Texas or Illinois. Which has less expensive Medicare coverage?

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Re: Texas or Illinois. Which has less expensive Medicare coverage?

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Here is a comparison between Medicare Advantage Plans if you are internested:

Texas Medicare Advantage

Medicare Advantage Illinois

 

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@brianm569230wrote:

Thank you for the very comprehensive explanation. I'm clear now that only Medicaid may be affected by a state's participation (or lack thereof) in the ACA. After doing some more digging, she has traditional Medicare with Part C gap insurance, you guessed it, through AARP. Apart from the change in address, she also has a qualified life event due to the death of my father-in-law who was also covered by their joint policy.


There is NO such thing as Traditional Medicare with Part C gap insurance.

Medicare.gov - How do Medicare Advantage Plans work?

 

A beneficiary has one or the other :

Traditional (Original) Medicare with or without a Medigap plan (Medicare Supplemental Plan)\

A Medicare Advantage Plan

There are NO Joint Policies in Medicare - it is an individual program all the way around - Nothing Joint about it.  Even when one spouse has never worked and gets their benefits from the other spouse, they get to individually pick what type of coverage they each want - not joint decisions or policies.

 

Are you talking about "Special circumstances"  for Special Enrollment ?

 

What is her plan name? 

If she has a Medigap (Medicare Supplemental) plan what is the name of it?

 

You have to know what type of coverage she has in order to proceed .


* * * * It's Always Something . . . Roseanne Roseannadanna
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Thank you for the very comprehensive explanation. I'm clear now that only Medicaid may be affected by a state's participation (or lack thereof) in the ACA. After doing some more digging, she has traditional Medicare with Part C gap insurance, you guessed it, through AARP. Apart from the change in address, she also has a qualified life event due to the death of my father-in-law who was also covered by their joint policy.

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@brianm569230wrote:

Yes, she has traditional Medicare and a Medigap insurance policy. My concern is that Texas may not have as well funded a Medigap marketplace because of the political climate here and the move would be mean higher premiums than Illinois. Since we are trying to minimize her costs against her fixed annual income, we wanted to check to see if there is significant difference.


The payment for benefits in the Traditional Medicare program is at the Federal level.  Once these benefits are paid, CMS (Center for Medicare and Medicaid Services) just forwards the same claim onto the Medigap insurer and they pay 

whatever the letter plan she has pays.  As I said and gave the link to these plans by alphabet, the stated coverage as shown by each of these plans is governed by the Feds.  The only thing an insurer might do is sweeten the benefits but that is optional.

 

I Am saying all of this to let you know that NO state restricts this Medicare Medigsp coverage because the stated benefits by the plan ( alphabetical) are a Federal matter - available plan coverage is set by CMS.

 

if she does NOT change plans, her premiums should remain relatively constant under whatever her plan in the state where she currently resides allows.

 

 States DO NOT fund any part of MEDICARE - but MEDICAID for the low income is a state and federal program - we are not discussing MEDICAID.

 

She does NOT have to switch policies - she can keep the same one no matter where she resides.  

 

The Medicare.gov link says as I posted in my previous post -

I quote:

 You can keep your current Medigap policy no matter where you live as long as you still have (Traditional) Original Medicare.

 

It is ONLY if there is a switch in policies would anything change and then many other cautions come into play.

 

Again I quote from Medicare.gov

If you want to switch to a different Medigap policy, you'll have to check with your current or new insurance company to see if they'll offer you a different policy.


If you decide to switch, you may have to pay more for your new Medigap policy. You may also have to answer some medical questions if you're buying a Medigap policy outside of your Medigap open enrollment period.

 

 


* * * * It's Always Something . . . Roseanne Roseannadanna
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Yes, she has traditional Medicare and a Medigap insurance policy. My concern is that Texas may not have as well funded a Medigap marketplace because of the political climate here and the move would be mean higher premiums than Illinois. Since we are trying to minimize her costs against her fixed annual income, we wanted to check to see if there is significant difference.

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@brianm569230wrote:

My Monter-in-Law needs to move into assisted living from Georgia. My wife and I live in Texas and her sister lives in Illinois. Is there an advantage financially to choose one state over the other in terms of the cost of Medicare and gap insurance? I assume federal benefits like social security and basic Medicare are the same (or are they?).

 

Thanks in advance,

Brian


1st let me understand exactly what she has now -

The way I am understanding your post, your MIL has:

Traditional Medicare + a Medicare Supplemental Plan (Medigap Plan)

 

Traditional Medicare as well as Social Security are Federal Programs and there is no difference in their coverage nationwide. 

 

There is a difference by state for the Medicare Supplemental plans - The plans by Federal law have to cover the same benefits but how they are rated to determine premiums are different by state and some other rules too.

.

However, she might be able to keep her same exact plan.

 

Read the links below -

Medicare.gov - How to compare Medigap plans

 

Medicare.gov - Switching Medigap Policies

Notice this question:  "I am moving out of state"

Answer: 

You can keep your current Medigap policy no matter where you live as long as you still have (Traditional)  Original Medicare. If you want to switch to a different Medigap policy, you'll have to check with your current or new insurance company to see if they'll offer you a different policy.

If you decide to switch, you may have to pay more for your new Medigap policy. You may also have to answer some medical questions if you're buying a Medigap policy outside of your Medigap open enrollment period.

 

Therefore, IF she now has TRADITIONAL (ORIGINAL) MEDICARE + a MEDIGAP (MEDICARE SUPPLEMENTAL) Plan - there is really no reason to change it -  she should just  keep the same plan because you do not want them to rate her because of her age or health, premiums would go up, most likely.  However, once she has moved to whatever state, she or her representative could talk to a Medicare Insurance agent in the new state just to find out about premiums, ratings, and actuarl approval or acceptance - but if a change is contemplated - make sure that she has a new policy BEFORE cancelling the current one.

 

Now if I am misunderstanding you as to what she has now - all bets are off and you need to clarify.

YES, it is complicated - what to do with government, isn't????

 

 


* * * * It's Always Something . . . Roseanne Roseannadanna
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Texas or Illinois. Which has less expensive Medicare coverage?

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My Monter-in-Law needs to move into assisted living from Georgia. My wife and I live in Texas and her sister lives in Illinois. Is there an advantage financially to choose one state over the other in terms of the cost of Medicare and gap insurance? I assume federal benefits like social security and basic Medicare are the same (or are they?).

 

Thanks in advance,

Brian

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