Changing Medigap w/Underwriting Options

[CRLLS]

I am currently in the process of changing my Medigap coverage, both company and Plan. I had to fill out a medical questionnaire. The only "iffy" part that I can see if that I have not seen a primary phys or specialist in the last 2 years. I applied and the tentative premium is per the published online numbers. Totally acceptable. But that is subject to their review and approval. If I end approved and put in group B (higher premiums) can I simply cancel the application and just stay with my current Medigap company and plan?

[Telly]

If you haven't found the answer yet, look at this link, and scroll down to
Medigap free-look period

https://www.medicare.gov/supplements...digap-policies

[CRLLS]

Thanks Telly. I finally found that link. It says I can have the two policies overlap for up to 1 month.

Does anyone know if I have the right of refusal before a replacement policy is issued if the underwriters put me in the higher premium group? I'm trying to understand the process. I can't seem to find that specific info. It feels like I would be in a legal contract without knowing the actual cost beforehand.

[CRLLS]

As a follow-up to this, I received notice from UHC that I was approved. No mention as to what the monthly amount will be. I created my account on the web and checked there. There was no mention anywhere about of monthly cost. Today I called to find out. I passed underwriting and am in the low premium class. Weeeee! We were (are) on BCBS F-HD plan and moved to AARP Plan G starting Jan 1 2020.

DW just finished her application for her transition to Plan G.

[Telly]

Somehow I missed your follow-up news.

That's GREAT! Yeah, I sweated the wait a bit, though other than no viable PCP anymore (which they didn't ask about), I couldn't think of any possible reason I would be turned down, I have nothing health-wise. So the review was pretty quick and I was approved. I'll try not to spend all their money before you come on board in January Actually, I'm only half-way to my Part B deductible, and it's November.

My PCP, who I rarely saw, the practice sent me a letter over 6 mos. before I turned 65, telling me that their multi-location practice with many doctors, would NOT take Original Medicare! What? No, only the 2 MA Plans that they preferred, and 2 more MA Plans that they would accept. So much for them. I think they were bought a couple years ago by one of these companies that goes around buying up larger practices.

[badatmath]

Curious what kind of questions they ask at Medigap age? Surely they expect something will have gone wrong with you by then?

[wmc1000]

DW and I switched Plan G supplement carriers lat month. While DW is diabetic it did not cause any issues in changing other than she had a phone call interview with the adjuster. They didn't call me for anything. Both approved at regular rates with new company, a subsidiary of Manhatttan Life, that reduced our annual cost by $500.

As for initial medigap supplement enrollment it doesn't matter what your health conditions are as it is guaranteed enrollment and you can't be excluded from coverage. Rates are only different I believe if you are a smoker vs a non-smoker.

[REWahoo]

Quote:

Originally Posted by badatmath Curious what kind of questions they ask at Medigap age?

None, provided you purchase the policy in your initial 6 month enrollment window.

[CRLLS]

Quote:

Originally Posted by badatmath Curious what kind of questions they ask at Medigap age? Surely they expect something will have gone wrong with you by then?

When you are first eligible for Medicare, generally when you are 65, some Plans are "Guaranteed Issue" which means they cannot deny you or increase the monthly premium for any reason. In fact, they don't even ask you your medical history. Other Plans are not and one must get approved (Underwriting) before you are accepted. In our state (not in all) since we were changing plans and companies, there was no "Guaranteed Issue". We had to go thru Underwriting which is a fancy word for a Q&A and approval process. I could not find anywhere the specific questions asked. I'll attempt to hit the highlights of our questions.

For changing from BCBS F-HD to AARP Plan G, we were asked about some chronic serious issues, asked about any cancer history, asked about any recommended procedures that were not acted upon. If we were hospitalized within the last 90 days. We were also asked to provide our PCP's name and address.

Within the last 2 years did you have or were medically diagnosed, treated, given medical advice or prescribed medications/refills for any of the following conditions:

A-fib
Artery Blockage
Peripheral Vascular Disease
Cardiomyopathy
Congestive Heart Failure
Coronary Artery Disease
COPD
Chronic Kidney Disease
Diabetes (only if you have Circulation problems or Retinopathy)
Cancer including Melanoma( But not other skin cancers), Leukemia, or Lymphoma
Cirrhosis of the Liver
Macular degeneration (only if you have the set form)
Rheumatoid Arthritis
Systemic Lupus Erythematosus

Within the last 2 years, have you had a Heart Attack, Stroke, Transient Ischemic Attack or Mini-Stroke

There were no questions about Kidney, Appendix, Gallbladder or prostrate issues, or even AIDES!

I do not know what actions they would take if you have answered unfavorably to one or more questions. I do not know if the same questions are used for every AARP plan or if other companies use the same list. I hope this gives helps to some idea for you.

[Telly]

Quote:

Originally Posted by CRLLS ....For changing from BCBS F-HD to AARP Plan G, we were asked about.....

AARP/UHC Medical Underwriting questions in TX:
I had applied in TX wanting to change from a MoO UW Plan G that I just had clicked over 11 months on in early October, to an AARP/UHC Plan N. So I was switching companies, and downgrading in premium cost AND coverage. I had found a current enrollment kit for TX online (180 pages, but only 16 pages including some blanks and agent-only areas for the actual enrollment form).

The enrollment form was not specific to plan level (F, G, N etc.) but there is a question on the form where the user specifies which Plan level they are applying for.

I worked with BB via phone and email, and since I had all the info in advance on my own, I could just follow along to answering all the questions over the phone. The form did not ask anything about who my PCP was, I figured that would never come up unless an underwriter decided to call me on any clarification needed, and asked that specific question, which did not happen. I answered everything truthfully, and figured there should be no problem, which there wasn't.

These were the medical things asked in the TX form, I'll quote some of CRLLS's text to save me typing:

5. Eligibility health questions only if your acceptance is not guaranteed as defined in Section 3:
5A. Within the past 90 days, were you hospitalized as an inpatient (not including overnight outpatient observation)?
5B. Are you currently being treated or living in any type of nursing facility other than an assisted living facility?
5C. Has a medical professional told you that you have End Stage Renal (Kidney) Disease or that you require dialysis?
Answering YES to any question in Section 5 will result in a denial of coverage. They go on to say if your health status changes in the future that allow you to answer NO to those 3 questions, you could reapply. And: If you answered NOT SURE to any question in Section 5, we will contact you for further information.

6. Answer these health questions to determine your rate only if your acceptance is not guaranteed as defined in Section 3:

Quote:

Within the last 2 years were you diagnosed as having, treated, given medical advice or prescribed medications/refills by a medical professional for any of the following conditions?: 6A. A-fib Artery Blockage Peripheral Vascular Disease Cardiomyopathy Congestive Heart Failure Coronary Artery Disease COPD Chronic Kidney Disease Diabetes (only if you have Circulation problems or Retinopathy) Cancer including Melanoma( But not other skin cancers), Leukemia and Lymphoma Cirrhosis of the Liver Macular degeneration (only if you have the set form) Rheumatoid Arthritis Systemic Lupus Erythematosus

6B.

Quote:

Within the past 2 years, did you have (as determined by a medical professional) a Heart Attack, Stroke, Transient Ischemic Attack (TIA) or Mini-Stroke?

If you answered YES to any question in Section 6, your rate will be the Level 2 rate. See the "Cover Page - Rates". If you are NOT SURE to any question, we may need to contact you for additional information.

7. Tell us about your tobacco usage.
7A. At any time within the past 12 months have you smoked tobacco cigarettes or used any other tobacco product?
If you answered YES to question 7A, your rate will be the tobacco rate. See the "Cover Page - Rates".

They did ask about Kidneys, in my Section 5(C) and in 6(A).

I think it's safe to assume that they pull anything in the MIB (Medical Information Bureau) about you, as you give them permission to acquire data from wherever as part of the application form. You also sign the "to the best of my knowledge" statements, which if you knowingly answer falsely, they can disallow coverage of you at a later date.

The rates are state-specific, and parts of the forms may be too, as the last 3 questions in Section 6A that CRLLS had, were not on the TX form (I lined them out for clarity), nor did they ask about PCP.

[audreyh1]

So are quite a few people switching from Mutual of Omaha to AARP/UHC due to the former hiking rates and pulling stunts with new plans?

[REWahoo]

Quote:

Originally Posted by audreyh1 So are quite a few people switching from Mutual of Omaha to AARP/UHC due to the former hiking rates and pulling stunts with new plans?

At least for now I'm going to stay with MoO. My reasoning:

After the heads up from Telly regarding MoO's "close the book" strategy, I did some follow up. Yes, MoO did close their subsidiary (United World) to new membership in TX, meaning the pool of insured will get no new, younger and presumably healthier members going forward. This will probably result in higher rate increases as the pool ages and health declines. Not good.

MoO's rates in TX for Plan N, including a 12% discount for DW and I, are very competitive. The first year rate increase for my N policy was only 6% while MoO increased F and G by 10%. AARP/UHC rates for N are considerably higher, likely due to not playing the "close the book" game and being community, not age rated.

It appears I have the choice to pay now with AARP/UHC or pay later with MoO.

I decided to stay with MoO for now, hoping Plan N will continue to see lower future increases than other plans, even with the closed book. If the increases/rates become excessive and there are better options available at that time, perhaps we can pass underwriting and make a change.

If not, it will be pay me later time.

[badatmath]

Thanks to those who shared some of the questions. I had always heard horror stories about individual insurance like if you ever had a cold you were doomed for life. I mean of course I figured that was exaggerated but still. . . having only been on group plans before I really didn't know.