Autumn has arrived and with it Medicare Annual Open Enrollment (AEP), the time when one can make a change in ones Medicare Advantage Plan (MA) or Prescription Drug Plan (PDP).
Even though AEPs have nothing at all to do with Medi-Gap policies, more Medi-Gaps are exchanged or sold during this seven week period from Oct 15 to Dec 7th than any other time of year. Change is in the air! If you feel your insurance claims department is too sluggish, you have to wait too long for someone at customer service to put up the phone, or your policy is getting too pricy, you may want to consider switching companies.
However, in the case of Medi-Gap policies ( a.k.a. Medicare Supplements), one has to keep several things in mind. As you probably know, Medi-Gaps come in a dozen different “sizes” arranged by letters of the alphabet from “A” to “N”. Each letter plan covers a different amount of the gap in coverage left by Medicare, where Plan “A” (not to be confused with Medicare Part A) covers the least of the gap and the Plan “F” covers the entire gap. Other popular choices are Plan “N” which covers somewhere in the middle between A and F, and Plan “High Deductible F” which covers nothing at all until one has spent $2340 on medical bills in a given year as a result of what Medicare missed. After that “High Deductible F” covers everything medically necessary that Medicare does not until the end of the year. However, unless you turned age 65 before January 1st, 2020, you can no longer can obtain a High Deductible F Plan or a Plan F!
As a result of the recent phasing out of The “F Troop” the latest soup-du jour is Plan G.
Plan G was already destined for greatness for a number of reasons. It covers everything that Plan F covers with the single exception of the $203 Medicare Part B annual deductible. So for approximately the cost of one doctor visit you can cover all of your medical bills for the year. Not bad!
That means after that first $203 comes out of your pocket, every other medically necessary expense (with the exception of pharmaceuticals) is covered between Medicare Part A and B and The Medi-Gap Part G.
In addition to the near complete coverage offered by a Plan G, Plan G’s rate, comparatively speaking, tends to be considerably less expensive, dollar for dollar, then Plan F’s rate.
So Plan F gave you an extra $203 dollars of coverage a year. But in many cases the extra cost for that $203 of coverage would cost the consumer anywhere from an extra $250 to as much as $1100 dollars more in annual premiums (over Plan G rates). To quote my dear departed grandfather “such a deal!”
So, if you are one of the ones that turned 65 after January 1, 2020, weep not for the loss of Plan F. Happy day are here again!
How to realize the Medi-Gap of your Dreams!
Within each letter Plan, the coverage from Insurance Company to Insurance Company has to be precisely the same by law. So the Plan G from Aetna is exactly the same Coverage that you will get from a Plan G from United Health Care. However, now some Medi-Gap ( a.k.a. Medicare Supplement) policies are starting to tack on optional extras that Medicare normally does not cover, such as discounted gym memberships or vision services. Another important difference, apart from how well a company responses to Claims and Customer Service, is the cost of the policy itself.
In addition, the health eligibility questions that are often times necessary to qualify for a Medi-Gap policy varies from one company to the next. Although there are a number of reasons why people are offered Guaranteed Issuance of a Medi-Gap policy without having to satisfy and standards set by personal health questions.
One of the most common reasons is that a person has just turned 65 and they are already signed up for Medicare Parts A and B. In that case they have the time from 3 months before their birthday to 6 months after to obtain the policy without needing to answer any health status questions. This time is referred to as “Open Enrollment”
However, if one decided that they wanted to switch their policy to another company when they were another age they would have to deal with health eligibility questions. One company like, Health Net might ask about whether the person has suffered from various illnesses and had to go to a hospital in “the last year”. Whereas Anthem Blue Cross might ask the same question replacing the “one year” with “five years”. So if you find yourself with the need to change your policy during a time when you have to respond to health questions, you may have to make a compromise between what is least costly and what health status questions you can answer suitably.
Those who live in California and Oregon have a special escape clause, however. For those in the Sunshine State, every year starting 30 days before and 30 days after one’s birthday, anyone with a Medicare Supplement is allowed to switch Insurance Carriers to any other Medi-Gap policy of equal or lesser coverage as a matter of Open Enrollment. So if you live in California and want to switch Medi-Gap Insurance companies without difficulty, just have a happy birthday!
In Service, Martin Miller Ca Lic. # 0G91837
