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GailL1
May 17, 2025

Your State law involving switching or picking up a Medigap plan AFTER your initial enrollment period

  • May 17, 2025
  • 3 replies
  • 1851 views

Do you know your State law involving switching or picking up a Medigap plan AFTER your initial enrollment period.

 

IF NOT - you need to review them to see what effect they have on you and your specific situation.

    3 replies

    TRL1111
    Community Champion ⭐
    May 19, 2025

    The ignorance about this topic is astounding, and it's a real shame.

     

    Here's one I'll never understand:  New York, where people can switch supplements whenever they want, no questions asked.  And everybody in a given area pays the same premium because it's truly community rated (not the faux community rating AARP/UHC uses with their age-related discount).  So shopping is super easy.

     

    I looked for supplements in Syracuse, and Plan G is available at the following monthly premiums:

     

    Transamerica  $252

    AARP/UHC  $293

    Globe     $305

    Emblem  $350

    Mutual of Omaha  $404

    Humana  $412

    BlueShield  $425

    Bankers Life  $655

     

    This is all for exactly the same coverage, and same amount out-of-pocket except for the premium.  I can almost kind of understand someone not thinking $50 a month is worth filing some paperwork over, for the people on AARP/UHC or Globe to switch to Transamerica.  (Although around here, paying $50 more incites a LOT of anger.)  

     

    But all the others are $100 or more higher than the Transamerica premium, and in one case $400 higher.  For the same thing.

     

    I looked at New York City, too.  In zip code 10003 in Manhattan, Plan G premiums range from $325 with AARP/UHC to $826 with Bankers Life.  Is there something I don't understand about supplements in New York, or is it really the case that people are choosing to pay $826 when they could be paying $325 for exactly the same thing?

     

    Studies show that seniors are averse to shopping around; maybe that's what keeps people in these very high premium supplements?  Or better yet, I hope I'm completely misunderstanding how year-round guaranteed issue works in New York, because if what's going on is what looks like is going on, then it's bound to be based on ignorance and that's very sad.

    GailL1Author
    May 19, 2025

    @TRL1111 

    2025 New York Medigap rates by zip code, insurer and plan type.

    New York Dept of Finance.gov - Medigap Communiy Rated - by plan, zip code and insurer 

     

    There are not a lot of High Deductible Plan G’s available but when there are, the difference in price is staggering. 

     

    In New York with continuous enrollment and of course, the higher premiums for this Medigap protection - the do have a wait period for preexisting conditions if the insurer decides to exercise it but this only covers people that have gone without credible coverage for over 60 days.  The maximum wait period is 6-months but there are some insurers that have their listed as 3 months or less.

    NY Dept of Financial Services - Medigap Wait Period for Preexising Condition IF there has been a lapse in creditable coverage for 60 days  

     

    All the premiums are higher because of the way NY lets people pick up and switch Medigap plans. They also have no set plan availability for those who are less than 65 and eligible for Medicare.  

     

    Wonder if the majority of the people in NY realize their choices and how it works in their state? 

     

    TRL1111
    Community Champion ⭐
    May 20, 2025
    @GailL1 wrote:

    There are not a lot of High Deductible Plan G’s available but when there are, the difference in price is staggering. 

     

    Well, all you need is one because the coverage is identical regardless of what company you're with. 

     

    I enjoy the simplicity of my Plan G and having to keep track of only my Part B deductible, but a high-deductible G would be very attractive if I were in New York.  The only reason I have an AARP/UHC supplement is for the gym membership, and they don't offer that in New York.

     

     

     

    @GailL1 wrote:

    the do have a wait period for preexisting conditions if the insurer decides to exercise it but this only covers people that have gone without credible coverage for over 60 days. 

     

    Since we're talking about switching supplements to get a lower price, presumably the person has the proper creditable (not credible) coverage.

     

    It has to be that people just don't know they can change supplements whenever they want.  I suspect one problem is that agents make a very small commission on guaranteed-issue supplements, so they don't have a big incentive to sell them.

     

    I think it's also that seniors in particular don't like change, and in studies, a significant number of them have said they don't shop around because they like their supplement company, even though there's nothing to like or dislike about it.

     

    As I said, the ignorance is astounding.  But at least I can understand ignorance.  I can't understand why anyone would knowingly pay $800 for something they can get for $500 less each month.

     

     

     

     

     

     

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