Medigap Policy

[its2much]

I recently applied for a Medigap policy to be effective 1/1/16. I was just told that once you enroll in a Medigap policy you are pretty much stuck with that insurance carrier forever, i.e. it is extremely difficult to change the health insurance carrier at a later date.
Is that true? What if the premiums go up alot? What if you're unhappy with the service you get? Etc., Etc,.....

[jreagan70]

I was just told that once you enroll in a Medigap policy you are pretty much stuck with that insurance carrier forever, i.e. it is extremely difficult to change the health insurance carrier at a later date.

Who told you that and in what context?

You can always disenroll from a carrier at the end of the year. And you can remain on just Medicare or apply to a different program during the open enrollment period every year. That's why companies do so much advertising during open enrollment. Whether the next carrier accepts your application depends on whether you meet their eligibility requirements. But you're not locked into a particular carrier. And if the next carrier really wants your business, they don't care which company you're with or are disenrolling from.

There's information about Medigap policies on the Medicare.gov site.

[its2much]

THANKS

Will another carrier enroll someone with MS? I was told this by one of the DMD company reps. Said Part D is easy to change at open enrollment time but getting a new Medigap policy with another carrier can't be done.

[jreagan70]

Will another carrier enroll someone with MS?

How do you know that the carrier you applied to will enroll someone with MS? How many carriers/policies did you look into before choosing one to apply to?

I was told this by one of the DMD company reps.

Drug reps know drugs and how insurance pays for drugs. They may not know the insurance business in general.

There's nothing built into the Medigap industry that doesn't allow people to change carriers. So it sounds like that rep has personal knowledge of a few particular instances that led to that opinion. You'll have to ask that person how s/he came to that conclusion.

The only thing I can think of that this person might have been referring to -- and this is purely speculation -- is that, unlike with ACA general health policies, Medigap carriers are not required by Medicare or federal law to enroll people under 65 who have pre-existing conditions. (Some states do require no age requirements for pre-existing conditions for Medigap.) So if you're under 65 and find a carrier who will issue a policy to a person with MS, it might be difficult to find another one who will. But once a person reaches 65, Medigap carriers are not allowed to decline to enroll them based on a pre-existing condition.

So if a pre-existing condition is what the drug rep was referring to, it doesn't mean a person can never change Medigap carriers. It only means that it might be difficult up to age 65.

Unless somebody else weighs in with some specific information, you're back to having to ask the person who said it what it means and where the information came from.

[its2much]

Are You Saying

that you can change Medigap Health Insurance carriers fairly easily?

Are you subject to a six-month waiting period if/when you make the change? (Could be a real disaster for someone with MS)
Unfortunately, so little information is given out to the public when it's time to make a serious decision.

[jreagan70]

This is beginning to make more sense.

Changing policies is allowed every year during the open-enrollment period. But there might be a 6-month waiting period under the new policy for a pre-existing condition or particular benefits.

It doesn't mean that you can't change policies. You just might not want to change policies if the potential new policies you have available to you impose a waiting period that you can't live with. That may be what the drug rep meant by "difficult" to change policies.

The choice to change during open enrollment is yours. You'll just have to decide whether a waiting period under a new policy is better than putting up with bad service or high rates for another year under an existing policy.

Some states have laws that don't allow waiting periods for Medigap policies. So it might be a good idea to check with your state insurance commissioner's office whether your state is one of them.

The Medicare website has some information about Medigap polices and changing policies (some of it isn't very well written though ):

https://www.medicare.gov/supplement-...nce/index.html

https://www.medicare.gov/supplement-...#collapse-2513

[its2much]

The Medigap Carrier I Applied To

says you can change your Medicare supplement plan at any time of the year.
This is my first application fo a Medigap plan. Medicare Part A was effective October 2015 and Part Bis effective January 2016.
How long does it generally take to get approved for a Medigap plan? I thought the carrier has to accept you if it's during your open enrollment period.
Thanks.

[jreagan70]

Guaranteed acceptance into a Medigap plan during a person's first eligibility applies to Medicare enrollees who are at least 65. Federal Medicare rules don't require guaranteed acceptance or guaranteed rates for pre-existing conditions below 65, but some state laws do. It sounds like it would be a good idea to read up on Medigap policies on the Medicare website and to contact your state resources to find out what laws and terms apply to your application. I hope your enrollment goes smoothly.