainly recommend that people with more tenuous finances bank/invest their HDG savings early on so that cash flow problems do not bite them during hospitalization years. The difference between states is amazing. That has to be one of the key messages for all viewers to take to heart. I'll keep my opinions of NY approach to G/HDG to myself ;) Cheers! Eric
I'm glad I could finally get it published, as I mentioned it to you months ago! As you said, some of the key takeaways are that whether or not the HDG makes sense will vary significantly based on the individual and where they live. For someone who lives a healthy lifestyle and has the funds to cover the "worst case," it's a great way to potentially save over time, and I would say it's worth the risk. But just like with practicing medicine, what makes sense on paper won't work for everyone in practice. Not everyone will invest the premium savings for the "what ifs," and some people simply can't.
@@midasgoldmail I don't live in NY so I haven't given this question any thought from the perspective of how I as a consumer would choose a plan if I was a NY resident. I was just thinking that from a bird's eye view, NY is blurring the underlying risk pooling that these different plans (in the end) are based off. People with lifestyle risk factors should not choose HDG, and the NY approach encourages the opposite with its guaranteed plan G issue. The result is expensive G plan for everybody. NY has poisoned the G plan by turning it into the pool of last resort.
Cheapest N where I live is 170. Cheapest G is 260. Cheapest HDG is 55. I really wanted G but I'd be paying a little over 3000 per year whether I needed medical care or not. So I'm trying HDG. I live in CT so I can change if I need to, without underwriting. If I lived elsewhere I probably wouldn't do a HDG
Yes, in WA state, where I am, you can switch from one medigap with guaranteed issue, even switching to different letter plans (with a few exceptions for the odd ball or obsolete plans), at any time of year, and all plans are community rated, so they can't charge you more due to your age, gender, etc. But you can't switch from Advantage to Medigap without going through underwriting unless you have one of the trial rights (allowing you to try out an Advantage plan for a period of time, under certain conditions). It seems like very few medicare counselors understand state of WA rules. I spent lots of time on this and confirmed all of my understanding with my SHIP representative.
thanks for bringing the perspective of making these decisions from a long-term perspective! with that in mind, how concerned should I be when I hear about one of the larger providers having the practice of frequently "closing books" leading to larger increases after a few years? is this something all companies do? or is this a reason to shy away from a particular provider(s)?
It is something to be aware of, but it is hard to spend too much time worrying about it since almost all carriers close blocks of business. Also, the companies that generally don't close their blocks of business have still been experiencing large rate increases in the past couple of years. If you do want to get into the weeds, you can check out this video from us: ruclips.net/video/j66oGQqz2Mc/видео.html
There are too many variables to answer that. The ER visit should be a Part B covered service, so with the standard Plan G, you would be responsible for the Part B deductible. For the HDG, you would be responsible for the Part B deductible, and than any remaining 20% costs after that (up to the $2,870 deductible)
Very helpful, thanks! I live overseas most of the year, but I want to keep coverage in the USA when I return for periodic visits and any possible future major medical need. At my age of 70 and home state of Alabama, I can get Plan N for $125 a month (MOO) and a HD-G for around $50 a month. Would you agree that HD-G makes the most sense in this scenario? Or is it worth paying the extra of getting into Plan N now while I can, no health issues?
Tough to say since it really just comes down to your preference now that you understand how both plans work. I would say that both options make sense and might come down to if you plan on moving back to the U.S. full-time in the future. With that said, the HDG could be a great compromise in your situation.
Shoot! Thanks for catching that and for letting me know. Turns out I put the 4.5% increase data for both the 4.5% line and the 5.5% line, so they completely overlapped. So, in the video, the 5.5% line is actually 4.5%, and the actual 5.5% line is slightly higher. Here is an image of the correct chart for anyone who wants to see it: drive.google.com/file/d/1pmDScHCvHrZhwqJAfF3QSkwPXL_90EBu/view?usp=drive_link
Wow. We don’t have this alphabet soup in Massachusetts. We have three options. (Well, really two because they retired one.) I don’t know how the rest of the country deals with juggling these letter plans on top of the rest of the confusing Medicare mess. 😳
Greta video. Leaning towards HDG as we do have nice HSA balances and have been on employer $5k high deductible plans for years HDG works even better as we would be paying as we go so to speak. Can you speak more to HDG plans that convert to G that you briefly touched on and your thoughts are on those? Thanks.
Those plans that convert will depend on where you live. It's a bit too much detail to comment, but if you connect with us or a different broker the details will be more straightforward to go over. Generally the main companies that offer a product like that are Physicians Mutual or Federal Life
Nice job. First thorough review I've seen of HDG. With that in mind, I wonder if I could switch from HDG to G in Connecticut as I'm being rolled down the hallway to get a heart-lung transplant.
Are you able to do Florida ? Sw Florida ? I need a broker for my parents in Naples FL. They picked advantage plan HMO when they sign up and now that they are 70 and 78 I finally found out.. and want to get them out but I fear it's too late.. So far no one mentioned HD plan G.
I live in Wisconsin and we are one of three states that can customize our medigap plans. We basically just have a base plan and can add riders to them to make them equivalent to the national plans. Plan G in Wisconsin would be the base plan plus four riders and N would be the base plan plus three riders. I'm not of age yet, but for me it will come down N or HDG. I simply don't think plan G is a good value considering the high utilizers of healthcare flock to that plan, resulting in that plan with the biggest increases per year.
I would say they are pretty predictable. You can always see the health questions well ahead of time, and I show some real-world health questions at the 7:22 minute mark in this video: ruclips.net/video/tfVYpougjWM/видео.html
Hi: I have a HDG plan which I just started, along with Parts A&B, on 9/1/24. When I am, for example, paying the 20% for a doctor's visit, does that amount somehow get recorded by my HDG insurance company so that they know when, or if, I reach the $2800 deductible for 2024? So, I just go to the doctors and present my Medicare card, not the HDG card....my Medicare account is tied to my HDG account behind the scenes ? Thank you
It’s worth pointing out that it’s hard to hit that $13,000 figure in Medicare-approved payments to reach the HDG out-of-pocket ceiling. My experience over years of HDG is that Medicare payments are a small fraction of the billed amounts and much less than the one-third estimate you cite. For example, I had some finger surgery billed by the provider at $20,000 but only $2,000 was approved, so my 20% share was $400. At this rate, I would need something extraordinary such as heart surgery or cancer treatments to get me to $2800 out of pocket. This might happen, of course, but how often? If it’s one year in four, I still end up saving a lot over time with HDG.
It provides a financial limit (the deductible amount) for what you would pay for Medicare-approved procedures during the year. With only Original Medicare, there is no limit to what you might pay for Medicare-covered procedures.
yes, HDG out-of-pocket might feel you have no coverage because never reach the limit, however for Advantage Plan C Max out-of- pocket for 2025 is now $6900 in network and Max out-of-pocket both in and out of network is $14,400 is worst I think. I hope I'm starting to understand these plans.
So here is the question: It looks like the game here is whether or not the out of pocket amount on this plan increases faster than the premiums on a regular G or N. Seems like the increase on the high G premiums could be more stable . So where does regular G and N go in a 3.5-4% annual inflation . I’d be saving $1200 a year on a high G plan quote I just got for next year when I turn 65. I’m well off financially by the way.
Essentially, that is correct. The "game" is really what your health will be over the upcoming decades (which, of course, is impossible to know), and also, if you choose the HDG, are you comfortable with the "worst case" scenario of having to pay the full deductible limit in exchange for the "best case" scenario which is needing very little healthcare, while saving on premiums compared to Plan N and Plan G.
I started Medicare and HDG for the first time effective Sept 1. If/when premiums and deductble goes up. When will this affect me - Sept 1 2025 or Jan 1 2025 ? For the premium, can this go up at any time, or just once a year ? Im asking because ive seen comments elsewhere saying their premiums went up during the year. Thank you
Premium increases will depend on the company you enrolled with. Many companies don't do a rate increase during your first 12 months on the plan, but after that, the increases can certainly happen mid-year. The deductible increase (if there is one) will impact you January 1st and your deductible will start from $0 at the beginning of the calendar year in January
I’m so lost. Can anyone help? I don’t want to be stuck with any astronomical hospital bills. I would like 100% coverage (or as close as I can get). Currently I have Medicare A and B AND I have BCBS. I live in North Carolina. I WAS going to enroll in the HDG plan for my 81 year old husband… and for me (I am 66). Could someone please advise. I struggle with understanding all of this. Thank you so much. ❤❤❤
If Giardini Medicare if willing, let them advise you. If the situation is that your 81 year old husband has been on a Medicare Advantage plan and you now want to switch him to a Medigap plan, he will have to go through underwriting. To be blunt, a medigap plan did not collect premiums while he was healthy(ier), so they are not keen to take him on now that his medical consumption is high(er) I'm describing the Medicare Advantage trap, and only making a (hopefully) reasonable guess about your situation.
We have the HDF and for us, there's a way around your CONS . Here's why. You calculate your budget for your supplement by annualizing your premium +annual max HD. So for $60/ mo premium, your MOOP is $720 + $2800=$3520. United American offers an interest-earning Reserve Annuity you can fund with this annual amount and they will debit your premium and pay your providers on your behalf (your part) of the cost -sharing Medicare doesn't cover. Just like having an F or G policy but you've "prepaid" the account in January. At the end of the year you top off the balance to the new HD and premium. After a good or healthy year it might mean adding less than $1500. Your less healthy years are like having an F or G for less than a $300 premium ($3520/12) And an average year less than $200/mo. Look at your G medigap total they paid to providers compared to what you paid in increasing premiums. I went from F to G to HDG. When I had plan G, I was meeting my B deductible in November. HDG is the only plan that Pays You when you're healthy. As you age the G premiums increase faster and the closer it gets to the HDG MOOP the clearer the choice. But you have to be able financially, to set aside the HD. The Annuity is the key to hands off happiness.
@@lyndayoung8761 Really appreciate the added perspective! Not everyone will be able to do an arrangement like the one you described, but like you said the HDG can be a great option for many.
You are really good at explaining it, even though I have to listen more than once. That's me, not you. The one thing that is very scary, and I have heard many stories from people, is that clause "when you are admitted". Drs go out of their way to leave you sitting in the emergency room and not admit you so all of your care falls under Part B. OR they consider anything after 2 days considered "admitted" and they will discharge you at night on Day 2 so it doesn't go into Day 3, so it still falls under Part B. The games they play with senior citizens is disgraceful. HD_G is OK if you have a nice retirement nest egg saved up and $2800. is not a problem, but what has happened to our economy in the past years not many people have much of a nest egg still saved up except the wealthy. It's a pretty big risk if you have savings that is dwindling. Again though, none of this is your fault. This was the most understandable video I have seen. Your charts are very helpful. I am seriously thinking of moving to another country because healthcare in other countries is not even a fraction of healthcare in America. Thailand is rated number 6 in the world for good economical healthcare and USA is number 16!
Thanks for the thoughtful response! Having been to Thailand, I can say it's an amazing country, but I can't say I had first-hand experience with the healthcare system there😅 Also, I will definitely accept some of the blame for making the video confusing.
@@GiardiniMedicare No not confusing at all. I just never realized how complicated they made it. There has to be an easier way. It’s like taking a course at school trying to remember all the details. I watch all your videos now.
My take from someone who has not visited a doctor or a hospital was HDG __ if I have a $13,000 bill I pay $2800 and Medicare will pay the rest $10,200 (around 80%) __ anything over that I still only pay $2800 and Medicare will pay 100% of the rest so on a $150k bill my expense is $2800 (1.87%) __ I only got this insurance to protect myself from a catastrophe as fortunately $2800 a year is nothing compared to all the other expensives of living in the USA __ car insurance, house insurance, taxes etc __ for $39 a month HDG is A Great Deal
Correct. But $2,800 is a big deal for many people, and it's not $2,800 forever since it likely increases slightly every year. Glad it works well for you, though!
The 2025 High Deductible limit for 2025 has been officially released and it is $2,870 as you can see here from the CMS announcement: www.cms.gov/files/document/cy2025-medigap-high-deductible-options-fjg.pdf
This is inline with the typical annual increase to this deductible that we mentioned in the video
@@GiardiniMedicare Thank you. Right now I have HDG in FL but I may move to WA. Not sure it’s good idea to have HDG in WA. Ideal is N, isn’t it? So I’m thinking I should try to change to Plan N before I get sick (right now pretty healthy). I wish I could change when I move there.
If it is possible to change to Plan N when I move, my problem will be solved, is there any way to do that?
@@めぐ-n6mCan't think of why having the HDG in Washington would be worse than having it in Florida, but Plan N is always a good plan to consider.
In Washington, you are able to change to a different Plan B through N with guaranteed issue, if you are already already enrolled in another Plan B through N. However, we aren't licensed in WA, so we don't know if this applies to changing from the HDG once you move.
Here is a good link to a Washington Medicare Supplement guide: www.insurance.wa.gov/sites/default/files/documents/what-you-need-to-know-medigap-plans_4.pdf
This is hands down the best analysis of HDG -- backed up by reasonable data and appreciate the data driven analysis . Bravo and thank you
Thank you for your honest assessment and disclosure of commissions on HD Plan G. You earned another subscriber.
Excellent analysis and presentation. Three years ago I signed up for Plan G high deductible thinking of only Hospital costs. This year I was diagnosed with Wet Age Related Macular Degeneration and I go to the Retina Specialist for an injection in the eye every 4 weeks and the injection itself is 2000 dollars each time plus doctor and lab charges costing me $ 420 out of pocket each visit. Contrary to my planning now I have to first meet the 2800 dollar deductible ( ever increasing ) every year. My advice to those who can afford it, just take the Medigap plan G ( the regular one) and be happy.
I really appreciate you sharing your experience! What is described is often overlooked by many when it comes to choosing the high-deductible G. If you are willing to share, do you happen to know the actual billing code for the injection? Would like to include it in future examples if possible.
Cameron, this video is the BY FAR the best compilation of G-vs-GHD-vs-N stats ever; it pulls together information that would've required watching multiple other videos by you and others (which I already have!). It's strange how the "Medicare and You" book practically hides GHD. BTW my spouse and I have chosen N for New York.
Thanks for the feedback! It took me longer than I would like to admit to make this video, so I appreciate it. The HDG is a good value, but you are right that it is somewhat of a "hidden" plan. Medicare certainly barely mentions it, and both brokers and insurance companies don't love selling it.
I really appreciate how honest you are about commissions and explains why it was harder to find a policy. With a well funded HSA, HDG was the way to go for me but many tried to steer me away from it. Being in WA state, I can switch to another medigap plan without a penalty.
Thanks for the informative video. My wife and I live in NYS and are currently on a Medicare Advantage Plan. For a number of reasons, we are planning on switching back to Medicare + a Medigap policy. Given the very high Plan G and N costs in NY, we are currently planning on utilizing the HDG plan. I have done my own 20 cost analysis and it seems that the HDG plan will almost certainly save us a significant amount of money over that 20 year period. As you showed in one of your tables, in NYS, the worst case HDG year (premium + full deductible) essentially is the same as the normal Plan G year right now. And, since the Plan G premiums will likely increase faster than the HDG premiums and deductible, over time it looks as though the worst case HDG yearly costs will become increasingly cheaper than the normal Plan G costs.
Makes sense to me! Thanks for watching
This is the best video I have ever seen on the medigap coverage.
Appreciate it!
Cameron, as with the SERFF video that you did earlier in the year, this video was excellent, excellent!!! Thank you SO much for putting all of this together. If I lived in NY or FL, I'd definitely go with the HDG plan. The analysis in your video confirmed for me that I made the right decision to go with Plan N here in Texas. Again, thank you SO much!
Thanks for watching! Personally, I think your conclusion is correct.
I gave Cameron's summary graph (at around 20:00 into the video) some more thought. All else being equal, two plans that end up at the same cumulative cost in inflation adjusted money by age 90 are not equal cost wise because they have different time values of money.
This was an exceptionally good video. I appreciate the time and effort that must have been required to generate some quantitative examples. It is valuable, even with all the understandable caveats.
Appreciate you watching! Glad it helped a bit
So when I go to my primary doctor with a High Deductible Plan G I owe them nothing at the time of the visit. They must bill Medicare first and then they will bill me for the balance of the alloted Medicare amount and I pay that untill I hit the deductible ? Seems like a better deal by far than what I have had all my life as I have always paid for Health insurance for me and my family as a small businessman and the deductibles were a heck of alot higher than that. Thank you for taking the time to put this together, you did a great job, not just a sales pitch like so many others.
You understood it correctly! Definitely the right plan for the right situation. Appreciate you taking the time to watch.
Do you write plans in Florida ?@@GiardiniMedicare
Correct. The doctor sends the bill to Medicare, and they pay their portion, if any. Then the Bill goes to the Supplement company, and they pay the amount (if any) they are obligated to pay. If there is still a balance left after all that, then the doctor bills the patient for the remainder.
With High-Deductible G, you will pay 20% of Medicare-approved charges, after satisfying the annual Medicare deductible. then if your 20% hits the HD-G deductible ($2800 for 2024), then the Supplement pays 100% for the rest of the year. The HD-G deductible is really an annual maximum out-of-pocket.
@@g0989 This was very helpful and concise! To confirm I'm understanding, the statement "Then the Bill goes to the Supplement company, and they pay the amount (if any) they are obligated to pay. If there is still a balance left after all that, then the doctor bills the patient for the remainder." The remaining balance would be whatever I have yet to pay to my deductible if in HDG plan (or, I suppose, any non-Medicare covered charges). I, too, am in FL and looking at the HDG plan.
I appreciate these analyses, and I think you made a good case for HDG.
This is the most informative video on this topic that I have come across. Thank you.
Thank you, thank you. There is a dearth of information on the High Deductible plans, so this analysis was much appreciated. It seems to me that a patient who lives in a State where it is easy to change Medigap plans at any time of year without underwriting requirements (eg. New York, or Washington) would be the most attractive places for a healthy person to use a High-DG plan to save on premium costs for un-used coverage, yet still provide a cap on one's exposure to unlimited costs in a bad year.... Saving $100+ per month, per person, in premiums adds up quickly for healthy people, but I can see how the paperwork burden could get ugly if you start actually going to see doctors. Add that to juggling at least three other policies for Part D, Dental and Vision, the whole Original Medicare / Supplement approach is quite complex and very expensive when compared to a good Advantage plan.
Totally agree! Thanks for watching and for providing your detailed thoughts on the HDG debate. I don't think there will ever be a clear answer between the HDG and Medicare Advantage route
We have plan G for more than 50 years without any problems or complaints. We hope to stay with plan G for another 50 years ❤❤
Really, 50yrs plan G after turning 65 is 115 yrs old… such lie
Ohhhhhh k 🤭
Fantastic comparison of plans! Thank you!
great job explaining, the efficacy of which was aided and abetted by the tempo and cadence of your delivery
Thanks for the straight talk about HDG. The pie chart showing just 6.3% enrollment was a good fact to have included. I started on BCBS Medex, Core plan, when I lived in MA. They allow you to keep that plan if you move, so long as you were a MA resident when you signed up. 2025 premium is $130; Medicare deducs $1676, 257). I'm in NY now, considering the HDG ($60; $2870 deduc). Living nicely but a very tight budget (Soc Sec + a small inheritance). Ridiculously healthy (running 5x/week for 43 years; labs all good), rare MD visits, 70+ year old; won't be that way forever but ... Switch to NY's HDG or keep BCBSMA Medex? Would so appreciate your thoughts to add to my own.
Cameron it would be amazing if your full Florida projection at 19:40 could be made available with the ability to plug in values to project for other states such as NY.
I'll work on making something! Thanks for the idea
@@GiardiniMedicare 👍
First, excellent presentation providing many details and nuisances of how this works. Thank you ! Next, I have a question about the graphs that project the costs under the various plan choices. Are they expenses only or do they take into account the differences in premiums ? For example, Plan G appears to be the most costly, with N being less and HDG being even less. So when graphing plan HDG is the cost line reduced by the amount of savings from premiums that are lower than G ? I apologize if that was information was specified and I missed it, but I couldn't seem to find that information when I replayed a few parts of the video. Thank you ! (P.S. - I live in Florida).
Thanks for watching, and good question! The projections I ran include the premiums (as well as estimated premium increases) AND estimated out-of-pocket spending for the different plan letters
GHD has the incentive to stay healthy to avoid medical costs and the horrible medical industry.
I worked for a hospital complex for 22 years before retiring.
That's an interesting perspective, but I will say that I don't think people can just choose to be healthy because they have a financial incentive to be.
@@GiardiniMedicare They can choose to be healthy by eliminating processed sugar and processed carb foods and other junk including alcohol.
Eat nutrient-rich foods, exercise, and take nonsynthetic supplements.
Being healthy requires effort.
@@GiardiniMedicare Physician here. I cannot help but chime in..
There is a subtle point here. No one can "choose" to be healthy, but anyone can choose to reduce risk, and people who have a lifetime of a healthy lifestyle have a risk adjusted incidence for just about all the common morbidities of about 1/3 of average. The HDG plan lets these people monetize their lifestyle.
If only a HD Part B also existed !
@@ericgold3840 Absolutely. I agree with both of you, and will defer to you as the experts on the actual healthcare side of things.
@@ericgold3840I still go by the: "you're healthy until you're not" mantra..
In 2020 my healthy 74 year old brother lost an eye to a freak accident AND then was diagnosed with acute myeloid leukemia IN THE SPAN OF 30 days. No cancer in our family on either side. Yep, he could have worn eye protection, but it was just a few seconds to use the drill. The bit hit something, broke off, and hit his eye. He could have lived with that. The leukemia expense was profound. They had enough insurance etc so their money wasn't drained when he died a year later, which was good. His wife was part way in to her dementia diagnosis and subsequent memory care facility residence. In the blink of an eye both lives were irreparably changed. So, yes, you are healthy now, taking steps to prevent illness, but what will tomorrow bring?
One thing I don't think you mentioned is if you have an HSA.
HSA can't be used towards medigap premiums, but can be used towards the deductibles.
If you have a sufficient size HSA, you could avoid the large premiums of a full G and use the HSA to cover the deductibles of the HDG.
I did mention it briefly in the "pros/cons" section at the 26:18 minute mark in the video, but thanks for the comment so it is highlighted for people who don't reach the end of the video!
@@GiardiniMedicare Yep, sorry, I missed it.
That's what I do... HDG with HSA. My HSA is well funded and I have the funds invested for continued growth. So I can pay the deductibles (and Part B premium if I want to) tax free. It works great... the high deductible is much lower than my high deductible group health plan that I had during my working years. Furthermore, my premiums are quite low and even lower than the retiree Medicare Advantage plan that my company offers, and gives me the freedom to go anywhere, even to the best hospitals, for health care.
Could you please do a comparison of plan G and plan L. I am leaning to L because of low premiums and that is pays 75% of the 20% part b co ins AS YOU USE IT, so it helps right away up to its max out of pocket
We are publishing a video about Plan K and Plan L at the end of the month, so good timing! However, as you will see, you should likely consider Plan N instead of Plan L.
Comprehensive and detailed video.
Hi Cameron,
I've been waiting for this video ever since you mentioned it was in the pipeline. Thanks !
I analyze it a bit differently, but your approach is sound. My take home conclusion is that depending on health utilization, HDG may be as expensive as G in the worse case, or progressively cheaper as utilization decreases. HDG simply saves healthy people money.
I cannot speak to 'psychological' considerations or cash flow since neither affect me. I would certainly recommend that people with more tenuous finances bank/invest their HDG savings early on so that cash flow problems do not bite them during hospitalization years.
The difference between states is amazing. That has to be one of the key messages for all viewers to take to heart. I'll keep my opinions of NY approach to G/HDG to myself ;)
Cheers! Eric
@ericgold3840 I'd be interested in hearing your thoughts on NY
I'm glad I could finally get it published, as I mentioned it to you months ago! As you said, some of the key takeaways are that whether or not the HDG makes sense will vary significantly based on the individual and where they live.
For someone who lives a healthy lifestyle and has the funds to cover the "worst case," it's a great way to potentially save over time, and I would say it's worth the risk. But just like with practicing medicine, what makes sense on paper won't work for everyone in practice. Not everyone will invest the premium savings for the "what ifs," and some people simply can't.
@@midasgoldmail I don't live in NY so I haven't given this question any thought from the perspective of how I as a consumer would choose a plan if I was a NY resident. I was just thinking that from a bird's eye view, NY is blurring the underlying risk pooling that these different plans (in the end) are based off. People with lifestyle risk factors should not choose HDG, and the NY approach encourages the opposite with its guaranteed plan G issue. The result is expensive G plan for everybody. NY has poisoned the G plan by turning it into the pool of last resort.
@@ericgold3840 Excellent point - thanks!
thank you for discussing the commissions angle
Happy to help! It's an important part of the discussion
Cheapest N where I live is 170. Cheapest G is 260. Cheapest HDG is 55. I really wanted G but I'd be paying a little over 3000 per year whether I needed medical care or not. So I'm trying HDG. I live in CT so I can change if I need to, without underwriting. If I lived elsewhere I probably wouldn't do a HDG
Very similar to the NY example in the video. Based on your situation it sounds like you are doing the right thing.
I just want to
make sure that HDG deductible is included $ from Part A, not only from Part B?
@@めぐ-n6m Correct. It includes both
@@GiardiniMedicare Thank you
So I just learned that the annual OEP is for advantage plans only! how did I miss that? Fortunately my state allows medigap changes (WA).
A lot of people don't realize this time of year doesn't let you change Medigap plans without underwriting!
Yes, in WA state, where I am, you can switch from one medigap with guaranteed issue, even switching to different letter plans (with a few exceptions for the odd ball or obsolete plans), at any time of year, and all plans are community rated, so they can't charge you more due to your age, gender, etc. But you can't switch from Advantage to Medigap without going through underwriting unless you have one of the trial rights (allowing you to try out an Advantage plan for a period of time, under certain conditions). It seems like very few medicare counselors understand state of WA rules. I spent lots of time on this and confirmed all of my understanding with my SHIP representative.
thanks for bringing the perspective of making these decisions from a long-term perspective! with that in mind, how concerned should I be when I hear about one of the larger providers having the practice of frequently "closing books" leading to larger increases after a few years? is this something all companies do? or is this a reason to shy away from a particular provider(s)?
It is something to be aware of, but it is hard to spend too much time worrying about it since almost all carriers close blocks of business. Also, the companies that generally don't close their blocks of business have still been experiencing large rate increases in the past couple of years. If you do want to get into the weeds, you can check out this video from us: ruclips.net/video/j66oGQqz2Mc/видео.html
Interesting. So if you go to the ER what would the cost be uder the HDG plan? compare to std G plan. I'm in michigan.
There are too many variables to answer that. The ER visit should be a Part B covered service, so with the standard Plan G, you would be responsible for the Part B deductible. For the HDG, you would be responsible for the Part B deductible, and than any remaining 20% costs after that (up to the $2,870 deductible)
Very helpful, thanks! I live overseas most of the year, but I want to keep coverage in the USA when I return for periodic visits and any possible future major medical need. At my age of 70 and home state of Alabama, I can get Plan N for $125 a month (MOO) and a HD-G for around $50 a month. Would you agree that HD-G makes the most sense in this scenario? Or is it worth paying the extra of getting into Plan N now while I can, no health issues?
Tough to say since it really just comes down to your preference now that you understand how both plans work. I would say that both options make sense and might come down to if you plan on moving back to the U.S. full-time in the future. With that said, the HDG could be a great compromise in your situation.
CT has the same rules regarding medigap as NY. That is why I'm on A HDG until I turn 70 and I will then switch to a plan N or G.
The Plan N (4.5%) yellow line is missing in the Texas graph.
Shoot! Thanks for catching that and for letting me know. Turns out I put the 4.5% increase data for both the 4.5% line and the 5.5% line, so they completely overlapped. So, in the video, the 5.5% line is actually 4.5%, and the actual 5.5% line is slightly higher. Here is an image of the correct chart for anyone who wants to see it: drive.google.com/file/d/1pmDScHCvHrZhwqJAfF3QSkwPXL_90EBu/view?usp=drive_link
Wow. We don’t have this alphabet soup in Massachusetts. We have three options. (Well, really two because they retired one.) I don’t know how the rest of the country deals with juggling these letter plans on top of the rest of the confusing Medicare mess. 😳
Greta video. Leaning towards HDG as we do have nice HSA balances and have been on employer $5k high deductible plans for years HDG works even better as we would be paying as we go so to speak. Can you speak more to HDG plans that convert to G that you briefly touched on and your thoughts are on those? Thanks.
Those plans that convert will depend on where you live. It's a bit too much detail to comment, but if you connect with us or a different broker the details will be more straightforward to go over. Generally the main companies that offer a product like that are Physicians Mutual or Federal Life
Nice job. First thorough review I've seen of HDG. With that in mind, I wonder if I could switch from HDG to G in Connecticut as I'm being rolled down the hallway to get a heart-lung transplant.
Certainly wouldn't recommend it😅
No matter the procedure, isn't the max out of pocket $2800 with HD plan G?
@@KatieLibby1315 If it's Medicare approved, yes
How does the latest $2000 limit effect the limits for HDG?
It doesn't. That is only for prescription coverage
Cameron, do you know if florida allows conversion from HDG to G without underwriting?
With some carriers, yes!
Are you able to do Florida ? Sw Florida ? I need a broker for my parents in Naples FL. They picked advantage plan HMO when they sign up and now that they are 70 and 78 I finally found out.. and want to get them out but I fear it's too late.. So far no one mentioned HD plan G.
@@sfok09 We do work in Florida (just not in person). If you send us an email to info@gmedicareteam.com we can see what we can do for them
May I ask which carriers? How can I find out?
@@めぐ-n6m If you email us at info@gmedicareteam.com we can give you a break down
Plan N comes with no coverage for excess charges... does that matter? is it a big concern?
We go over everything you need to know about Plan N in this video: ruclips.net/video/S29PdLxpUi0/видео.htmlsi=1nvovryCcVzqG7Sb
I live in Wisconsin and we are one of three states that can customize our medigap plans. We basically just have a base plan and can add riders to them to make them equivalent to the national plans. Plan G in Wisconsin would be the base plan plus four riders and N would be the base plan plus three riders. I'm not of age yet, but for me it will come down N or HDG. I simply don't think plan G is a good value considering the high utilizers of healthcare flock to that plan, resulting in that plan with the biggest increases per year.
Are the health questions they ask predictable?
I would say they are pretty predictable. You can always see the health questions well ahead of time, and I show some real-world health questions at the 7:22 minute mark in this video: ruclips.net/video/tfVYpougjWM/видео.html
A very informative video but you have way too many sound effects LOL. It was a little bit distracting but still worth watching.
Thanks
Hi: I have a HDG plan which I just started, along with Parts A&B, on 9/1/24. When I am, for example, paying the 20% for a doctor's visit, does that amount somehow get recorded by my HDG insurance company so that they know when, or if, I reach the $2800 deductible for 2024? So, I just go to the doctors and present my Medicare card, not the HDG card....my Medicare account is tied to my HDG account behind the scenes ? Thank you
Yes, Medicare sends the claims to the HDG insurance company.
It’s worth pointing out that it’s hard to hit that $13,000 figure in Medicare-approved payments to reach the HDG out-of-pocket ceiling. My experience over years of HDG is that Medicare payments are a small fraction of the billed amounts and much less than the one-third estimate you cite. For example, I had some finger surgery billed by the provider at $20,000 but only $2,000 was approved, so my 20% share was $400. At this rate, I would need something extraordinary such as heart surgery or cancer treatments to get me to $2800 out of pocket. This might happen, of course, but how often? If it’s one year in four, I still end up saving a lot over time with HDG.
Appreciate the first-hand experience! You are certainly correct.
So how does high detectable plan G protect us financially? I still don't get that.
It provides a financial limit (the deductible amount) for what you would pay for Medicare-approved procedures during the year. With only Original Medicare, there is no limit to what you might pay for Medicare-covered procedures.
yes, HDG out-of-pocket might feel you have no coverage because never reach the limit, however for Advantage Plan C Max out-of- pocket for 2025 is now $6900 in network and Max out-of-pocket both in and out of network is $14,400 is worst I think. I hope I'm starting to understand these plans.
So here is the question: It looks like the game here is whether or not the out of pocket amount on this plan increases faster than the premiums on a regular G or N. Seems like the increase on the high G premiums could be more stable . So where does regular G and N go in a 3.5-4% annual inflation . I’d be saving $1200 a year on a high G plan quote I just got for next year when I turn 65. I’m well off financially by the way.
Essentially, that is correct. The "game" is really what your health will be over the upcoming decades (which, of course, is impossible to know), and also, if you choose the HDG, are you comfortable with the "worst case" scenario of having to pay the full deductible limit in exchange for the "best case" scenario which is needing very little healthcare, while saving on premiums compared to Plan N and Plan G.
I started Medicare and HDG for the first time effective Sept 1. If/when premiums and deductble goes up. When will this affect me - Sept 1 2025 or Jan 1 2025 ? For the premium, can this go up at any time, or just once a year ?
Im asking because ive seen comments elsewhere saying their premiums went up during the year.
Thank you
Premium increases will depend on the company you enrolled with. Many companies don't do a rate increase during your first 12 months on the plan, but after that, the increases can certainly happen mid-year.
The deductible increase (if there is one) will impact you January 1st and your deductible will start from $0 at the beginning of the calendar year in January
@@GiardiniMedicarethank you !
Does High Deductible Plan G allow doctor second opinion (or third if first 2 disagree) similar to Original Medicare? TIA
Just like with all Medigap plans, the HDG follows the coverage guidelines set by Original Medicare
I’m so lost. Can anyone help? I don’t want to be stuck with any astronomical hospital bills. I would like 100% coverage (or as close as I can get). Currently I have Medicare A and B AND I have BCBS. I live in North Carolina. I WAS going to enroll in the HDG plan for my 81 year old husband… and for me (I am 66). Could someone please advise. I struggle with understanding all of this. Thank you so much. ❤❤❤
Do you currently have a Medicare Advantage plan or a Medicare Supplement plan with BCBS?
Did you figure your problem out?
If Giardini Medicare if willing, let them advise you.
If the situation is that your 81 year old husband has been on a Medicare Advantage plan and you now want to switch him to a Medigap plan, he will have to go through underwriting. To be blunt, a medigap plan did not collect premiums while he was healthy(ier), so they are not keen to take him on now that his medical consumption is high(er)
I'm describing the Medicare Advantage trap, and only making a (hopefully) reasonable guess about your situation.
We have the HDF and for us, there's a way around your CONS . Here's why. You calculate your budget for your supplement by annualizing your premium +annual max HD. So for $60/ mo premium, your MOOP is $720 + $2800=$3520. United American offers an interest-earning Reserve Annuity you can fund with this annual amount and they will debit your premium and pay your providers on your behalf (your part) of the cost -sharing Medicare doesn't cover. Just like having an F or G policy but you've "prepaid" the account in January.
At the end of the year you top off the balance to the new HD and premium. After a good or healthy year it might mean adding less than $1500. Your less healthy years are like having an F or G for less than a $300 premium ($3520/12) And an average year less than $200/mo.
Look at your G medigap total they paid to providers compared to what you paid in increasing premiums. I went from F to G to HDG. When I had plan G, I was meeting my B deductible in November. HDG is the only plan that Pays You when you're healthy. As you age the G premiums increase faster and the closer it gets to the HDG MOOP the clearer the choice. But you have to be able financially, to set aside the HD. The Annuity is the key to hands off happiness.
@@lyndayoung8761 Really appreciate the added perspective! Not everyone will be able to do an arrangement like the one you described, but like you said the HDG can be a great option for many.
You are really good at explaining it, even though I have to listen more than once. That's me, not you. The one thing that is very scary, and I have heard many stories from people, is that clause "when you are admitted". Drs go out of their way to leave you sitting in the emergency room and not admit you so all of your care falls under Part B. OR they consider anything after 2 days considered "admitted" and they will discharge you at night on Day 2 so it doesn't go into Day 3, so it still falls under Part B. The games they play with senior citizens is disgraceful. HD_G is OK if you have a nice retirement nest egg saved up and $2800. is not a problem, but what has happened to our economy in the past years not many people have much of a nest egg still saved up except the wealthy. It's a pretty big risk if you have savings that is dwindling. Again though, none of this is your fault. This was the most understandable video I have seen. Your charts are very helpful. I am seriously thinking of moving to another country because healthcare in other countries is not even a fraction of healthcare in America. Thailand is rated number 6 in the world for good economical healthcare and USA is number 16!
Thanks for the thoughtful response! Having been to Thailand, I can say it's an amazing country, but I can't say I had first-hand experience with the healthcare system there😅 Also, I will definitely accept some of the blame for making the video confusing.
@@GiardiniMedicare No not confusing at all. I just never realized how complicated they made it. There has to be an easier way. It’s like taking a course at school trying to remember all the details. I watch all your videos now.
Having spent a long time using high-deductible health insurance plans, Plan G is suitable for me; I will pass on any others
That's the conclusion for most people!
My take from someone who has not visited a doctor or a hospital was HDG __ if I have a $13,000 bill I pay $2800 and Medicare will pay the rest $10,200 (around 80%) __ anything over that I still only pay $2800 and Medicare will pay 100% of the rest so on a $150k bill my expense is $2800 (1.87%) __ I only got this insurance to protect myself from a catastrophe as fortunately $2800 a year is nothing compared to all the other expensives of living in the USA __ car insurance, house insurance, taxes etc __ for $39 a month HDG is A Great Deal
Correct. But $2,800 is a big deal for many people, and it's not $2,800 forever since it likely increases slightly every year. Glad it works well for you, though!
Even though HDG could end up being the best value over time, it's a little scary. Seems like plan N is a good compromise.
Doesn't sound like HDG is offered many places;.
It is widely available
Cameron is politely pointing out the difference between 'not available' and 'not widely offered or promoted by many Medicare agents'
Please try harder not to move your hands like that.
Sorry, I can’t🥲
That’s an Italiano thing. We cannot change that :)
@@ItsMe-rr9nh Exactly! I don't even realize I'm doing it😅