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

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Message 1 of 22

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

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

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@madmower70 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.


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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 22

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.....

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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 22

@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.

* * * * It's Always Something . . . Roseanne Roseannadanna
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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 22

@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.

 

 

 

 

* * * * It's Always Something . . . Roseanne Roseannadanna
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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 22

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 7 of 22

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.

* * * * It's Always Something . . . Roseanne Roseannadanna
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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 22

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 9 of 22

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 10 of 22

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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