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Is Plan F a Viable Medicare Supplement Option?
Medicare Plans

Is Plan F a Viable Medicare Supplement Option?

by Garrett Ball
written by Garrett Ball

When you look over the Medigap coverage chart, which shows the standardized Medigap plans, you may notice an asterisk beside the Plan F. Most people never pay much attention to this or read the fine print below the chart to understand exactly what this signifies. Is Plan F a Viable Medicare Supplement Option?

Actually, this notation represents an entirely separate Medigap plan called the High Deductible Plan F (often referred to in shorthand as HDF).

High Deductible Plan F is a unique Medigap plan that has a large deductible of $2,200 (for 2017) that must be met before any plan benefits begin. After that deductible is satisfied, the HDF plan works like a “regular” Plan F, paying everything that Medicare does not cover at the doctor and hospital.

How Does High Deductible Plan F Work?

The HDF plan works like any standard Medigap plan in that you can go to any doctor or hospital. There are no networks on any Medigap plan, including HDF.
If you have this plan, Medicare is still your primary coverage. Medicare pays its portion of your medical bills, then you pay the remainder of the charges until you have paid out the $2,200 deductible amount. After that amount is satisfied, Medicare plus the HDF would cover your medical bills in their entirety.
Also, like with other Medigap plans, claims payments are handled automatically through the Medicare crossover system. You are not responsible for paying at the time of service. The doctor’s office or hospital would bill Medicare first and then bill you the remainder after Medicare has paid its portion.

Advantages of High Deductible Plan F

Obviously, High Deductible Plan F is best suited for someone who is in relatively good health with minimal known doctor visits or recurring or chronic medical conditions.
It does allow you to plan for your medical costs on a predictable basis because you can figure in the premium for HDF, plus the $2,200 deductible to come up with a maximum out of pocket cost that you would have in a calendar year.
The premiums for HDF are typically half the premiums of other common Medigap plans, such as Plan G or Plan N.

Downsides of High Deductible Plan F

While the premiums are lower on HDF, you are responsible for a significantly higher amount of out-of-pocket costs, so that is one downside of this plan. You are responsible for anything Medicare does not cover until you’ve met the annual deductible.
Also, you should keep in mind, if you are considering this plan, that you do have to qualify medically to change Medigap plans in most cases. So, although you may be in good health now, if that changes and you want to change plans, you may not be able to do so.
Lastly, the deductible amount, which is currently $2,200, does change annually. Whereas other Medigap plans expand to fill the Medicare “gaps” as they change, your out-of-pocket costs under the High Deductible Plan F do change over time as the deductible itself changes.
Overall, the HDF is a viable option if you are in good health and just looking to keep your premiums down. However, you should certainly take the time to understand the long-term implications of this plan or any other plan you are considering. Is Plan F a Viable Medicare Supplement Option?

Is Plan F a Viable Medicare Supplement Option?

Is Plan F a Viable Medicare Supplement Option? Is Plan F a Viable Medicare Supplement Option? Is Plan F a Viable Medicare Supplement Option? Is Plan F a Viable Medicare Supplement Option? Is Plan F a Viable Medicare Supplement Option? Is Plan F a Viable Medicare Supplement Option?

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3 Rating Methodologies for Medigap Plans
Medigap

3 Rating Methodologies for Medigap Plans

by Garrett Ball
written by Garrett Ball

3 Rating Methodologies: Attained-Age, Issue-Age and Community

There are three rating methodologies that insurance companies can use when they sell Medigap policies – attained-age, issue-age and community rating. A rating methodology just means the method by which a company sets and changes their rates over time. 3 Rating Methodologies for Medigap Plans
The rating methodologies can be confusing and misleading, so it is important to have some understanding of them when you are comparing Medigap policies from different companies, particularly if you are turning 65 and starting with Medicare.

Attained-Age Rated Medigap

Attained-age rated Medigap policies are, by far, the most common among the three. In some geographic areas, these are the only types of policies even offered, at least on certain plans.
The rates on attained-age policies are based on the age you have “attained” the time you purchase the policy and the rates change based on your age as you get older over time.
For this reason, attained-age policies are generally cheaper than issue-age or community rated when you turn 65 or first start Medicare. Sometimes, they can be significantly cheaper. But the rates will go up as you get older.

Issue-Age Rated Medigap

Issue-age rated policies are the 2nd most common among the rating methodologies. This is also known as “entry-age rated”. In other words, your rate is based on your age at the time you enter the policy. So if you sign up for an issue-age policy as a 65 year old, your premium should always be lower than someone who started with the same policy at 70 years old.
The premiums on issue-age rated policies do not increase based on your age. However, the premiums do go up regularly due to inflation, changes to Medicare, and other factors.
There are some states which require companies that offer Medigap plans to offer them as issue-age policies (examples include Georgia and Florida).

Community Rated Medigap

Community rated policies are plans where everyone is grouped together, regardless of age, gender or health. On these plans, everyone within a certain geographic area pays the same premiums regardless of your age and whether you are male or female.
Community rated policies are often higher in costs. While the premiums do not go up based on your age, they do go up over time (just like issue-age rated) due to inflation, changes to Medicare and other factors as determined by the insurance companies.

So, Which Rating Methodology is Better?

It is difficult to give a “catch-all” answer to this question, since the plans vary so much from state to state. But, here are few important bullet points to keep in mind when comparing Medigap policies, especially as it pertains to their rating methodologies.

  • All three types of rating methodologies go up over time. If an agent or company tells you their plans do not go up in price, be very wary.
  • There are some states that offer plans of only one certain type of rating methodology. Before you even give this much thought, find out if your state is one of those. That may simplify the decision process for you.
  • Attained-age rated is much more prevalent in states where companies are allowed to decide from any of these three. Since older people cost insurance companies more money, they prefer to charge older people more premiums.
  • Be cautious of issue-age or community-rated policies that have that classification but give some sort of discount that goes away each year as you get older. Even though they may be rated as issue-age or community-rated, if they are still going up each year as you get older (plus any inflation-based increases), there is no difference from attained-age rated.
  • Overall, the most important thing, when comparing Medigap plans, is to pick a reputable company (highly rated) with competitive pricing – if not the best price for your age and zip code, one of the best. The most accurate predictor of which company will be lowest priced in 5 or 10 years is which company starts with the lowest price.

    3 Rating Methodologies for Medigap Plans

    3 Rating Methodologies for Medigap Plans 3 Rating Methodologies for Medigap Plans 3 Rating Methodologies for Medigap Plans 3 Rating Methodologies for Medigap Plans 3 Rating Methodologies for Medigap Plans 3 Rating Methodologies for Medigap Plans 3 Rating Methodologies for Medigap Plans 3 Rating Methodologies for Medigap Plans 3 Rating Methodologies for Medigap Plans 3 Rating Methodologies for Medigap Plans 3 Rating Methodologies for Medigap Plans 3 Rating Methodologies for Medigap Plans

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Why Compare Part D Plans Annually?
MedicareMedicare Plans

Why Compare Part D Plans Annually?

by Garrett Ball
written by Garrett Ball

What is Medicare Prescription Drug Coverage (Part D)?

Prescription drug coverage is available to everyone who is enrolled in Part A and Part B of Medicare. You have two options for getting your Part D coverage: Why Compare Part D Plans Annually?

  • Buy a stand-alone prescription drug plan (PDP)
  • You can enroll in a Medicare Advantage Plan that already includes prescription drug coverage.

If you do not sign up for a PDP when you are first eligible, you will have to pay a penalty every year for the duration of Part D. It is also important that you be a resident in the service area of the drug plan you are planning to enroll in, as plan vary by geographic location. Why Compare Part D Plans Annually?

What is the cost for Part D coverage?

Cost is one of the most important factors in signing up for Part D. Finding the right plan can save you big bucks! Your actual costs may vary depending on:

  1. which prescription drugs you take and if they are found on your plan’s list of covered drugs (formulary);
  2. which “tier” your prescription drug is in. Prescription drugs are categorized into tiers, the lower the tier, the less expensive the drug;
  3. which plan you enroll in;
  4. how you get your drugs, i.e. in-network, out-of-network, mail order, retail pharmacy;
  5. whether you get “extra help” or not. This is a Medicare program that assists those persons with limited income and resources pay for their prescription drug costs.

Please note that plan costs may change each year, which is why it is crucial to compare your Part D plans annually.

How Do You Compare Part D Plans?

The simplest way to compare your prescription drug plan to other plans is to call Medicare
(1-800-633-4227), TTY users,1-877-486-2048. However, during busy times you may be on hold for quite a while. Another alternative is to compare the plans yourself by viewing the Medicare Plan Finder at Medicare.gov/find-a-plan TTY users, 1-877-486-2048. Here is a step-by-step guide to comparing Part D plans. And, below, there are quick and easy steps to run a comparison report:

  • Click on the Find Health and Drug Plans found halfway down the page;
  • Enter your zip code and click on Find Plans – more than one county may come up and in that case, select your county;
  • Choose one of the choices under the two questions that appear on the following page, then click Continue to Plan Results;
  • Enter your medications into the box and click on Find My Drug. A list of several drugs might appear with the various dosages. Choose the one that pertains to you;
  • When you are finished entering your medications, click on My Drug List is Complete;
  • Various pharmacies may appear – choose your preferred one. You may extend the zip code to search a greater distance;
  • Click “Continue to Plan Results”.
  • Check the box for “Prescription Drug Plans”, then click “Continue to Plan Results”.
  • On the next screen, you will see “Original Medicare” listed first. You can skip that.
  • Under “Prescription Drug Plans”, you will find a list of the plans that are available to you. They range in order from the lowest estimated annual cost, which comprises premiums, deductibles and co-pays based on the medications on your drug list at the pharmacy you selected.
  • You can select up to three plans and click “Compare Plans”. You can also just click on the plan you want more information on without comparing it to any others.
  • Once you view a comparison of the plans you have selected, you can print these plans by clicking on Print Comparison Report found under the drug coverage section halfway down the page.

 

By following the steps above and running your Part D comparison, you may be able to find a cost-effective plan that will result in substantial savings in your pocket. You will be able to see the difference between utilizing generic drugs instead of brand name drugs, as well as choosing your preferred way of buying your medications, i.e. retail pharmacy or mail order company. Why Compare Part D Plans Annually?

Why Compare Part D Plans Annually?

Why Compare Part D Plans Annually?

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Making Changes to your Medicare During Open Enrollment
Medicare Plans

Making Changes to your Medicare During Open Enrollment

by Garrett Ball
written by Garrett Ball

The Medicare Annual Enrollment Period: How to Make Changes to Your Plans
Now that we are in October, the attention of many seniors has turned to the Medicare annual enrollment period. How could you not be thinking about it, right? The television commercials have begun, and the mailings have started piling up. Making Changes to your Medicare During Open Enrollment
During this time of year, it is important to understand exactly what changes you can make to your Medicare plans and how to go about making those changes.
Medicare Advantage Plan Changes
If you are in a Medicare Advantage plan currently, you should have received a “notice of plan changes” in late September/early October detailing exactly how your Medicare Advantage plan would be changing for 2018. This type of plan changes each year – premiums, deductibles, co-pays, networks, etc.
While it can be tempting to just toss that mail out with the rest of the “junk” you receive this time of year, it is not wise to do so. This document contains vital information about how much your plan will cost and how it will work for the following year.
It is prudent to compare your Medicare Advantage plan against other Medicare plans during the annual election period each year, which runs from October 15 to December 7. Unless you fall into a special circumstance, this is the only time that you can make changes to your existing Medicare Advantage plan. Making Changes to your Medicare During Open Enrollment
There are several ways to go about doing this. One, you can compare the plans yourself on Medicare.gov. Medicare’s website will give you at least some idea of the differences in the plan costs; however, for more detailed information, including exclusions, networks, and more, you would need to acquire plan-specific information.
The other way that you can compare Medicare Advantage plans is by using an independent broker that works for many companies, not just one specific insurance company. They can provide all the details and make recommendations based on your specific situation.
Medicare Part D Changes
The other type of plan that you should compare during the annual election period is Medicare Part D prescription drug plans. If you have traditional Medicare, you probably also have a prescription drug plan through Medicare Part D. Part D plans are sold by private insurance companies, and they can vary tremendously.
Just like with Medicare Advantage, these plans can change each year, in terms of premium, deductible and co-pays. Also, your medications may change over time. The plan that was good for you this year may not work for you as well next year.
It is absolutely critical that you don’t let the annual election period slide by without at least taking a look at your “notice of plan changes” for Part D. And, if you really want to be proactive, which is advisable, you should compare the Part D plan options online.
There is a tool on Medicare’s website (www.medicare.gov), on which you can plug in your zip code, medications and pharmacy. Then, the Medicare Plan Finder will rank all the plans in order of which ones would give you the lowest overall annual cost, based your specific situation and medications. The tool can be a little tricky to use, but here are step-by-step instructions for using it.
A Word about Medigap and the Annual Enrollment Period
Contrary to popular misconception, the annual enrollment period does not affect Medigap plans at all. These plans have an open enrollment that coincides with your 65th birthday or Medicare Part B effective date, but there is not a recurring, annual period for Medigap plans.
That said, the annual period provides a great opportunity to compare your Medigap plan to other plan options and see how your rates stack up against the rest of the marketplace.
Any time you change Medigap plans or companies you do have to answer medical questions and be “approved” medically, unless you are in one of a few states that prohibits medical questions on the application. Making Changes to your Medicare During Open Enrollment

Making Changes to your Medicare During Open Enrollment

Making Changes to your Medicare During Open Enrollment Making Changes to your Medicare During Open Enrollment Making Changes to your Medicare During Open Enrollment Making Changes to your Medicare During Open Enrollment Making Changes to your Medicare During Open Enrollment Making Changes to your Medicare During Open Enrollment

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Medicare Plans

Understanding Medicare Enrollment

by Garrett Ball
written by Garrett Ball

When is the Medicare Open Enrollment Period?

The Medicare Open Enrollment period is terminology that many people often use to refer to the end of the year period during which you can change medical and prescription plans. However, there is definitely some confusion about this period and some misuse of the term. Let’s clear up the Medicare open enrollment period confusion. Understanding Medicare Enrollment

Medicare Open Enrollment: When You First Turn 65 or Start Medicare

The actual Medicare open enrollment period is when you first turn 65 or go on Medicare Part B. During this time period, you have “open enrollment” into a Medigap (Medicare Supplement) plan. This open enrollment period lasts for 6 months starting with the first day of the month you turn 65 (or your Part B effective date if that date is later). During this time, you cannot be made to answer any health questions or undergo any medical underwriting to be approved on a Medigap plan.

Likewise, when you turn 65 or start on Medicare Part B, you have an “initial election period” during which you can select a Part D plan (prescription drug plan) without restriction or penalty. This initial election period lasts for 7 months – the month you turn 65 and three months on either side of that month. During this time, you can select any Part D plan without restriction or penalty.

If you are opting to go with a Medicare Advantage plan, you get the same initial election period as detailed above – 7 months including the month of your 65th birthday and three months on either side of that month. Understanding Medicare Enrollment

So, What is the Annual Medicare Enrollment Period?

The period that occurs annually, at the end of each year, is actually the “annual election period” or AEP. This period does not apply at all to Medigap policies (Medicare Supplements). On the contrary, this period only applies to Part D and Part C (Medicare Advantage).

The annual election period runs from October 15 to December 7. During the AEP, you can make changes to your Part D prescription drug plan or your Part C Medicare Advantage plan. Any changes that you make will take effect at the start of the following calendar year.

Many people often mistakenly think that you can also make unrestricted changes to your Medigap plan during that period; however, that is not the case. While you certainly can compare and change your Medigap plan during that period, you do still have to answer medical questions and be approved (3 Steps to Compare Medicare Supplement Plans). It is not, technically, an open enrollment period for Medigap plans though. Understanding Medicare Enrollment

How to Prepare for the Medicare Annual Election Period?

If you have either a Part D plan or a Medicare Advantage plan (Part C), you will receive a notice of plan changes for the following year in the mail. This usually comes in late September or early October. It is crucial not to merely disregard this mailing. Some of these plans change drastically each year, and you don’t want to get stuck in a deteriorating plan. Understanding Medicare Enrollment

When you receive your notice of plan changes, you should look over it carefully. It should show a side-by-side comparison with the previous year’s benefits. See what changes have been made and decide, based on the plan changes, your satisfaction with your plan, and any changes to your health or finances, whether you want to “shop” for a new plan.

If you do want to shop for a new Part D or Advantage plan, keep in mind that you can do so during the annual election period, which runs from October 15 to December 7. Understanding Medicare Enrollment

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How Aging with Friends Fills the Void of Being Alone
Medicare Plans

United Healthcare Plan G

by Garrett Ball
written by Garrett Ball

United Healthcare Plan G: Old Plan, New Company

Plan G is an increasingly popular Medigap plan, even more so with the announcement of the end of Medigap Plan F. Plan G has been increasing in market share and momentum as a viable alternative to the most common plan, Plan F. Now, one of the largest providers nationally of Medigap plans is entering the Plan G fray. United Healthcare AARP Plan G
United Healthcare Plan G is now being offered in many states, as of 7/1/2017. United Healthcare partners with AARP for Medicare plans, giving them a broad national reach and making them a leader in the Medicare insurance marketplace.

For the last few years, United Healthcare has been one of the few major players in Medigap plans that did not offer a Plan G. They have focused the majority of their Medigap marketing efforts on Plan F and Plan N. However, now that is changing.

United Healthcare currently offers Medigap plans in all 50 states. The United Healthcare Plan G is being offered in 25+ states starting in July. Other states are expected to approve the Plan G rates in the coming months.

What You Need To Know

Keep in mind that all Plan G’s are the exact same – they all provide identical coverage and go by the standardized Medigap coverage chart. Plan G is full coverage at the doctor and hospital, with the exception of coverage of the Medicare Part B deductible (currently $183/year). That is the only out-of-pocket costs that you are responsible for on this plan.

The plan standardization means that you can compare plans from United Healthcare with plans from other companies with the assurance that you will receive the same Federally-standardized benefits.

Likewise, in addition to the coverage being standardized, the way that the plans work is the same as well. All Medigap plans pay claims through the Medicare “crossover” system – this is Medicare’s electronic system for coordinating payments between Medicare and your Medigap plan.

Also, all Medigap plans can be used at any doctor or hospital that takes Medicare, nationwide. So there are no networks with Medigap plans. United Healthcare AARP Plan G

Medigap rates are determined by a variety of factors, including where you live, your gender, and your age. So, it is prudent to compare plans for your specific situation before making or considering a plan change.
United Healthcare AARP Plan G United Healthcare AARP Plan G United Healthcare AARP Plan G United Healthcare AARP Plan G United Healthcare AARP Plan G United Healthcare AARP Plan G United Healthcare AARP Plan G United Healthcare AARP Plan G

United Healthcare AARP Plan G

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Preventative Care Covered by Medicare
Health Insurance

Preventative Care Covered by Medicare

by Garrett Ball
written by Garrett Ball

Preventive care is, without a doubt, a significant factor in your physical well-being. This is also true, maybe even more so, as you age. Fortunately, after years of having limited coverage of preventive care, Medicare does now cover more preventive care. The key for the Medicare beneficiary is being aware of these and taking advantage of them. Preventative Care Covered by Medicare

Annual Visits Covered by Medicare

“Welcome to Medicare” Visit – Each Medicare beneficiary is entitled to a “Welcome to Medicare” visit within their first 12 months of being on Medicare Part B. During this visit, your provider will help you map out your current health situation and any future follow-up or ongoing needs (What Does the Welcome to Medicare Visit Cover?). Make sure your provider knows that this is your “Welcome to Medicare” visit, as this is coded differently than the annual wellness check (see below) and can cause problems if not handled correctly.
Annual Wellness Check – After your initial visit, each Medicare beneficiary can also do an annual wellness visit. During this visit, which is completed with your primary care doctor, you will review any further preventive care needs as well as your current health concerns or questions.

Preventive Services That Medicare Covers at 100%

Now, Medicare covers many preventive care services at a 100% level, as long as they are deemed to be “medically necessary”. Keep in mind that what Medicare considers “medically necessary” is person-specific in some cases – it can be based on your past health history, family history and other medical variables. Here is a list of medical preventive services that are covered by Medicare Part B at 100%:

  • Abdominal Aortic Aneurysm (AAA) Screening: This is for at-risk beneficiaries. You are considered at-risk if you have a family history of AAA or are a tobacco user
  • Alcohol Misuse Screening and Counseling: This is designed to eliminate/reduce alcohol use for someone considered to be misusing alcohol by their primary physician
  • Bone Mass Measurements: Medicare covers a bone density measurement every two years for people at risk for osteoporosis. Those classified as at risk for purposes of this screening are: estrogen-deficient women, those with vertebral abnormalities, those taking steroid treatments, those with hyperparathyroidism, and those that take an osteoporosis drug
  • Cardiovascular Risk Reduction: ALL Medicare beneficiaries are eligible for this visit. Doctors should screen for blood pressure and provide behavioral counseling and diet-related tips
  • Colorectal Cancer Screening: Medicare covers this for people age 50 and over. This includes a fecal occult blood test, flexible sigmoidoscopy (once every 4 years), and/or colonoscopy (once every 10 years or once every two years for those that are high risk)
  • Depression Screenings: Covered annually for all Medicare beneficiaries and must be performed in a primary care setting
  • Diabetes Screening: This is covered by Medicare either once or twice a year, depending on your risk factors, current health and whether you have been diagnosed as pre-diabetic
  • HIV Screening: Medicare covers this annually for all beneficiaries
  • Heart Disease Screening: Medicare covers this once every five years to test for cholesterol, lipid, and triglyceride levels
  • Mammograms: All women (over age 40) are eligible for an annual screening
  • Medical Nutrition Therapy: Medicare covers medical nutrition therapy, which may include dietary counseling for those with certain chronic diseases or risk factors
  • Obesity Screening/Counseling: Medicare covers screening for those that are classified as obese to help you lose weight. The baseline used for this is a body mass index (BMI) or 30 or more.
  • Pap Smears/Pelvic Exams/Breast Exams: If you are considered low risk, Medicare covers this every two years. If you are considered high risk, Medicare covers one exam per year.
  • Prostate Cancer Screenings: Medicare covers a blood test for prostate cancer for all male beneficiaries once per year
  • Smoking Cessation: Medicare covers two counseling attempts at quitting smoking per year
  • Vaccines and Immunizations: Medicare covers flu shots (once/year), pneumonia shots (once/lifetime), hepatitis B, and shingles (covered through Part D with some cost-sharing)

Preventive Services That Medicare Covers at 80%

There are other preventive care services that Medicare covers at 80%. If you have a Medigap plan, your plan may pick up the remaining 20% depending on which plan you have. Here is a list of those preventive services:

  • Colorectal Cancer Screening: This applies to Barium enema once every 48 months (or once every 24 months for someone classified as high risk)
  • Glaucoma Screening: Medicare will cover this at 80% if you are at risk (family history, diabetes, etc)
  • Prostate Cancer Screening: Medicare covers the digital rectal exam once a year for all male beneficiaries over age 50
  • Diabetes Self-Management Training: Medicare covers up to 10 hours of training during your first year if you are at risk of complications of diabetes or have recently been diagnosed

 

Overall, Medicare is covering much more preventive care than it has in the past. It is up to each Medicare beneficiary, in conjunction with their medical providers, to stay on top of this. Make sure you take advantage of the preventive care options that you have at your disposal as a Medicare beneficiary. Preventative Care Covered by Medicare

Preventative Care Covered by Medicare

Preventative Care Covered by Medicare Preventative Care Covered by Medicare Preventative Care Covered by Medicare Preventative Care Covered by Medicare Preventative Care Covered by Medicare

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Switching Medicare Supplement (Medigap) Plans
Medicare Plans

Switching Medicare Supplement (Medigap) Plans

by Garrett Ball
written by Garrett Ball

If you need to drop, change or enroll in a Medicare Supplement (Medigap) plan, you can do it at any time of the year. But before you make any changes, you need to consider whether you should make any changes or stay with whatever plan you currently have. Although you might be very satisfied with your Medicare Supplement plan now, it might not be suitable any longer because of your present needs or because of changes to the cost of your plan. As life events may have arisen, your current coverage could fall short of providing you with adequate coverage or may not meet all your needs for the duration of your life. You should consider very carefully the decision to change to another Medigap plan and/or company. Switching Medicare Supplement (Medigap) Plans
Some common reasons why you should consider switching Medigap plans, or switching from a Medicare Advantage plan to a Medigap plan are described below.

  • You are unhappy with your current Medigap policy because
  • the customer service being provided is substandard
  • your premiums have sky rocketed and you can no longer afford the increases
  • you want to change your level of coverage (i.e. Plan F to Plan G)
  • You have a Medicare Advantage Plan, but you are not happy with it because
  • the customer service being provided is substandard
  • your doctors are not in the Advantage plan network
  • you feel you just don’t have enough coverage and buying a Medigap policy would cover your healthcare more adequately
  • you fear that if you do acquire a major illness, you might be declined if you decide to switch at some time in the future, and you would rather change now.

What to consider when switching plans

When making that change to a Medigap plan, you should do a comparison of plans, i.e. which plans are available in your area and what benefits they offer (Plans F, G, N, etc). Medicare Supplement plans are standardized, however, they may vary widely in cost. You must get the same level of coverage no matter which company you buy your supplement from. In other words, one Medigap Plan G is the exact same as another Medigap Plan G. Your main goal is to find the best company at the lowest premium. Switching Medicare Supplement (Medigap) Plans
Note: If you are not satisfied with your Medicare Advantage plan, you have certain rights by federal law to buy a Medicare Supplement plan. You are entitled to these rights provided it is within 12 months of signing up for Original Medicare.

You cannot have both Medicare Advantage and Medigap, so you must be disenrolled from your Medicare Part C (Advantage) plan at the time a Medigap plan takes effect. You will need to contact your current plan and let them know that you want to go back to Original Medicare. Or you can disenroll from Medicare Advantage by signing up for a standalone Part D plan. For Medicare Advantage, the disenrollment process can only be done during certain times of the year or under special circumstances:

  • Annual Election Period (only for Part C and Part D): October 7 to December 15 each year. The change will take place the following January 1st. What changes can you make during the annual election period?
  • Annual Disenrollment Period (only for Part C and Part D): January 1 to February 14 each year. The change takes effect the 1st of the month following your request.

If you had a Medigap policy before you enrolled in a Medicare Advantage plan, you may be able to get the same policy back if it is still sold by that company. Otherwise you can buy another Medigap policy. Please note, that some states may provide additional special rights.

When is the best time to enroll in a Medigap Plan?

The best time for you to enroll in a Medigap plan is:

  • when you first turn 65. However, for you to be eligible, you must have already signed up for Medicare Part B. This is called the “Open Enrollment Period”. It is the 6-month period, which begins the 1st day of the month that you turn 65 and are in Medicare Part B. During this time, you have guaranteed issue rights. This means you cannot be declined in a Medicare Supplement plan because of your health. Even if you have health issues or pre-existing conditions, you are waived from answering any health questions, and must be offered the best available rate as anyone else who is in good health.
  • You are not limited to purchase a Medigap plan only during the open enrollment period or guaranteed issue rights. You are permitted to change it at any time since Medicare Supplement plans are not subject to the same guidelines as Medicare Advantage plans are. That said, you will, in most cases, have to undergo medical underwriting.

Whatever Medicare Supplement plan you switch to, make sure that you contact your current insurance company after you get approved by your new plan’s insurance company. This will prevent any duplication of coverage or any gap in coverage. You cannot have two Medigap plans at the same time. Switching Medicare Supplement (Medigap) Plans

Switching Medicare Supplement (Medigap) Plans

Switching Medicare Supplement (Medigap) Plans Switching Medicare Supplement (Medigap) Plans Switching Medicare Supplement (Medigap) Plans Switching Medicare Supplement (Medigap) Plans Switching Medicare Supplement (Medigap) Plans Switching Medicare Supplement (Medigap) Plans

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What Happens to Medicare Coverage When You Move
Medicare Plans

What Happens to Medicare Coverage When You Move

by Garrett Ball
written by Garrett Ball

 
When you change your residence, whether it be in the same city you are living, a different city or out of state, and you are on Medicare, you need to do the following: What Happens to Medicare Coverage When You Move

  • The Social Security Administration handles Medicare enrollment. If you receive Social Security benefits, you can change your address online at ssa.gov, or by phone at 1-800-772-1213.
  • If you have you Original Medicare, changing your address as noted above is all you need to do. However, if you have a Medicare Advantage Plan or Part D Prescription Drug Plan, or if you have a Medigap policy, there are additional steps you need to take. What Happens to Medicare Coverage When You Move

Medigap Plans:

If you are enrolled in a Medicare supplement plan (Medigap), the first thing you need to do is change your address with your current Medigap plan company. It is suggested that as soon as you know what your new address is, you should contact them. You can still keep your same Medigap plan as the plans are standardized in most states. It is important that you are aware that your new plan rate might be higher (or lower) in your new state. Also, you might have to answer additional health questions if you do try to change plans or companies.
When moving out of your plan’s service area, in the case of Medicare SELECT plans, which may require you to use in-network providers:

  • You will be eligible to enroll in a standardized Medigap policy from your current policy company which has equal or lesser benefits compared with your current Medicare SELECT policy.
  • You may enroll in any Medigap Plan A, B, C, F, K or L that is available in your service area.
  • If you have had your Medicare SELECT policy for longer than six months, you will not have to go through medical underwriting. What Happens to Medicare Coverage When You Move

Medicare Advantage Plans:

There is a “Special Enrollment Period” for those who change their residence address outside of their service area. You have the choice of either:

  • You will be disenrolled by your Medicare Advantage plan if you move out of the service area. You will then have Original Medicare. but will keep your Medicare Part A and Part B. It is important you understand that if you do not enroll in a new Medicare Advantage plan during your Special Enrollment Period, the next chance you have will not be until the next SEP, from October 15-December 7;
  • if your current plan is offered in your new service area, you can stay with that plan;
  • if new plan options are offered in your new location, you may choose to enroll in one of these;

The Special Enrollment time frame is as follows:

  • If you let your plan know before your move, your window of opportunity to change plans will begin the month prior to your move, and will continue after your move for two full months.
  • If you do not notify your plan until after your move, you will only have the month in which you contact your plan plus the two full months that follow.

Part D Prescription Drug Plans:

Part D prescription drug plan members must notify their current plan about a permanent move. If the member notifies the plan prior to the move, the Special Enrollment Period begins the month before the move and continues for two full months after the move. If the member notifies the plan after the move, the SEP begins the month that notification was given and lasts for two full months. Once you sign up for the new plan, you can choose an effective date of up to three months following the month the enrollment was submitted. What Happens to Medicare Coverage When You Move
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What Happens to Medicare Coverage When You Move

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