NAF, thanks for the information in this thread. It seems to revolve around those at or approaching age sixty-five. We need to get my wife on a Medicare Advantage / Medigap plan by next month. She is mid forties and has Medicare A/B do the rules change? She was covered by my employer supplied plan until I was Obamacared out of a job.
IIRC, anyone newly eligible for Medicare gets the open enrollment period to buy a Medicare Supplement plan.
So is she just now starting Medicare or was she covered under both your previous employer and Medicare?
Both. COBRA runs out this month.
She has six months from the date of lost coverage/enrollment in part B (she should not have been able to enroll in B if she had the other coverage.) If she is under 65 stay away from MA plans if you can. They are far too high a risk and she will be stuck with that plan until she turns 65.
She can change MA plans during the Annual Enrolment Period (AEP) which runs October 15th tru December 7th of each year. Outside of AEP she can still change plans if she qualifies for a Special Election Period (SEP).
She can. She can always change to a different MA plan. Sorry for the lack of clarity. MA plans frequently have almost no underwriting, but she won’t have the option of going with Medigap. Read my posts above for reasons why that might still be pretty risky. While she might qualify for SEP before she turns 65, that’s going to be fairly unlikely. Not that it can’t happen, but it is unlikely.
Waking up this thread because I just learned something about this from my provider, Premera Blue Cross.
I was told that once you are signed up for Medigap, the ability to switch between plans is allowed between plan types (high to low deductible, G to F) and insurance companies is mandated by the federal government. This change can be made at any time and takes effect the next month - with no underwriting or risk of refusal.
I have also been told that I can switch from high to low deductible prior to an expensive treatment or surgery and then drop back to high deductible.
Do you live in Michigan? That’s the only state I know of with that rule. I don’t know a ton about the quirks in states outside of PA, but what you posted isn’t true for most of the country.
Missed the edit window. I don’t mean to imply that Michigan is the only state with that rule, just the only one I know of. It’s not a common rule. But there will be some differences between the state regulations on medigap plans.
Washington State.
They do; CMS allows 14 calendar days unless the provider requests that it be expedited due to risk of loss of life or limb (in which case it’s 72 hours).
Also Medicare Advantage plans serve a defined geographic area (typically either an entire state, or only certain counties within a state), and if you report a physical address change the plan has to disenroll effective the last day of the month. I’ve had to tell members who’ve reported address changes on the last day of the month that yes, their insurance really is going to end tomorrow. :smack: It’s not quite as bad as it sounds; they do revert to Original Medicare (but w/o an Rx coverage), but it sucks. With supplemental plans typically you still have to live in the plan’s service area to sign up, but once your in you can keep the same plan and move anywhere within the US.
My advice is to choose a supplemental plan over an MA plan; you will be better off in the long run (especially once you’re in an a nursing home). Unless of course you like dealing with stuff navigating provider networks and having random procedures need to be approved in advance by your insurance company.
1: If you have an MA plan and are moving, can you switch to a regular supplemental plan w/o underwriing, or are you stuck with an MA plan that covers the new location? What if there is no MA plan for that area?
2: If you sign up for a supplemental plan at price X, then move to another state or county where the pricing is different, do you keep your original pricing? Wondering, because probably when this thread first cropped up, I looked at rates as if I were about to retire. Where my in-laws live (“God’s Waiting Room”, a.k.a. southern Florida) has much higher rates than where we live (a DC suburb). I’ve got roughly zero desire to move to Florida, but if we do want to move somewhere when we’re ready to retire, that might affect the timing of the move and/or where we move to.
Typically yes. If you move out of the area that your MA plan covers you are thrown into a guaranteed issue period and have 6 months to get a new plan. You can get any MA plan or a plan F or plan A with no questions asked.
If you move you can, kinda, keep your traditional supplement. You aren’t really supposed to, but I know people who have stayed with their traditional supplement for 6 or 7 years after moving to a new state. Eventually you will probably want to change due to price increases.
Also, Florida is a crazy place to shop for a Med Sup. They have a lot of state specific rules and prices are very much out of step with the rest of the country.
Good to know. I don’t sell outside of PA but I try to keep up with the stuff going on in other states.
I’m also a licensed agent and I just wanted to chime in that , at least in my area, AARP supplement plans tend to run a little higher rate wise but they are fantastic if I have a client with significant medical issues. For the most part, if the person has not been hospitalized in the last 6 months, is not battling cancer or has a recommended surgery they did not pursue yet, I have a much better chance of getting them in. Last year I was able to get a diabetic approved with no rate increase (he did have minimum complications than is typical but was denied elsewhere) and a very elderly gentleman with the beginning stages of Parkinson’s also approved (though increased rate) so he could go to the neurologist his MA plan wouldn’t allow him. I also got a person approved 6 months after his hospitalization for a stroke, also with no rate increase.
It’s not an open door policy at AARP but they do have more liberal underwriting policies than anyone else in my area at least.