Medigap Plans to Rule Out?

[ShokWaveRider]

Quote:

Originally Posted by MichaelB That is specific to UHC policyholders, and does make their policies worth consideration. Mentioned a number of times in MediCare discussions here. A couple of threads that mention this http://www.early-retirement.org/foru...f-g-87496.html http://www.early-retirement.org/foru...ml#post2064657 UHC is under no obligation to provide this and can withdraw or change it at any time. Have you read other threads on Medicare, or all the posts in this thread? Lots of good advice, and these questions have been addressed.

I just called my Florida Blue Rep also and she said they do it too. Again "Currently".


Anyway, not worth

[MichaelB]

Quote:

Originally Posted by ShokWaveRider I just called my Florida Blue Rep also and she said they do it too. Again "Currently".

Well, it sounds as if UHC and Florida Blue have all the options and flexibility you need.

[audreyh1]

Quote:

Originally Posted by ShokWaveRider I am sorry to keep on about it, but I just called AARP United HealthCare. I asked the specific question. They said currently if you change plans between the OE dates that "Currently" there is NO Underwriting. Please feel free to call them and ask too. That is with UHC of course I cannot speak for anyone else. BTW er.org seems really slow to post today.

That's during the open enrollment dates, which is a single period when you first become eligible for Medicare, and does not occur thereafter.

I'm not sure why you would expect otherwise?

[ShokWaveRider]

Quote:

Originally Posted by audreyh1 That's during the open enrollment dates, which is a single period when you first become eligible for Medicare, and does not occur thereafter. I'm not sure why you would expect otherwise?

I wish someone else would call their insurance agent and confirm. I called UHC and FloridaBlue today and asked this question:

"If I have Medicare Part F and in 2 years time I want to change to Part G during Open Enrollment will I have to go through Medical Underwriting?"

The answer in both cases was no. The FB agent said there "Should" we no underwriting if you change at any time with FB. But certainly not if done during open enrollment. They only ask the smoking Question. Could the Agents and the insurance companies themselves are misinformed?

[Another Reader]

Quote:

Originally Posted by audreyh1 That's during the open enrollment dates, which is a single period when you first become eligible for Medicare, and does not occur thereafter. I'm not sure why you would expect otherwise?

Because different states have different rules. I believe California allows this as well.

ETA I believe Medigap insurance policies are regulated by the states, not by Medicare or another federal agency. The plan benefits are the same everywhere, but the administrative rules differ.

[ShokWaveRider]

Quote:

Originally Posted by Another Reader Because different states have different rules. I believe California allows this as well.

Maybe so, I am in Florida.

[MichaelB]

Quote:

Originally Posted by Another Reader Because different states have different rules. I believe California allows this as well. ETA I believe Medigap insurance policies are regulated by the states, not by Medicare or another federal agency. The plan benefits are the same everywhere, but the administrative rules differ.

MediGap policies are standardized by law and regulated by CMS. States can impose additional requirements on insurers, and a few have. Florida has no additional requirements.


A Medicare Supplemental (MediGap) policyholder in Florida can change policies only if the insurer chooses to accept. Based on previous threads (see links above) UHC allows that without underwriting, and ShokWaveRider reports that Florida BCBS does as well. Florida residents planning on a future change in MediGap policy (for example, from G to G Hi-D) rely entirely on the insurer's good faith to do this.

[Another Reader]

Quote:

Originally Posted by MichaelB MediGap policies are standardized by law and regulated by CMS. States can impose additional requirements on insurers, and a few have. Florida has no additional requirements.

I guess co-regulated would be accurate?

Actually, you raise a good point. I knew they are standardized, but not how they are priced. How is pricing set? Is it set or approved by the states via their insurance commissions?

[MichaelB]

Quote:

Originally Posted by Another Reader I guess co-regulated would be accurate? Actually, you raise a good point. I knew they are standardized, but not how they are priced. How is pricing set? Is it set or approved by the states via their insurance commissions?

Only states can regulate insurers. Congress passed a law standardizing MediGap policies, and CMS oversees that. The pricing and general compliance is a state responsibility.

Pricing is done like any other insurance product. The insurer submits pricing requests to the state insurance commission, which then acts to approve, reject or modify. Insurers are free to price as they wish, within state guidelines.

[audreyh1]

Quote:

Originally Posted by ShokWaveRider I wish someone else would call their insurance agent and confirm. I called UHC and FloridaBlue today and asked this question: "If I have Medicare Part F and in 2 years time I want to change to Part G during Open Enrollment will I have to go through Medical Underwriting?" The answer in both cases was no. The FB agent said there "Should" we no underwriting if you change at any time with FB. But certainly not if done during open enrollment. They only ask the smoking Question. Could the Agents and the insurance companies themselves are misinformed?

By definition, in your example, two years later you are no longer in open enrollment. I think that is what you are missing.

There is no such thing as "in two years time...during Open Enrollment" once you start Medicare.

Now it appears that some of these insurers are currently allowing people to switch from F to G plans without medical underwriting. That has nothing to do with open enrollment. And they are not obligated to do so in the future, either, outside of open enrollment.

[ShokWaveRider]

Quote:

Originally Posted by audreyh1 By definition, in your example, two years later you are no longer in open enrollment. I think that is what you are missing. There is no such thing as "in two years time during Open Enrollment" once you start Medicare.

Open enrolment Occurs Annually.

What’s the Medicare Open Enrollment Period?

Medicare health and drug plans can make changes each year—things like cost, coverage, and what providers and pharmacies are in their networks. October 15 to December 7 is when all people with Medicare can change their Medicare health plans and prescription drug coverage for the following year to better meet their needs.


On another note, perhaps UHC allowing this with no underwriting, could that be one of the reasons AARP endorses them?

[MichaelB]

Open enrollment does not mean guaranteed issue. This distinction is critical. You have the right to guaranteed issue only once, when you first become eligible for Medicare. See here https://www.medicare.gov/supplement-...scenarios.html

Annual open enrollment does not apply to Medicare Supplemental Policies (except where states impose a requirement. Florida does not).

[REWahoo]

Quote:

Originally Posted by MichaelB Open enrollment does not mean guaranteed issue. This distinction is critical. You have the right to guaranteed issue only once, when you first become eligible for Medicare. See here https://www.medicare.gov/supplement-...scenarios.html Annual open enrollment does not apply to Medicare Supplemental Policies (except where states impose a requirement. Florida does not).

^ What Micheal says.

SWR, I think you are "too busy looking at other more interesting parts of their anatomy" and failing to see the hairy armpits of Medigap policy change restrictions.
__________________

[ShokWaveRider]

Quote:

Originally Posted by REWahoo ^ What Micheal says. SWR, I think you are "too busy looking at other more interesting parts of their anatomy" and failing to see the hairy armpits of Medigap policy change restrictions. __________________

LOL. True. Just trying to get to the BOTTOM of it. I need to make the decision between F and G this year. I am concerned that in 2020 Insurance companies being what they are will put the prices of "F" up to encourage people to leave it. BUT I like the convenience of not having to worry about the deductible.

You would think calling the companies direct (FB and UHC and then talking to 5 (yes 5) different agents who specialize in Medicare Supplemental and Advantage plans and handle it every day, I could get a consensus.

They all say the same thing as I have reported here. However there still seems to be some that disagree. This is how I feel

No disrespect, but I am inclined to accept their comments as correct, all 7 of them I called today. At least until they change the rules, which can be any time.

[audreyh1]

Quote:

Originally Posted by ShokWaveRider Open enrolment Occurs Annually. What’s the Medicare Open Enrollment Period? Medicare health and drug plans can make changes each year—things like cost, coverage, and what providers and pharmacies are in their networks. October 15 to December 7 is when all people with Medicare can change their Medicare health plans and prescription drug coverage for the following year to better meet their needs. On another note, perhaps UHC allowing this with no underwriting, could that be one of the reasons AARP endorses them?

Open Enrollment does not occur annually for Medigap plans. That is what you are missing.

[NYEXPAT]

I live overseas so I will only be getting Plan A&B at this time. I am on SS and am turning 65 this year, do I have to apply or is it automatic?

[MBSC]

Quote:

Originally Posted by NYEXPAT I live overseas so I will only be getting Plan A&B at this time. I am on SS and am turning 65 this year, do I have to apply or is it automatic?

You will need to apply since you do not live in the states.

Quote:

Individuals already receiving Social Security or RRB benefits at least 4 months before being eligible for Medicare and residing in the United States (except residents of Puerto Rico) are automatically enrolled in both premium-free Part A and Part B. People who are automatically enrolled have the choice whether they want to keep or refuse Part B coverage. Reference: https://www.cms.gov/Medicare/Eligibi...rol/index.html

[Dawg52]

As of now there is no part G-hd but it will be available in 2020....right? Next year I have to make a decision on which one I want. Been thinking about F-hd but many seem to think F and F-hd could increase rapidly due to being closed. So if I went with F-hd next year, there is no guarantee that I or anyone else can convert to G-hd w/o underwriting.....right? Kind of sucks if I have it right.

[REWahoo]

Dawg, I think you have it right.

One suggestion - maybe sign up for G, then when G-HD is introduced see if you can make the switch. An insurer might look favorably on a downgrade where they are on the hook for fewer claims dollars.

[MichaelB]

Quote:

Originally Posted by REWahoo One suggestion - maybe sign up for G, then when G-HD is introduced see if you can make the switch. An insurer might look favorably on a downgrade where they are on the hook for fewer claims dollars.

This is my plan. I will sign with UHC, their rate is competitive at all age levels. If they introduce G-HD and allow changes I'll switch. If not, I can live with UHC G.


It didn't occur to me to check pricing at other age levels until I read REWahoo's posts about changing his policy.