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Re: Plan F will no longer be offered after 2019; premiums likely to riseDeptDoes an

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@lliann

 

After looking over that 2018 Colorado list of Medigap insurers and their premiums, it appears that AARP/UHC Medigap policies are also rated under the Community Rated method in CO too - maybe it is like that in every state - I don't know.

 

However, it does appear that any pre existing condition can be uncovered for (3) months unless there is credible coverage beforehand.

 

Best thing to do would be to check this all over again when you have firmed up your moving plans.  I could not find the 2019 Colorado Medigap rates only the 2018 ones.

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Message 2 of 19

@lliann wrote:

This is an incredibly helpful link. Thank you so much.

 

2 questions just to take it as far as I can.<G>

 

1. what is the difference between continuous guaranteed and annual guaranteed?

 

2. which may hold the answer.  I believe I can keep the medicap policy I just purchased in NY forever if I make no changes and just pay my premiums on time forever.

 

However, if I were to move to say CO, can I request a premium pricing for UHC AARP medigap plan f.(research tells me premium would actually be lower in Co) Would that remain the same ins. product or would it end the moment because it would now originate in Co instead of NY.  Thank you so much!  Barb


It is a science since Medicare Medigap coverage is one of those thing that is governed by BOTH state and federal law.  In general, Medigap insurance is state regulated, but also subject to certain federal minimum requirements and consumer protections.

 

The KFF link which I provided earlier also goes into more detail on each of these consumer related issues.

 

Guaranteed-Issue:  The period of time when a medigap policy can be issued to a Medicare beneficiary age 65 or older WITHOUT regard to a person's age or health condition.

 

  • Initial coverage (Open Enrollment) or "Medigap Protections" (Special circumstances or specified qualifying events) at a special time when you have other health coverage that changes in some way, like when you lose the other health care coverage.  (Federal)  In almost all situations, a Medigap policy is "guaranteed renewable" as long as you pay your premiums for it and were truthful on the application.

Medicare.gov - Guaranteed Issue Rights - When Can I Buy a Medigap policy

Medicare.gov - Switching Medigap Policies

Medicare.gov - Dropping or losing Medigap coverage

 

  • Continuous guaranteed enrollment (state) - guaranteed issue protections for Medigap issuace for all beneficiaries in traditional Medicare ages 65 and older, regardless of medical history. Guaranteed issue protections prohibit insurers from denying a Medigap policy to eligible applicants, including people with pre-existing conditions.  This is a continuous open enrollment period with guaranteed issue rights throughout the year but based on state rules beware of any crucial special caveats like a period of time when a preexisting condition might be uncovered.

From the KFF link provided previously  https://www.kff.org/medicare/issue-brief/medigap-enrollment-and-consumer-protections-vary-across-sta...

Three of these states (Connecticut, Massachusetts, and New York) have continuous open enrollment, with guaranteed issue rights throughout the year, and one state (Maine) requires insurers to issue Medigap Plan A (the least generous Medigap plan shown earlier in Table 1) during an annual one-month open enrollment period. Consistent with federal law, Medigap insurers in New York, Connecticut, and Maine may impose up to a six-month “waiting period” to cover services related to pre-existing conditions if the applicant did not have six months of continuous creditable coverage prior to purchasing a policy during the initial Medigap open enrollment period. Massachusetts prohibits pre-existing condition waiting periods for its Medicare supplement policies.

 

  • Annual guaranteed enrollment - (State) a period of time during the year when there is an open enrollment for those wishing to switch a Medigap policy to one of equal or lesser benefits.

From the KFF link above:

Some states provide additional guaranteed issue rights for current Medigap policyholders. Two states (CA and OR) allow beneficiaries to switch each year to a different Medigap plan with equal or lesser benefits within 30 days of their birthday, and another state (MO) allows policyholders to switch to an equivalent plan within 30 days before or after the annual anniversary date of their policy. Medigap policyholders in Maine can switch to a policy with equal or less generous benefits at any time during the year (not only during the annual open enrollment period) if there is less than a 90 day gap in coverage. Some Medigap insurers may also provide guaranteed issue rights to their policies that go beyond the state requirements. In Illinois, Blue Cross Blue Shield of Illinois and Health Alliance provide ongoing guaranteed issue rights for all beneficiaries ages 65 or older.

 

  • Other expanded guaranteed special circumstances or specified qualifying events (State)

Many other states have expanded on the federal minimum standards in more narrow ways by requiring Medigap insurers to offer policies to eligible applicants during additional qualifying events For example, 28 states require Medigap insurers to issue policies when an applicant has an involuntary change in their employer (retiree) coverage. (This qualifying event is more expansive than federal law, which applies only when retiree coverage is completely eliminated.) Nine states provide guaranteed issue rights for applicants who lose their Medicaid eligibility

 

See Table 3: Medigap Guaranteed Issue Requirements for Medicare Beneficiaries Ages 65+, by State, 2017

 

The best way to find out about any state rules on Medigap issuance is to to go to a specified state Dept of Insurance.  2018 Colorado Dept of Insurance - Medigap Coverage

 

Yes, you can keep your New York issued Medigap policy of choice forever and like I said, because it is Community Rated - the cost of such a policy might be better down the road - MAYBE - than one in Colorado which is Issue or Attained Age rated.  But of course, you are also dealing with the difference in medical cost between New York and Colorado too.

 

When you choose a new Medigap policy or plan in a new state - the new state's rules apply at that time.

 

A knowledgeable local Medicare Insurance broker or SHIP representative also can help because they should know all the rules of the state where they are writing policies.

 

 

 

 

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Re: Plan F will no longer be offered after 2019; premiums likely to riseDeptDoes an

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Message 3 of 19

This is an incredibly helpful link. Thank you so much.

 

2 questions just to take it as far as I can.<G>

 

1. what is the difference between continuous guaranteed and annual guaranteed?

 

2. which may hold the answer.  I believe I can keep the medicap policy I just purchased in NY forever if I make no changes and just pay my premiums on time forever.

 

However, if I were to move to say CO, can I request a premium pricing for UHC AARP medigap plan f.(research tells me premium would actually be lower in Co) Would that remain the same ins. product or would it end the moment because it would now originate in Co instead of NY.  Thank you so much!  Barb

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Re: Plan F will no longer be offered after 2019; premiums likely to riseDeptDoes an

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Message 4 of 19

Here is a source that list Medigap consumer protections in every state.

 

Go down to the point where you will see the heading

Some states require guaranteed issue and other consumer protections for Medigap beyond the federal minimum requirements

 

KFF 07/18/2018 - Medigap Enrollment and Consumer Protections Vary Across States

 

You don't want to change your New York issued Medigap plan because they are a Community Rated State.  Even if you move to Colorado, you can still continue your NY issued Medigap plan because you can use a Medigap plan anywhere in the country because Medicare is a national program.

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Re: Plan F will no longer be offered after 2019; premiums likely to riseDeptDoes an

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Message 5 of 19

Also regarding premiums. It is likely they would go up. Premiums are determined by regions and populations, etc.

 

Premiums don't usually go down but I live in a somewhat isolated region so NY premiums here would actually be higher than Co. Unless something changes. Which often happens.<g.

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Re: Plan F will no longer be offered after 2019; premiums likely to riseDeptDoes an

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Message 6 of 19

I did a lot of research like you did. I also downloaded my new plan to review (Aarp UHC Plan F.

 

I have never had interruption of coverage so I was able to add Medigap to my Medicare without issues. Esp. since I live in NY, a guaranteed state. It's difficult getting guaranteed answers about guaranteed coverage, but this is what I found for me. I have a rider eliminating the pre existing clause. If I move, as long as I keep the exact same plan f, I can request premium review are lower without jeopardizing my guarantee coverage (I can quote the passage if you want)

 

If you dont live in a guaranteed state, and move, or want to change plans, you probably will have to go through underwriting. I did some research on that too and UHC can be a little lenient on pre existing conditions. They are looking for the major things but not all things. HBP is not one of the pre existing conditions. If you are still questioning, I would also suggest you look up what they consider pre existing for underwriting and what they don't.

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Re: Plan F will no longer be offered after 2019; premiums likely to riseDeptDoes an

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Message 7 of 19

I do not know about Colorado. I know Kansas doesn't have guaranteed issue past  the 6-month window after initial sign-up. Missouri and California both have an open enrollment period where you can change plans with medical underwriting. That's all I know about the different states. Premiums will rise for Plan F faster than for the other plans as most agents aren't even mentioning Plan F to propects anymore. Anyone enrolled in the plan when new enrollment ends at the end of 2019 will be grandfathered in. I would check with a Medicare broker in Colorado to find out how Medicare Supplement Plans (i.e. Medigap Plans) are handled there.

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Re: Plan F will no longer be offered after 2019; premiums likely to riseDeptDoes an

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Message 8 of 19

I have just chosen Medigap Plan F. I was confirmed that it would be portable, renewable, etc. I asked that question because while I live in NY and it IS a guaranteed issue state, I may move to Colorado , which is not. Is there a websight indicating each state's approach to Medigap plans and whether they are guaranteed, able to change (due to no interruption in coverage?) or is therre a circumstance that would make Plan F not transferrable or changable?

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Re: Plan F will no longer be offered after 2019; premiums likely to riseDeptDoes an

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Message 9 of 19

   Thanks to the author for the heads up.    I did a quick search of Medicare F and there is lots of information about the plan, which is a Medigap for Medicare Part B.   I can only suggest that people do their own search and calculate the additional cost of that premium and determine for themselves if the additional cost was actually worth it.    ( " Medicare Part F" were the search words)

PRO-LIFE is Affordable Healthcare for ALL .
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Re: Plan F will no longer be offered after 2019; premiums likely to riseDeptDoes an

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Message 10 of 19

You seem to be missing my point.  My point is not so much that rates will rise but that I will not have an option to change my medigap policy as, without guaranteed issue, I will not be accepted in another plan.  All I'm looking for is the option to change plans at least one time when Plan F premiums rise.  I don't think that is an unreasonable option. Rates are set by region and are based on many factors, including the number of policyholders paying into a particular plan. A state such as Florida with a huge population of seniors would see less effect as the premium base for a plan decreases; however, states with far fewer participants in a particular plan are going to see premiums rise more rapidly as the premiums collected for that plan decrease over time. A plan that is actively adding participants to replace those dropping out of the premium pool will see premiums stay static or rise less rapidly that a plan that is no longer adding premium payers.  This is just insurance. Medicare, as a federally mandated plan, probably has more say over rates.  I am talking about medigap premiums here; I'm talking about the premiums you pay for your supplemental insurance, which is separate from what you pay to Medicare for Part A & B.  With Plan F no longer adding participants, as people die or cancel because they can't afford the Plan F premiums, those remaining on Plan F will see steeper increases. Adding to the dilemma is the fact that as the remaining participants grow older the claims paid for those in the plan will grow and there won't be younger, less costly participants coming into the plan to reduce the cost.  So, in upcoming years, when a provider goes to the state with a case to raise the premium for Plan F participants, they are going to have the numbers to prove their case. I merely want to provide an option when seniors are squeezed by premium increases and have too many health problems at that point to change plans. Perhaps your state offers medigap changes with guaranteed issue during open enrollment; Kansas, as well as other states I suspect, does not.

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