Medigap Plans to Rule Out?

[molly312]

I would like to add that the rules for changing Medigap providers and/or plans depends on your state laws. We thought that we could not change Medigap providers and were told this when we lived in another state. However, after we moved to a new state and were here 1 year, we were told that we could change providers on our "sign up" date. (Missouri). Check at you state insurance website.

[kaneohe]

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Originally Posted by Another Reader ...................................... Someone up thread or possibly in another thread said it was more expensive to buy the AARP plan through them than by buying it through AARP. I'm going to verify through the pension system that I have to buy through them to get the reimbursement. .................................................. ......

ymmv but I bought my AARP plan thru them (when they were Extend Health) and the price was the same as if I had bought directly from AARP. Did it only to make the reimbursement automatic. Again ymmv but I would have been reimbursed if I had bought directly from AARP but would have had to submit a request for reimbursement plus proof of enrollment/payment periodically .

[Buckeye]

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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.

My 84-year old mother attempted to change from her Florida UHC AARP Plan F policy to an N policy at the end of 2017 during what apparently is only the Part D open season. She was denied because she has COPD. I understood she could change without underwriting during that period but that was not the case. Like someone said in another post, the only true 'open enrollment' period for supplemental plans is those first months after you turn 65. After that initial period of 6 months, you can change supplemental policies at any point during the year but you have to pass underwriting. You cannot pass underwriting if you have been diagnosed with COPD or a couple of other conditions.

[REWahoo]

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Originally Posted by Buckeye Like someone said in another post, the only true 'open enrollment' period for supplemental plans is those first months after you turn 65. After that initial period of 7 (?) months, you can change supplemental policies at any point during the year but you have to pass underwriting.

Yep, that is correct except in a few states that have limited exceptions, and Florida isn't one of them: https://www.medicarefaq.com/faqs/sta...edicare-rules/

[Buckeye]

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Originally Posted by audreyh1 Open Enrollment does not occur annually for Medigap plans. That is what you are missing.

Only Part B (switching between regular Medicare and an Advantage Plan) and Part D have annual open enrollment, right?

Open enrollment for Medigap/Supplemental plans is a one time event that lasts for the first 6 months after turning 65 and signing up for Medicare. After the initial (and only) open enrollment period, you can attempt to change your supplemental policy at any time during the year but any change requires underwriting.

[Buckeye]

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Originally Posted by TromboneAl Let's say I go with a Medigap G plan. The next steps are to: 1. Choose a provider. 2. Go to SSA.gov and sign up for A, B, and D, and G?

You will sign up for Medicare Part A and Medicare Part B with SSA.

Part D is a separate activity that is between you and an insurance company (or agent) although I find the Part D drug plan screener on the medicare.gov website to be very helpful when shopping for the right plan for my mother every year. You load in your meds and it gives you an overall cost as you attempt to balance the deductible (should you choose a plan with one), co-pays, formulary (are my drugs covered), and monthly premium.

Your other task is to purchase a supplemental plan and you have chosen Plan G. That is also between you and an insurance company (or agent).

[audreyh1]

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Originally Posted by Buckeye Only Part B (switching between regular Medicare and an Advantage Plan) and Part D have annual open enrollment, right? Open enrollment for Medigap/Supplemental plans is a one time event that lasts for the first 6 months after turning 65 and signing up for Medicare. After the initial (and only) open enrollment period, you can attempt to change your supplemental policy at any time during the year but any change requires underwriting.

Medicare Advantage plans have annual open enrollment. But switching from an Advantage plan back to original Medicare part B after the initial 6 months would expose you to underwriting for a Medigap plan.

[ivinsfan]

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Originally Posted by audreyh1 Medicare Advantage plans have annual open enrollment. But switching from an Advantage plan back to original Medicare part B after the initial 6 months would expose you to underwriting for a Medigap plan.

So I'm just doing my Medicare stuff right now ...joining Medicare Oct 1 and this isn't correct... if you pick an Advantage Plan on your initial signup and don't like it you have 12 months to go back to Medicare with no underwriting.

If you switch from Medigap to MA and you don't like it within the first 12 months you have the right to go back to the plan you had before you went to the Medicare Advantage plan. If your original plan is no longer available you may buy any Medigap policy..


Not trying to call anyone out, I've spent the last week reading this stuff

[audreyh1]

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Originally Posted by ivinsfan So I'm just doing my Medicare stuff right now ...joining Medicare Oct 1 and this isn't correct... if you pick an Advantage Plan on your initial signup and don't like it you have 12 months to go back to Medicare with no underwriting. If you switch from Medigap to MA and you don't like it within the first 12 months you have the right to go back to the plan you had before you went to the Medicare Advantage plan. If your original plan is no longer available you may buy any Medigap policy.. Not trying to call anyone out, I've spent the last week reading this stuff

I was specifically talking about underwriting with Medigap plans.

Some states have more flexibility.

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Medigap But in most states, you will not have guaranteed issue access to a Medicare supplemental insurance (Medigap) plan when you leave Medicare Advantage to switch to Original Medicare, although there are some exceptions to this. You can enroll in a Medigap plan, but you will generally be subject to medical underwriting unless you qualify for a Medigap special enrollment period or guaranteed issue right — which does include some limited situations in which the enrollee is switching from Medicare Advantage to Original Medicare during the trial right period. But some states have regulations to ensure ongoing access to Medigap plans, outside of the initial Medigap open enrollment period. New York and Connecticut don’t allow medical underwriting for Medigap plans. You can check with your State Health Insurance Assistance Program (SHIP) to see about rules in your state.

https://www.medicareresources.org/fa...inal-medicare/

But it does look like you can switch from Medigap and try a Medicare Advantage plan for up to 12 months and still switch back to your old plan.
https://medicare.com/medicare-advant...e-trial-right/

[ivinsfan]

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Originally Posted by audreyh1 I was specifically talking about underwriting with Medigap plans. Some states have more flexibility. https://www.medicareresources.org/fa...inal-medicare/ But it does look like you can switch from Medigap and try a Medicare Advantage plan for up to 12 months and still switch back to your old plan. https://medicare.com/medicare-advant...e-trial-right/

I've found private sites like your first link don't always get things right. I've been sticking to what I find on the medicare site which was your second link. There is no underwriting requirement for Advantage Plans.If you have end stage renal disease you may not use an Advantage Plan.. So any underwriting rules would apply only to Medigap. You have 6 months starting with the date you go on Medicare without underwriting for a regular Medigap plan. If you spend less then 12 months on an Advantage plan you may switch out to your previous plan. If your MA plan was the first plan you tried you have 12 months to switch to Medigap and will not be subject to underwriting and may pick any plan you choose. If you spend more then 12 on an Advantage plan you must complete underwriting before you can switch.

Check and double your state rules and see if they are more liberal then the national rules.

[NoMoreJob]

Talking about Medicare/Medigap/Drug Plans/Medicare Advantage and all things related on national forums like this can be helpful but it can also be a bit frustrating because there are many nuances to the program and because there can be additional differences from state to state. Sometimes I find myself trying to help only to realize I may have confused the situation. I'm sure others find themselves in the same position.

The moral to the story is to make sure and double check what you learn here. Although I've never been one to use brokers for much, I was fortunate to find a reputable insurance broker who helped guide be through the selection and sign-up process and saved me a few bucks and a ton of frustration in the process.

[ivinsfan]

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Originally Posted by NoMoreJob Talking about Medicare/Medigap/Drug Plans/Medicare Advantage and all things related on national forums like this can be helpful but it can also be a bit frustrating because there are many nuances to the program and because there can be additional differences from state to state. Sometimes I find myself trying to help only to realize I may have confused the situation. I'm sure others find themselves in the same position. The moral to the story is to make sure and double check what you learn here. Although I've never been one to use brokers for much, I was fortunate to find a reputable insurance broker who helped guide be through the selection and sign-up process and saved me a few bucks and a ton of frustration in the process.

Agree, but educate yourself even if you use a broker so you know what going on and because brokers are not perfect.

I talked to a broker and didn't sign up yet and none of these underwriting issues even came up. If you have a preexisting condition you need to be very careful.

[NoMoreJob]

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Originally Posted by ivinsfan Agree, but educate yourself even if you use a broker so you know what going on and because brokers are not perfect. I talked to a broker and didn't sign up yet and none of these underwriting issues even came up. If you have a preexisting condition you need to be very careful.

Agree 100%. Doing the research both here and elsewhere (I bought the "Dummies" book as well as reading online and the official Medicare mailings) prepared me to ask the right questions of the broker. Asking those questions enabled me to better judge his knowledge, approach and honesty.

[TromboneAl]

Will call BoomerBenefits tomorrow, thanks!

[TromboneAl]

That you guys recommend BoomerBenefits is enough for me, but I need to ask (due to years of bias against financial planners) ...


Their site says:



"They are appointed by many different insurance companies so that they can find the right fit for you."


Does that mean that they may be more likely to recommend one of the insurance companies that they are appointed by?

[REWahoo]

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Originally Posted by TromboneAl That you guys recommend BoomerBenefits is enough for me, but I need to ask (due to years of bias against financial planners) ... Their site says: "They are appointed by many different insurance companies so that they can find the right fit for you." Does that mean that they may be more likely to recommend one of the insurance companies that they are appointed by?

It means they are an "independent agency" and will give you information on a number of different insurance companies. I think the companies they deal with represent the major Medigap insurers in the US, and which one you choose is up to you.

Remember, the coverage is exactly the same for all the Medigap plans. The only difference is the cost and customer service. And if you go through these folks, they will do the customer service work for you if you ever need to contact your insurer.

[ivinsfan]

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Originally Posted by TromboneAl That you guys recommend BoomerBenefits is enough for me, but I need to ask (due to years of bias against financial planners) ... Their site says: "They are appointed by many different insurance companies so that they can find the right fit for you." Does that mean that they may be more likely to recommend one of the insurance companies that they are appointed by?

Short answer who knows. Long answer everybody has a reason for recommending something. Brokers can't work for free and since we don't pay them it's fair to assume the insurance company does.

I did notice you can't really get much info on their site. I logged on to try and do some research and got the contact pop-up info. Since it's been vetted here I went ahead and gave my details at that point I just got the Thanks we'll call you message. Cant do much looking on the site which makes me think yes they do have preferred providers. When they called I told the guy I was just trying to look at your website and already have a broker. This doesn't mean the recommendations won't work for you but buyer beware.

If I was you I might be more inclined to find someone local so that you can go in and B$%^ch in person if/when you have a problem.
In my case the broker represented me for my ACA signup and called the state to stop my coverage and such while I was sitting in his office. If I have a problem with that it's now his problem not mine.

[NoMoreJob]

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Originally Posted by TromboneAl Does that mean that they may be more likely to recommend one of the insurance companies that they are appointed by?

Absolutely. And they could also lean toward a company that offers them a greater commission than another.

Agencies like this (I know nothing about this particular one) are good resources for information but IMO shouldn't be relied upon exclusively and certainly not without checking other sources of information.

I agree that using a local broker has advantages but they all have their own self-interest that you need to consider.

[TromboneAl]

Just finished talking with Brad at BoomerBenefits. He's great--almost too good to be true.


I'm signing up for Medigap G through Anthem Blue Cross, and he's going to recommend a drug plan when I fill out some forms.

[ivinsfan]

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Originally Posted by TromboneAl Just finished talking with Brad at BoomerBenefits. He's great--almost too good to be true. I'm signing up for Medigap G through Anthem Blue Cross, and he's going to recommend a drug plan when I fill out some forms.

Glad you are moving ahead, hopefully after I see my broker on Thursday I'll have a resolution as well. Then I can concentrate on getting old in peace.