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Re: Changing AARP / UHC Supplemental (Medigap) Plans with No Underwriting

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Message 11 of 32

@jo7269379 UHC is changing their plan change / no underwriting rules on a state by state basis. What they do in GA may or may not be the same in OR.

 

The ability to change UHC plans without underwriting appears to be phasing out.

 

I would think that "peeking at your health records via an application" and deciding to change your rate on your EXISTING plan would not be allowed. I have never heard of a carrier doing that. If you qualify for a new plan then change. If you don't keep what you have.

 

Most (if not all) states prohibit an insurance carrier for singling  you out for a rate increase based on your claim or health history.

 

Each carrier has their own guidelines. What UHC does is not the same as Aetna, Blue or any other carrier.

 

UHC doesn't tell Blue what they are doing and vice versa.

 

Nor does Macy's tell Gimble's their trade secrets.


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Re: Changing AARP / UHC Supplemental (Medigap) Plans with No Underwriting

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Message 12 of 32

Over a year ago, I spoke with a UHC rep who said that if someone had plan F and wanted to enroll in plan G, they'd be subjected to medical underwriting.  He also said that if UHC found this then necessitated a higher premium for the plan G (higher tier?), then that person would also then have a higher premium for their plan F should they decline the plan G.  

That doesn't make sense to me and I checked with our state insurance commission which seemed to agree with me.

Recently I spoke with a BCBS rep and asked a similar question and was told a different answer.  That person said that the beneficiary could decline the Plan G rate and continue with their Plan F (i.e. no increase in premium due to underwriting issues).

 

Anybody have any good info on this one?

 

 

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Re: Changing AARP / UHC Supplemental (Medigap) Plans with No Underwriting

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Message 13 of 32

@MichaelO968701 I thought there were non-solicitation rules for posting on this forum.

 

Guess I was mistaken.


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Re: Changing AARP / UHC Supplemental (Medigap) Plans with No Underwriting

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Message 14 of 32

If you are looking to change the Medicare plan to cover the medical expenses for your health problem then The Health exchange Agency is the best option. I heard about it, the company guides you with the whole process of changing or taking the other health insurance plan. There are different health insurance plans available like Mutual of Omaha health insurance, Medigap plan G, Mutual of Omaha medicare and more. Take which one suits your reqirement.

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Re: Changing AARP / UHC Supplemental (Medigap) Plans with No Underwriting

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Message 15 of 32

@JohnL900627 wrote:

 

In my experience, which dates some 25 years from managing my parents as well as my own affairs, AARP/UHC has somewhat more expensive premiums, but they prevail in popularity because they pay right up to the end without all the arm wrestling and hoops that many of the other providers present with claims.

 

Bottom line: Don't just assume that all plan G plans for example are the same just because it looks that way on paper. Look at the satisfaction and complaint rankings that most states tabulate for providers within their states.

 

 


As mentioned in another reply, there is "NO ARM WRESTLING" when dealing with a Medigap carrier. They pay claims and pay on a timely basis. There is no second adjudication process. None.

 

Consumer complaints about Medigap almost always regard renewal rate increases. Not claims. Not provider acceptance.

 

Most of those complaints could have been avoided if the consumer had done proper research on something OTHER THAN a consumer forum. 

 

It is rare when consumers have something GOOD to say about a carrier but COMPLAINTS roll in like thunder


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Re: Changing AARP / UHC Supplemental (Medigap) Plans with No Underwriting

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Message 16 of 32

Providers have up to 12 months to file a claim with Medicare.

 

Patient see's provider.

 

Provider files with original Medicare.

 

Medicare adjudicates the claim and either approves or denies.

 

If approved, the claim is transmitted electronically via crossover to (most) Medigap carriers. Since the claim is pre-approved, there is no second guessing. No hassle. They pay their portion, usually in 5 business days or less once received from Medicare.

 

People who claim their doctor will not accept their Medigap plan, or say a particular supplement carrier does not pay claims, are most likely referring to an Advantage plan.

 

If Medicare denies the claim is never sent to the supplement carrier so nothing is paid by them either. The patient owes nothing unless they signed an Advance Beneficiary Notification form.

 

Quite often choosing a Medigap carrier is based on name recognition more than anything else. Rate stability over the long haul is a better criteria than picking a carrier because you know their name.


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Re: Changing AARP / UHC Supplemental (Medigap) Plans with No Underwriting

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Message 17 of 32

@JohnL900627 wrote:

For readers: Here is an interesting market share breakdown of the top medicare supplement insurance providers:

 

  1. UnitedHealth Care — 34%
  2. Mutual of Omaha — 10%
  3. HSCS — 5%
  4. Anthem — 5%
  5. Aetna — 4%
  6. CNO Financial — 3%
  7. Cigna — 2%
  8. Humana Group — 2%
  9. BCBS of MA — 2%
  10. BCBS of MI Group — 1%
  11. Others — 32% (Comprises 4.06 million enrollees)

In my experience, which dates some 25 years from managing my parents as well as my own affairs, AARP/UHC has somewhat more expensive premiums, but they prevail in popularity because they pay right up to the end without all the arm wrestling and hoops that many of the other providers present with claims.

 

Bottom line: Don't just assume that all plan G plans for example are the same just because it looks that way on paper. Look at the satisfaction and complaint rankings that most states tabulate for providers within their states.


Where did you get your data and how resent is it?

 

Your above statement is confusing - what a specific Medigap plan is suppose to pay is set in stone - there isn't a lot of leeway with the design - IF Medicare pays, they are suppose to pick up their part.

 

That is a far cry from the actual caliber of an insurance company - as we can see from all the different ones working in any field of insurance.

 

I find it hard to research on a mobile device, which I am on now, but I am pretty sure that CMS only gives Medigap plan insurers a specific amount of time to pay once Medicare pays and forwards the remaining claim to them.

 

Yes, everybody that is considering any sort of an Insurace product should make sure that the insurer is and stays on solid financial ground and works as agreed.

 

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Re: Changing AARP / UHC Supplemental (Medigap) Plans with No Underwriting

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Message 18 of 32

For readers: Here is an interesting market share breakdown of the top medicare supplement insurance providers:

 

  1. UnitedHealth Care — 34%
  2. Mutual of Omaha — 10%
  3. HSCS — 5%
  4. Anthem — 5%
  5. Aetna — 4%
  6. CNO Financial — 3%
  7. Cigna — 2%
  8. Humana Group — 2%
  9. BCBS of MA — 2%
  10. BCBS of MI Group — 1%
  11. Others — 32% (Comprises 4.06 million enrollees)

In my experience, which dates some 25 years from managing my parents as well as my own affairs, AARP/UHC has somewhat more expensive premiums, but they prevail in popularity because they pay right up to the end without all the arm wrestling and hoops that many of the other providers present with claims.

 

Bottom line: Don't just assume that all plan G plans for example are the same just because it looks that way on paper. Look at the satisfaction and complaint rankings that most states tabulate for providers within their states.

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Re: Changing AARP / UHC Supplemental (Medigap) Plans with No Underwriting

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Message 19 of 32

Great clarification, Thanks. I might add for other readers that joining AARP is not at all expensive and has many other benefits.

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Re: Changing AARP / UHC Supplemental (Medigap) Plans with No Underwriting

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Message 20 of 32

@JohnL900627 wrote:

I live in Missouri and it is Not a community rated state?

 

The respected resource link below may clear up some of the confusion on MediGap Plans:

 

www.kff.org/medicare/issue-brief/medigap-enrollment-and-consumer-protections-vary-across-states/

 


The AARP/United Heathcare Medigap plans are issued as GROUP coverage in most every state - that the reason why they are (most) all community rated.

In your state of Missouri - UHC issues NO individual Medigap plans - they all have to be the AARP/UHC brand and thus membership in AARP is required to participate in this group.

 

Ths is the Mo. Guide dated 09/2018.

 

https://insurance.mo.gov/seniors/documents/MedigapRateGuide_000.pdf

 

The KFF link which you provided also states this when talking about the rating methods:

 

The remaining 38 states and the District of Columbia do not require premiums to be community rated; therefore, Medigap premiums in these states may be subject to issue-age and attained-age rating systems, depending on state regulation. Medigap insurers are permitted to offer community rated policies in these states, but most do not.

 

 

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