Reply
Periodic Contributor

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

I found out accidentally through my Medicare insurance advisor that Plan F supplemental policies will no longer be offered to Medicare enrollees after 2019.  Many Medigap providers are already advising representatives not to offer plan F supplement policies when they talk to prospective clients.  Those already enrolled in Plan F at the end of 2019 will be able to keep that plan.  However, because there will be no new enrollees in the plan, premiums will rise much faster than for other plans.  Also, if you live in a state that does not allow you to change Medigap policies under guaranteed issue during open enrollment after the initial 12-month window, it may not be possible for you to switch to another Medigap plan.  I am shocked that AARP has not been informing members of this change. I have also not been able to get information from my state insurance department as to how to proceed in order to advocate for a solution that will allow enrollees to change plans with guaranteed issue, at least one time, when Plan F is no longer offered.  The Kansas State Insurance Dept. could not tell me whether the state or the federal government would be responsible for crafting a remedy for this dilemma.  I was told to open an inquiry with the department so that they can investigate who I would need to approach about a resolution.  I've been told by the state, as well as my broker, that ending Plan F was part of the compromise for getting the CHIP program temporarily renewed, the one that is now unfunded again. I would appreciate someone from AARP addressing this issue and bringing some clarity as to how to bring about a remedy for those with original Medicare and Plan F supplemental (medigap) plans.

3,060 Views
21
Report
Bronze Conversationalist

@theshiremaid MACRA is the reason why Medigap plan F will no longer be available to those who qualify for Medicare after 12/31/2019. Agents and carriers that have pushed the F plan for years will still do so right up to the bitter end.

 

Their motivation is greed and nothing else.

 

The F plan has been overpriced in most areas for years. Some are paying an extra $300 to $500 per year in premiums for the benefit of having their Part B deductible paid for them. That is a nice "pure" profit item for carriers. Agents pushing F over G or other plans are earning extra $$$ for selling a nothing benefit.

 

F plan premiums for new business and renewals have increased at a higher rate than G or any of the other plans for years. Once that block is closed the trend will still continue.

 

Carriers are not REQUIRED to continue offering F plans after 12/31/2019 but I would expect some will do so at least for a while.

 

I am not sure where you got the idea there is a 12 month window during the initial enrollment period. Perhaps your state is different. But Medicare states the window for changing plans without  E of I is only 6 months starting with your Part B effective date.

 

In the past when other Medigap plans were discontinued there was not a "universal" free pass to migrate to another plan without underwriting.


Bark less. Wag more.
0 Kudos
6,476 Views
0
Report
Regular Contributor

I see this is 2017 write up, but 2019 is here and even though the plan is not offered any more I can keep it however the pricing went up another 25% over last years price increase.

this must have been something the insurers saw when the ACA was written. they have taken advantage of all the payers.

they want to get everybody on the advantage plans for co-payers ETC. if I had enough money I would self insure.....

0 Kudos
6,514 Views
0
Report
Honored Social Butterfly

   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 .
0 Kudos
12,567 Views
0
Report
Social Butterfly

.

I have never sold insurance nor have ever worked for an insurance company. I couldn’t tell you the difference between one insurance company and another one and it makes no difference to me who you purchase insurance from. If you’re happy I’m happy.

 

I don’t know from state to state whether or not you can or when to switch supplemental plans without being underwritten. All states are different I think California and maybe Washington you can change plans every year on your birthday? There are people on here that made me aware of that I didn’t know before.

 

My concern has always been your tittle of this thread: Plan F will no longer be offered after 2019; premiums likely to rise. You do not have any proof that is factual. You cannot provide me with a link to say it is true. So good luck to you and nice talking with you.

0 Kudos
8,241 Views
9
Report
Periodic Contributor

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.

12,605 Views
8
Report
Contributor

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?

0 Kudos
8,245 Views
7
Report
Honored Social Butterfly

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.

0 Kudos
11,695 Views
3
Report
Contributor

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

0 Kudos
11,654 Views
2
Report
Honored Social Butterfly

@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.

0 Kudos
11,616 Views
0
Report
Honored Social Butterfly


@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.

 

 

 

 

0 Kudos
11,632 Views
0
Report
Periodic Contributor

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.

0 Kudos
11,759 Views
2
Report
Contributor

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.

0 Kudos
11,703 Views
1
Report
Contributor

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.

0 Kudos
11,701 Views
0
Report
Social Butterfly

.

A solution to what? A phone conversation between you and an insurance salesman speculating about what if? And I question if a state agency department of insurance or SHIIP would give you a direct comment to drop your plan F because the premiums are going up.

 

I think you mean well but there is no proof that plan F premiums will rise any faster than plan A, B, C, D, G, K, L, M or N. It’s only speculation and that’s what I believe the Kansas SHIIP told you.

 

I’ve asked several professionals myself and they all say the same thing plan H, I, and J were let go by CMS and their premiums did not rise because of lack of new enrollees. There premiums went up because they had home healthcare and prescription drug benefits attached to them and other benefits. They say there is no proof otherwise.

 

More people should do like you and take the time to call the different agencies to learn more about Medicare. I think that’s great that you do. It’s just that too many people visit these blogs and post stuff that’s just not been proven and it confuses people.

 

0 Kudos
8,238 Views
2
Report
Periodic Contributor

I never said they told me to drop my plan F.  I inquired about what remedy was available to me and they told me there was no guaranteed issue option if I wanted to change plans at this point.  Also, Kansas is not that populated and many of the seniors I know are on Medicare Advantage. No one has been able to tell me what the Plan F pool is in our region. Most providers offering plans do so by region, not nationwide. (I have owned an insurance agency so I am not uninformed about how insurance rates are established.) However, if our provider drops Plan F, we would then be able to change medigap plans with a guaranteed issue proviso.  I would like to know what other states do about guaranteed issue but no one I have contacted seems to know, as I have pointed out. I am not encouraging anyone to drop their Plan F; I would like to see those with Plan F have the option of rolling to Plan G with guaranteed issue. Also, not all variations of medigap plans are offered in all states, as the Medicare handbook points out. You might have options available that are not available in Kansas. I would like to see AARP use its influence to offer some clarification on this issue with a breakdown as to region and/or state and what recourse seniors have if  they wish or need to pursue other options.  Again, I wish to establish options for Plan F policyholders before the end of 2019; what plan is best for individual policyholders depends on their own needs and situation.  I do know that many seniors I have met in my state are totally unaware of which type of plan they have (i.e. Original Medicare with/without supplement or Medicare Advantage); this consists almost exclusively of Medicare Advantage participants and most of those didn't know they had an option other than Medicare Advantage.  I worked in a position that brought me into constant contact with residents who only pursued gathering information once a provider or premium issue developed. At that point, I was often having to help relatives find reliable sources of information so that they could take care of their parent or grandparent.  I am really confused at your unwillingness to explore options. Not everyone may have your resources.  AARP could be a powerful advocate for getting the legislatures, be they state or federal, to give Plan F seniors an option.  If we wait until later, there may be no remedy left on the table.

0 Kudos
8,237 Views
1
Report
Newbie

I am from Tennessee and called the number on the back of my AARP United Healthcare card. I have Plan F and asked about going down to Plan G and she said I would have to be underwritten. I asked about Plan N and I think she said I would not have to be underwritten. I don't hear well. I saw on another forum that because you have to fill out another application for Plan G you have to be underwritten.  But you don't have to fill out another application for Plan N. Makes no sense to me

0 Kudos
5,543 Views
0
Report
Social Butterfly

'

So you can’t provide proof to what you posted about premiums will rise much faster than for other plans. No links ... nothing.

You do more harm with your fearmongering speculations than good when you can’t prove one iota of truth to your claims.

2
Kudos
7200
Views
0 Kudos
8,210 Views
1
Report
Periodic Contributor

You can call the same Kansas departments that I did if you want confirmation or consult any insurance broker who will explain to you how insurance pools work when they set premiums. You obviously have no interest in pursuing a remedy; rather you would rather jump on me for attempting to alert Plan F policyholders that there is a problem coming down the line.  I would rather find a remedy before the end of 2019 rather than after.  As I noted, there is a simple if albeit imperfect fix.  I would like to see you encourage a solution raather than try to bury the problem.

Social Butterfly

.

This is old news. We’ve known about plan F for the last 2 years. Plan F is going to that place in the sky where Plan H, I and J went years earlier.

 

Can you provide everyone on here with a link that proves your statement: “However, because there will be no new enrollees in the plan, Premiums will rise much faster than for other plans.”

 

And not a link from some Friday night blogger. I’m talking about a link from a credible source, an insurance company or source, Medicare, ect. I don’t think you can. 

 

I’ve seen other people come on here and post disingenuous information about Medicare and insurance that they’ve heard at the barber shop or from Cousin Daryl and unable to back it up with proof.

 

You realize that’s not fair to everyone that visits these sites when someone comes on here with misleading information in bold print like you did. I hope you can back it up.

0 Kudos
7,654 Views
2
Report
Periodic Contributor

I would further suggest that other community participants who are currently on Plan F call their own states' insurance departments to find out how the guaranteed issue option operates in his/her own particular state.  It would be helpful if they would then report here how their own state handles the medigap guaranteed option issue. Kansas does not allow guaranteed issue on medigap policies the first 6 months of enrollment; I was originally told by SHICK that we had 12 months after enrollment to change medigap providers and still have guaranteed issue. During my recent conversations with the Kansas agencies I was informed this period is 6 months, not 12; but I didn't pursue whether or not that is a recent change.  They could only tell me they follow the "recommendations" provided by Medicare but, when I asked if those recommendations were mandatory, they said I would have to open an inquiry as they couldn't answer that question without researching it.

0 Kudos
8,220 Views
0
Report
Periodic Contributor

I cannot provide a link as my information comes from phone conversations with the Kansas Departmentth for Aging and Disability Services (KDADS) and the consumer division of the Kansas Insurance Dept. Those agencies told me my only remedy currently available in Kansas is to ask my Plan F provider to consider allowing me to roll to Plan G without any medical underwriting; however, that would be strictly up to the provider as that option for guaranteed issue ends for medigap enrollmet after your first 12 months. The Kansas Dept. of Insurance confirmed that premium increases are influenced by the number of enrollees in a particular plan and that premiums for Plan F partipants would almost certainly rise faster than other plans whose poicyholder pools are being refreshed with new enrollees on a continuing basis. I have mixed information as to how the guaranteed issue operates in other state and, in fact, the Kansas Insurance Dept. was unable to confirm whether guaranteed issue options are controlled at the state or at the Federal level, which is why they said I would have to open an inquiry so that they could research this. From personal experience, I can say that my and spouse's premiums have increased twice this year with another increase almost certainly coming on our policy anniversary date.  I am on the agenda to address the Silver-Haired Legislature in January.  I did not get my information from a blog. I found out about the change from the independent agent who advised us when we first went on Medicare. I then confirmed the information with phone calls to the state agencies noted above.

 

There is a simple legislative fix if someone can tell me which level, state or federal, would have to make the fix; that would be to allow Plan F participants at least a one-time option to change medigap plans with a guaranteed issue. Any participant with significant health problems is not going to be accepted by another Plan F issuer without a guaranteed issue proviso.  I have seen the form I would have to complete if I wanted to change plans at this point; it is a pretty standard medical underwriting form for individual health policy applicants no matter the age. 

 

 

0 Kudos
8,074 Views
0
Report