^^ great info. Thanks.
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^^ great info. Thanks.
Sent from my iPad using TGR Forums
"Zee damn fat skis are ruining zee piste !" -Oscar Schevlin
"Hike up your skirt and grow a dick you fucking crybaby" -what Bunion said to Harry at the top of The Headwaters
I knew it was an issue if you chose an advantage plan and wanted to go back to the regular supplement, but are you saying this is an issue within supplements too? Going from supplement g to n for example? Just trying to clarify what part of switching plans you’re referring to. Maybe I missed that detail up thread but I’m confused
If you are not in any of one of these seven states, or IL with that specific plan listed, then yes it is an issue with all supplements.
It's also an issue if you want to jump from insurer #1's Plan N to insurer #2's Plan N, this means any plan F G K L M N.
All this is dictated by the main rule "... guaranteed issue (GI) protections for Medigap policies exist only during a one-time, six-month Medigap open enrollment period..." when you reach age 65.
Anything other than that -- you reach age 75 and say fuck it these plans are too expensive I'm gonna switch -- there is no GI. Yes, you can (try to) switch but the insurers you are switching into get to accept or deny on their own terms. People always quote this as 'you'll need to pass underwriting.' From what I've read there is no standard rule for underwriting and no guarantee it will be the same 10 years from now.
To me this all means the Medigap (Supplement) plan and the carrier you pick during the initial signup is the one you should plan to stay with for life.
Reading those two KFF links is where I had the ah-ha moment in this when I signed up.
“The best argument in favour of a 90% tax rate on the rich is a five-minute chat with the average rich person.”
- Winston Churchill, paraphrased.
Correct me if I’m wrong,but it sounds like you’re saying; you can go from Medicare Advantage plans back to Straight Medicare, but it’ll be difficult (impossible) to also get a supplement plan (aka Medigap) at that time.
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However many are in a shit ton.
Just got a call, silverscripts, which is a great company and always had stable rates raised their $10 part d plan to,$40.
Just saw another plan that had 4000 in dental go to cleaning only.
This is what everyone is expecting. They capped total out of pocket drug costs at 2500, and now everything is changing to make up for it. Read your notices of change, look up your drugs on medicare.gov after October 15. You can change your own part d.
Last edited by Cono Este; 09-30-2024 at 02:27 PM.
That is true, IMO.
But it is not what I am ranting about.
My rant, and my pet peeve, is this: When you do the initial enrollment nowhere do they (they, being the entire medicare industry) tell you, in as few words and as few sentences as this: If you choose to go with a Medigap (Supplement) you should plan for and be prepared to stay with the same Medigap (Supplement) Plan, F G K L M N, and same carrier, Aetna, UHC, MoH etc., for the rest of your life. You can try to change plans or carriers or both however there are roadblocks in attempting to do so. The roadblocks are not regulated or agreed to, the carriers decide what they are.
I see Cone Este posted you have to answer a questionnaire, i.e., underwriting.
My take on the use of an underwriting questionnaire is it is not mandated or regulated, it amounts to common practice among all the medigap insurers. At this point in time.
Can you count on an underwriting questionnaire still being common practice 5, 10 or 15 years from now? The carriers could change common practice, for example to require a complete physical. Or you could be in the situation of having been using a Medigap supplement for ten or 15 years, meaning you are age 75 or 80. Is it realistic to believe the carriers are going to welcome with open arms every 80 year old who comes along and decides he or she wants to switch plans to save on premiums? "Sure, come join our insurance pool we want as many 75 or 80 year olds as we can get."
Reference for this is on medicare.gov: Can I change my Medigap policy?
The one exception to all this is the seven states (eight if you include IL with a specific carrier) having the continuous GI rules, or the birthday month or anniversary month GI rules.
If my take on this is wrong feel free to go ahead and say why.
“The best argument in favour of a 90% tax rate on the rich is a five-minute chat with the average rich person.”
- Winston Churchill, paraphrased.
“The best argument in favour of a 90% tax rate on the rich is a five-minute chat with the average rich person.”
- Winston Churchill, paraphrased.
We all signed our hippa privacy away at birth. They know meds we take.
There are many rules, mostly state specific. In Missouri, you can change once a yr. With no questions. It’s called the anniversary rule. Illinois does not have it and they are stuck with what they first buy if they are not healthy.
Everyone gets a shot at whatever they want in the beginning. If they hang up on me, their fault. The medicare and me book is pretty good, but in general, all these rules, enrollment windows are a fucking joke. Uselsss govt making up work for itself. Because of them, people have to have an agent to figure it all out.
"Don't pee on my leg and tell me it's raining!" comes to mind.
Cono, in the many pages of this thread you have shared your intimate knowledge of the byzantine labyrinth that is our healthcare system, and for that we all owe you our thanks. And as an agent that confused people turn to for help in navigating the same to your credit you have also stressed over and over that traditional Medicare is the best option, and pointed out the potential downsides of Part C, aka Medicare Advantage, perhaps the biggest being potential loss of access to a Medicare Supplement (Medigap) policy.
While I'm sure there are many Gov't bureaucrats as well as minions working in the insurance industry that cherish their cozy little cube cog jobs it is the industry itself that fights tooth and nail to keep itself attached leech-like to all the points where funds flow in the system. The irony is most of those minions are going to be replaced by AI any day now, but the industry, (in actuality the relative few at the top of the corporate power structure), is going to continue to buy political influence and deny as much service and suck as much profit out of the system as it can for as long as it can.
Now if by "useless govt" you mean the politicians who have sold their souls to facilitate perpetuating the system as is, well, ok.
Again, thank you for your service. It's pretty fuckin sad that we need someone like you, but as long as we do I'm glad someone like you is around.
The aforementioned Medicare book...
https://www.medicare.gov/publication...re-and-you.pdf
Section 5 deals with Medicare Supplement Insurance (Medigap)
The past is a foreign country; they do things differently there.
Question about Part D:
Can I freely change part D plans every year?
For example, I see a part D with monthly premiums of a couple bucks. Score? The same company also offers two more expensive plans. The "compare plans" option on medicare.gov says there's no difference besides the premium, though I believe that is a lie and each plan has a different list of covered drugs.
If I end up with some terribly expensive prescription, can I switch plans when October rolls around?
Yes, you can and should re-shop Part D every year during the 10/15 to 12/7 window, and you cannot be turned down by whatever you switch to.
Btw, if your Part D plan terminates, failing to re-shop can mean getting switched into a more expensive plan from that company, or left without D coverage if that vendor completely stopped participating in your area.
Edit: And of course the plans with different prices aren't the same; drug coverage of the cheaper one is going to approach the minimum that meets federal requirements. Different plans have different drugs in different cost baskets. But the cheapest plan is much better than not having a drug plan, and probably makes the most sense if you're relatively healthy and not regularly consuming prescription drugs.
Last edited by bobz; 10-16-2024 at 09:23 PM.
When I retired they told me to sign up for Kaiser Senior Advantage if you want your health care covered. So glad I never had to figure any of this stuff out.
Glad you like your plan. What I have is near-universal coverage, nationwide, rest of my life, for a fraction of what I was paying before I turned 65 (and that was for a policy that was near useless when I spent much of the year in Utah). It's such a breath of fresh air to be locked in to actually excellent health coverage, and where there's zero possibility of getting jerked around or getting a bill in the mail where I can't even guess how many digits the amount will be.
And all I had to do was set aside my then-current audiobook for about a week of driving to get up to speed on how A/B/D/supps work, and the differences between the most popular supplement plans. Then I looked for a good broker to tell me, yes, that's a good plan, and to steer me to a company that's well established and less likely to give me painful premium surprises long-term. No biggie. And no more decisions to make on that; it auto-renews and is paid out of my SS.
As for Part D, if you're healthy, it's a no-brainer; set a reminder for Oct 15 and pick the plan that costs a few bucks instead of far more. Otherwise, go to a site like MedicareInsuranceDirect.com where you can cost out expensive drugs with the different plans that are available to you.
Last edited by bobz; 10-17-2024 at 11:54 AM. Reason: it's "Part D", not "Plan D"; the nomenclature is annoying
FYI
If you’re on a group retiree plan, you have not lost your guaranteed right to a supplement. you can try your retirement advantage plan first, and switch at any age if things change n
Update
I’ve change at least 50 plans the last three days. All called about increase in part d premiums etc. all but one was spending more. Today a guy with 10k in meds was switched for next yr and he’s capped at 4k between he and wife. So he’s happy, but most are calling up and pissed. Haven’t done too much advantage, but here the dental etc was all slashed. No more $1200 from Aetna either to spend on a pass.
Busiest I e ever been. .booked fernie for Dec 8-15th. But, will,go,where the snow is.
Thunder Snowing here even as I type.
RE: bobz, now I understand why all the old farts (me now one) scream, "keep your hands off my Medicare"
I have been in this State for 30 years and I am willing to admit that I am part of the problem.
"Happiest years of my life were earning < $8.00 and hour, collecting unemployment every spring and fall, no car, no debt and no responsibilities. 1984-1990 Park City UT"
The other thing is, go ahead and just pick one if it's too confusing. Of the different supplement plans, the more popular 3 or 4 variants anyway, they all looked pretty acceptable. The beauty of Medicare Supplements is that they all cover the same thing, most or all (depending on plan) otherwise unpaid costs of Medicare covered care, and the supplement company has zero discretion or judgment as to what they do or don't pay for.
On Part D, I suppose you could just pick a mid-price one at random and it would probably be at least as good as whatever formulary an Advantage plan would saddle you with.
Depends on your state.
In Missouri we have the anniversary rule, also known as the birthday rule in other states. You can switch on your policy anniversary here without health questions.
Most states. You’re stuck with a pre existing condition.
If you want, I’ll look into your states rules.
Go with g, or high deductible g. It’s 99% of what I sell.
For drugs, go to medicare.gov, enter zip, drugs, and pharmacy, and it will list them least expensive to expensive.
We have a 0 dollar WellCare plan next yr. I’m throwing everyone into it that it suits.
Never pay up for a part d plan, if you get a prescription for something not on formulary, you can get an exemption.
Here's a list I made of states with special rules.
I've been interested in compiling this since I did my initial eligibility signup and have since read so many open-ended comments (not necessarily on here) "yes, but if you live in state X then you get to ... blah blah blah".
Source for this: https://www.kff.org/medicare/issue-b...across-states/
CT, MA, NY Continuous open enrollment, with guaranteed issue rights throughout the year. Any age 65 and up, any month. ME Requires insurers to issue Medigap Plan A (the least generous Medigap plan) during an annual one-month open enrollment period. ME Medigap policyholders 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. CA, OR Allows beneficiaries to switch each year to a different Medigap plan with equal or lesser benefits within 30 days of their birthday. MO Allows policyholders to switch to an equivalent plan within 30 days before or after the annual anniversary date of their policy. IL Blue Cross Blue Shield of Illinois and Health Alliance provide ongoing guaranteed issue rights for all beneficiaries ages 65 or older.
I believe that CA and OR rule means 30 days before the birthdate not 30 days after. Not 100% certain on this.
I'm also not clear why the KFF write up sometimes refers to policyholders and sometimes beneficiaries. One can be a beneficiary but not (yet) a policyholder, so there's that point.
“The best argument in favour of a 90% tax rate on the rich is a five-minute chat with the average rich person.”
- Winston Churchill, paraphrased.
The last two yrs, I’ve slacked off, and I pretty much just replaced everyone with the anniversary rule. Insurance companies hate it.
Prettt sure I’m their biggest money loser. I think they put my shit on the back burner on purpose. I just wait them out.
In follow up to the table I posted above, here's an approach I've been reading about figured it's worth mentioning on here.
It's a way to leverage to the absolute maximum the (very generous) guaranteed issue rights offered by three states NY, CT, MA. It's best described by a use case:
Someone is coming up on age 65*, i.e., the time in life when they first sign up for medicare. They research medigap plans and learn the plans in their state cost 2 to 3 times (200% to 300%) more than the same plan in another adjacent state. So what costs $115 per month else where costs $265 per month in NYS (actual example). This shouldn't be a surprise because the medigap insurance companies in those three states have to accept anyone at any age into their plans and accordingly everybody pays a higher cost for this. The soon-to-be 65 year old decides to go with Medicare Advantage primarily because of the significantly lesser cost involved.
After several years on MA the now 70 year-old needs a medical treatment and his MA plan declines it. He appeals and it's still declined. He then uses the any-age, any-time-of-the-year GI rights and signs up for a Medigap plan. He knows there is a six month waiting period for preexisting conditions and he's OK with this. His new medigap plan pays for his treatment and the D Plan he already had covers the drug costs.
*Coming up on age 65 is not a requirement, you can do this at any age and anytime of the year if you live in any of these three states. IMO it's a smart way to leverage the GI rights in those states. Any why not the rights to do this are written into the state's laws, you're not taking advantage of a loophole or flying under the radar.
Last edited by Nobody Famous; 10-22-2024 at 08:12 PM. Reason: spellin' and grammar; 3 states not 4.
“The best argument in favour of a 90% tax rate on the rich is a five-minute chat with the average rich person.”
- Winston Churchill, paraphrased.
If you've sussed it all out correctly that would indeed seem to be the smart strategy, understanding that things can, and often do, change over time.
Curious, why is the northeast out in front on this?
The past is a foreign country; they do things differently there.
Happy with Part G even though my fancy lifetime gym has a one year geezer waiting list now. I need the gym for the lady so not shopping elsewhere. Paying up.
Afa care it's great. Call any doc. No co-pay after medicare deductible. I have to have two derm procedures next month so my premium will be scratch for this year. My premium is $175/mo
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