Medigap Plans to Rule Out?

[REWahoo]

So what is Medicare assignment?

Accepting what Medicare pays and not charging more (excess charges).

 

[fosterscik]

Thanks for all the help on travel coverage! Medicare supplements are complicated enough without glaring errors in posted information. I appreciate the travel supplement suggestions. Lots to think about.

 

[aja8888]

That is interesting. When DH went on Medicare several years ago I checked then and the cost difference of the two was basically identical to the G deductible. So, for simplicity, he just selected F since G didn't really save anything. I go on Medicare next year and will revisit it for myself. I will likely choose F or G. I do agree with the post about simplicity. I remember during my mom's last couple of years when she had a lot of medical needs. She had Plan G and she could manage that. I think it would have been very difficult for her to manage some of the more complex plans with lots of co-payments.

I changed plans at age 72 as the full plan F premium was getting very expensive vs. G AT THAT TIME. The rate of premium increase each year of F was much higher than the rate of increase of G making the decision obvious. There was a thread here at the time where that was being discussed.

I wouldn't try this switch unless one can qualify medically. It's pretty hard to qualify unless you have a very clean medical history and no ongoing conditions (diabetic, COPD, heart issues, etc). If I would have known about the rate of premium increase difference when I enrolled in Plan F at age 65 (7 years earlier), I would have probably chosen G instead.

 

[Sue J]

Accepting what Medicare pays and not charging more (excess charges).

Thanks. Sounds like that is comparable to a provider accepting the negotiated rate in pre-medicare insurance like our Obamacare.

 

[ShokWaveRider]

I changed plans at age 72 as the full plan F premium was getting very expensive vs. G AT THAT TIME. The rate of premium increase each year of F was much higher than the rate of increase of G making the decision obvious. There was a thread here at the time where that was being discussed.

I wouldn't try this switch unless one can qualify medically. It's pretty hard to qualify unless you have a very clean medical history and no ongoing conditions (diabetic, COPD, heart issues, etc). If I would have known about the rate of premium increase difference when I enrolled in Plan F at age 65 (7 years earlier), I would have probably chosen G instead.

How can this be? Here is what I read.

What is the Medigap Open Enrollment Period?

Your Medigap Open Enrollment Period is a 6-month period that starts the day you are both 65 years old and enrolled in Medicare Part B.
During the 6-month Medigap Open Enrollment Period, you do not have to undergo medical underwriting and you can change insurance plans or companies without getting penalized.

 

[MichaelB]

How can this be? Here is what I read.

What is the Medigap Open Enrollment Period?

Your Medigap Open Enrollment Period is a 6-month period that starts the day you are both 65 years old and enrolled in Medicare Part B.
During the 6-month Medigap Open Enrollment Period, you do not have to undergo medical underwriting and you can change insurance plans or companies without getting penalized.

Right. When you are first eligible your enrollment is not subject to underwriting. After that period, you can apply for a new or different MediGap policy, but it is subject to underwriting.

 

[ShokWaveRider]

Right. When you are first eligible your enrollment is not subject to underwriting. After that period, you can apply for a new or different MediGap policy, but it is subject to underwriting.

But open enrolment is every year? I am very unclear on this. My insurance agent says as long as you have insurance and are in open enrolment you can change without medical checks.

I also read this, but it does not say without underwriting, but it does not say otherwise either.

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.

 

[MichaelB]

But open enrolment is every year? I am very unclear on this. My insurance agent says as long as you have insurance and are in open enrolment you can change without medical checks.

I also read this, but it does not say without underwriting, but it does not say otherwise either.

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.

Open enrollment for Medicare Supplemental is once, when you first become eligible. It's a 7 month window - 3 months before birth month to 3 months after, Period, that's it for Florida residents with regard to guaranteed enrollment to MediGap.

After that, any request to change MediGap policy is subject to insurance underwriting and approval. That's it for Florida residents.

Medicare Plan D pharmaceutical plans have an annual open enrollment period, you are free to change plans at that time, and you have guaranteed acceptance.

 

[ShokWaveRider]

Open enrollment for Medicare Supplemental is once, when you first become eligible. It's a 7 month window - 3 months before birth month to 3 months after, Period, that's it for Florida residents with regard to guaranteed enrollment to MediGap.

After that, any request to change MediGap policy is subject to insurance underwriting and approval. That's it for Florida residents.

Medicare Plan D pharmaceutical plans have an annual open enrollment period, you are free to change plans at that time, and you have guaranteed acceptance.

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.

 

[MichaelB]

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 is specific to UHC policyholders, and does make their policies worth consideration. Mentioned a number of times in MediCare discussions - here are a few.

http://www.early-retirement.org/forums/f38/aarp-uhc-medigap-plans-f-g-87496.html

http://www.early-retirement.org/forums/f38/medicare-choices-92364-3.html#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 many of these questions have been addressed.

 

[ShokWaveRider]

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/forums/f38/aarp-uhc-medigap-plans-f-g-87496.html

http://www.early-retirement.org/forums/f38/medicare-choices-92364-3.html#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]

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]

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]

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]

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]

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

Maybe so, I am in Florida.

 

[MichaelB]

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]

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]

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]

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]

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...edigap/guaranteed-issue-rights-scenarios.html

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

 

[REWahoo]

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...edigap/guaranteed-issue-rights-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]

^ 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]

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.