Why Most Brokers Don’t Sell Horizon BCBS Medicare Supplements

Horizon BCBSNJ has some great plans in the group and individual health market, but I want to share a few things about the Horizon Medigap plans and why most brokers, including myself, don’t sell them. I have a long history with Horizon and their other plans(individual health, group health) and they are typically one of my top choices, but not for their Medicare Supplemental options.

Horizon Blue Cross Medicare Supplements

Horizon BCBS of NJ sells six of the standardized Medigap plans to include plans A, C, F, G, K and N. Like all other carriers, the plans will vary in price and coverage.

BCBS Medigap Pricing

Horizon is a bit different than the other NJ carriers in how they work their pricing. They use a five year rate band so depending on when you join the plan, your rate will be the same as everyone else in that band.

Current Rate Bands

They don’t post these on their website anymore but from memory it was:

65-69

70-74

75-79

80+

So if you are 66, you pay the same price as someone who is 69.

 

BCBS 2016 Pricing

I pulled the rates from the NJ SHIP website to show the current prices of the most popular Medigap plans F, G, N and then compared them to the lowest price plans that I can offer in NJ. See chart.

horizon medigap comparison

As you can see, the Horizon Plan F is 26% higher for a female age 65 than the cheapest alternative. If the other carriers were run with a spousal discount, the disparity would be even larger. Does this mean you shouldn’t buy Horizon? No.. But in my opinion, there is no reason to spend any more than necessary for the plan you want. They are all identical in their performance with claims.

The prices are more competitive as you get closer to the top of the rate band, for example age 69, but then the next year your price shoots back up.

Let’s just say the average annual premium is $150 a month for plan F.. You are going to pay somewhere around $500/more per year for every year you have the plan. Not a good bargain.

 

BCBS Underwriting

To their credit, Horizon does not underwrite like the other carriers do, so you would expect their prices to be a bit higher. People who have guaranteed issue coverage(just enrolling in Part B or coming from a group) never need to answer medical questions, but Horizon extends that same offer to anyone regardless of their situation. What that means to you, is that you could never have bought a Medicare or group plan and at age 75 after being diagnosed with cancer, you can purchase a plan with no questions asked. They do impose a 6 month pre existing condition wait, but after that, the plan will work perfectly. That is +1 for Horizon but only if you can’t qualify with other carriers or are outside of your guaranteed enrollment.

 

Horizon Enrollment

As a broker, one of the best ways I can help my clients is with speedy enrollment and quick access to your ID cards. One of the issues that can spring up with the Horizon plans is if you are coming off of group or individual coverage with them. I’m not blaming them for this issue, but it happens all the time so its worth noting. If you are enrolled with Horizon under another plan and apply for a supplement, the new enrollment will be blocked until the old coverage is terminated. Sounds pretty straight forward but it never really works out that easy.

Why?

Brokers generally have 30 days to terminate someone’s coverage and in some cases it can be up to 60 days so there are a lot of brokers who put off your termination and don’t process them immediately. Some employers do the same thing. So if you are proactive with your Medicare Supplement enrollment but they are taking their time with terminating your old coverage, it becomes a mess. Your application will sit while they try to figure out what to do and then you wait… This happens all the time with individuals coming off of group coverage and enrolling in individual health coverage. Once Horizon comes up with a better way to handle people transitioning, it will be a smoother process… It has been a problem for 10 years though so I don’t see it changing.. So if you have Horizon coverage now, I would probably steer away from them with your supplement if you want an easy transition.

The second part of that is we as brokers have no way to check your coverage online like we can with other companies like Aetna and Mutual of Omaha. With a click of a button, I can pull up all of your details on those carriers, but not Horizon.

Commissions

This should not concern you as the consumer, but I’ll be completely transparent.. Horizon does not pay brokers for writing business with them and it doesn’t seem like that will ever change. From our point of view, if we are going to spend the time to educate our clients, and shop the plans, there is no way we would recommend a plan that is potentially 26% more in price and also end up not getting paid by the company. All other carriers in NJ pay their brokers a commission amount for selling policies and it will vary a bit per carrier. For me, I recommend the best choice or at least the top few and let you choose the company. If you really want Horizon, I have decided to not sell it as have the majority of other brokers.

 

What the Horizon Medigap Plans are Best At

Despite what I say, the Horizon BCBS supplement plans may still be the best for you. If you are in any of these situations, I would definitely take a look.

  • Have been on Medicare Part B and don’t have guaranteed issue issue rights AND you have medical conditions where you can’t qualify for another carrier.
  • Are under age 50 and on Medicare. Horizon is the only company that sells in NJ to under age 50.

 

Summary

Horizon is a great company for your group and individual health, but I would pass on them as a consumer and as a broker for their Medicare Supplement plans. They are priced very poorly compared to other companies and you will have trouble getting good advice from brokers because it is very time consuming for us and we are not able to earn anything for providing the service. If you have questions on the Horizon plans or want me to compare them, I am always happy to answer questions. When shopping, its easy to get lured in by the insurance companies you are familier with, but for Medigap, it doesn’t matter all that much. Every Plan F and Plan G in the state will work perfectly, without exception.