By Paul Davis | Contributing Writer

You may think this as a devious come-on from an unscrupulous insurance agent. But really, my intent is to try to connect with people who are truly overpaying on their present plans without realizing it.

If you watch TV, it’s difficult to avoid commercials for Medicare Advantage HMO plans that have zero monthly premium. Those plans are great for people who have doctors contracted with those plans and comfortable with the HMO concept. FYI, some of those plans include providers contracted with UCLA and Cedars-Sinai Medical Center. Many people find that surprising.

But this article is more for those people who want to have freedom of choice and do not mind paying a monthly premium for a Medicare Supplement (also known as a Medi-gap) plan.

If you’re on a Plan J, which has not been sold since 2010, you are on the richest standardized Medicare supplement plan.

Plan J has an at-home recovery benefit that does not exist on current plans. But how much extra are you paying for that benefit and is it worth it? Here are two 2020 case studies:

• We recently had a client who was on a plan J and his premiums were going up to $343 per month. He had been on that plan since 2009. When we shopped his plan this year, we found a Plan G coming in at $233 per month — a $110-per-month savings that equates to more than $1,300 a year.

There are two benefit differences: Plan J has an at-home recovery benefit of $40 per day for up to 40 days a year after discharge from a hospital and for every day you receive home healthcare. Sounds good, but I have never had a client make use of that benefit.

Plan J

Private insurers are reaping a veritable windfall from the federal government’s heavy spending on the elderly — with demand from the COVID-19 pandemic leading to more robust offerings.


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Following a trend that has been growing in the past few years, both Cigna (CI) and United Health Group (UNH) announced expansions of their Medicare Advantage plans for 2021 — with Cigna expanding in 67 counties and UnitedHealth expanding in 300 counties.

In addition, Walmart (WMT) has joined in with its own insurance education services, in order to help seniors sign up for Medicare plans.

The two health insurance giants are expanding in an increasingly competitive market, dominated by players like Humana (HUM) and Centene (CNC). They are also seeing a swell of startups including Clover Health, Oscar and Bright Health.

According to Brian Evanko, Cigna’s president of Government Business, insurers are faced with a convergence of factors that include a willing government payor, an increasingly aging population, and the flexibility to compete with robust offerings.

Many plans have $0 premiums —a key selling point — and thanks to the popularity of telehealth during the pandemic, both insurers are offering $0 copays on telehealth visits. Cigna is now offering behavioral health virtual visits, as well, while UnitedHealth promoted its $35 cap on insulin.

For Cigna, traditionally a big player in commercial and employer-sponsored plans, the expansion marks the largest in the space to-date. The overall number of counties, 369 in 2021, represents 30% of the Medicare market in America, and a 22% growth from the previous year, Evanko said. By 2024, the company is targeting 50% of the market.

And companies like Cigna will continue to shift their resources and efforts into the Medicare Advantage market, as ongoing bipartisan support fuels growth. It’s a captive pipeline, Evanko explained.

“There are

  • The Social Capital SPAC led by billionaire Chamath Palihapitiya is acquiring Clover Health in a $3.7 billion deal that’ll take the health insurance company public. 
  • In 2021, Palihapitiya projects the company will grow its membership roughly five times what it was this year.
  • Clover Health president and chief technology officer Andrew Toy said that projected growth largely comes from the potential participation in a new Medicare program that’s yet to be finalized. 
  • For more stories like this, sign up here for Business Insider’s daily healthcare newsletter.

Social Capital’s Chamath Palihapitiya is looking to acquire the health insurance company Clover Health via a SPAC. 

The special-purpose acquisition company Social Capital Hedosophia Holdings Corp. III will merge with Clover in a $3.7 billion transaction that’s slated to close in 2021, the companies said in a statement.

Clover offers private health-insurance plans for seniors, a product called Medicare Advantage. Competition is fierce for the more than 24 million Americans enrolled in Medicare Advantage plans, and for the thousands signing up daily as they turn 65. Startups like Clover are facing off against industry giants like UnitedHealthcare, Humana, and Aetna.

In a tweet Tuesday, Palihapitiya laid out his expectations of growth for Clover. By 2021, Clover’s membership is projected to be 273,000 people, roughly five times what it was at the middle of this year. Clover. That in turn would lead to revenue of $880 million, roughly double the company’s 2019 figures. Bloomberg News first reported that Clover was in talks to go public via the SPAC earlier on Tuesday.

The rapid expansion contrasts with the slower growth Clover has seen over the past few years.

Clover enrolled 39,400 members in 2019, 10,000 more than the year before. It signed on 54,400 people this year, according to Business Insider’s reporting. As of the

Walmart is entering the health insurance business, just in time for those signing up for Medicare open enrollment this fall.

The Bentonville, Ark.-based retailer announced Tuesday the opening of Walmart Insurance Services to “assist people with enrolling in insurance plans—and simplify what’s historically been a cumbersome, confusing process.”

“We want customers to feel confident in selecting a Medicare plan that best fits their needs, budget, and lifestyle,” David Sullivan, general manager of Walmart Insurance Services, said in a statement. “And we want to be a trusted partner on their health care journey.”


Walmart Insurance Services, a licensed insurance brokerage, will begin selling Medicare insurance plans during this year’s Annual Enrollment Period (AEP), which runs from Oct. 15 through Dec. 7.

The agency, which is licensed in all 50 states and Washington, D.C., will provide Medicare plans (Part D, Medicare Advantage, and Medicare Supplement plans) offered by Humana, UnitedHealthcare, Anthem Blue Cross Blue Shield, Amerigroup, Simply Health, Wellcare (Centene), Clover Health and Arkansas Blue Cross and Blue Shield.

Medicare Advantage plans cater to Americans who are older than 65 and those with disabilities.


According to Sullivan, only 1 in 10 Medicare beneficiaries is enrolled in a plan that saves them the most on out-of-pocket spending.

“Helping customers select the right Medicare insurance plan to meet their needs aligns with Walmart’s mission of helping people save money and live better,” he said in a statement on Tuesday.


The company said Tuesday that “more carriers may

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