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Medicare plan options starting this September

I'm in New York state. My Medicare eligibility begins Sept. 1.  New York has guarantee issue Medigap. Here are my questions.

  1. If I sign up to an MAPD plan with the large MOOP ($7,500) for the reminder of the 2022 plan year can I switch to a Medigap plan to avoid at least some of the OOP if a major health event occurs?
  2. If I start with an MAPD plan in New York for 2022 , and perhaps even switch to Medigap plan in 2023 while still living here, and later move to another state without guarantee issue, will I be subject to underwriting?   
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Newbie

First, I am a licensed agent; however, not in NY state. I would check with your local senior center for the name of an agent in your area. That said, traditionally the trade off of Med Supp premiums vs advantage plan MOOPs could be summarized over a five year snapshot. Look at three years of primary care and specialist visits, a few labs, and not much else. A week long stay in the hospital and maybe double those first co-pays; and year five, hitting the MOOP. Most advantage plan co-pays remain about the same year over year; however, some plans get more expensive as others come in low looking to gain customers. Generally, the five year advantage plan scenario will come in approx 60% that of the Med Supp/PDP premiums for the same five years. 

 

I hope this helps.

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@mesrins Thanks for your reply.  Just to button this up, I settled on a high-deductible Medigap Plan G. For the lower premium I have to meet a $2,490 deductible. However, amortized over the cost of a full year it's about the same as paying a full Plan G rate. 

The decision was guided by 1) I'm in good health, 2) constant headaches with private health insurance plans over the years with regards to their particular medical necessity guidance, 3) narrow networks in MA plans and portability of Med Supp plans, and 4) just plain incompetence by insurance companies in claims and payments causing excessive and needless management on my part. 

 

Of course, I also signed up for a Part D plan. Although I don't take any meds now, one has to sign up to avoid a penalty. I took the least expensive one in my area. 

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Honored Social Butterfly

Medigap HD Plan G sounds like a good plan unless you are in one of those states that gives you the option of changing a Medigap plan without underwriting at a specific time of the year - like on your birthday - 

Many of them have the stipulation that you can only change to an equal or lesser plan - in this case, Medigap HD Plan G is pretty low on the scale.  

This only matters if it involves you and your state's options.

 

 

 

 

It's Always Something . . . . Roseanna Roseannadanna
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Thanks.  I'm in New York. Nothing in the state literature, nor did my sales agent, mention anything about the inability to enroll in a full premium Medigap plan for next year if I so desire.  

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Honored Social Butterfly

New York is one of the most liberal Medigap rules states for switching - you are blessed.  

 

You can switch anytime for any plan - a community rated state - they can require underwriting but at the worse that's 6-months of coverage for any pre-existing condition but that rare for the companies doing Medigap coverage there -  the only bad thing is because of these liberal type Medigap rules, the premiums are always somewhat higher than in other states.

 

 

 

It's Always Something . . . . Roseanna Roseannadanna
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