Medicare Supplement Application – Three Things Not to Do

Applying for a Medicare Supplement plan is a relatively easy thing to do. It should not be made more difficult than it is, particularly if you are in open enrollment or guaranteed issue, during which you cannot be made to disclose medical information or answer medical questions. There are, of course, a few things that you should make sure not to do when you are applying for a Medicare Supplement plan. These will prevent future rescission of your policy or problems with claims in the future when you most need your policy.

  1. This should go without saying, of course, but it needs to be said. Do not be dishonest on your Medicare Supplement application. Of course, you shouldn’t be dishonest other times either, but that’s up to your own morality! I’m just concerned with the negative consequences that being dishonest on a Medicare Supplement application could/would have on you, your insurance, your family, your agent, etc. In most cases, there are medical questions on the application. Sometimes, there are terms that are not familiar to you, because they are medical terms. If you do not know if one of the terms applies to you, usually an agent can answer the question for you. Or, you can contact your doctor to find out the answer.
  2. Do not leave required information out. Some information is “required” because of just that – it has to be received in order for a company to process your application. There are some fields on most applications that are not required. However, the bulk of the information, if it is on there, is required and is necessary to process your application. Not a week goes by when someone tells me that they want to pay by monthly bank draft but don’t want the company to have their bank information or they want to link their supplement policy with their Medicare but they don’t want to give the supplement company their Medicare number. While I can certainly appreciate the need for security and privacy, it is sometimes necessary to divulge to the company enough information to serve you properly.
  3. Do not apply for multiple Medicare Supplement plans. So many people think this is a good idea, but it is simply not. You should apply for one Medigap plan only. First off, you only need one, and you cannot have more than one. Also, an agent cannot sell you one if you do not intend to replace one that you have currently. They cannot knowingly sell you two Medigap plans – this is for your protection. Sometimes, people do this because they are afraid they will not get approved for the plan. However, you should apply for the first plan, wait to see if it gets approved, then apply for a second option if it does not get approved.

Completing a Medicare Supplement application is not as difficult as many other types of applications. It is advisable to use an agent or broker when you are completing one, so that they can clarify any questions and help you submit the application properly. Whether it is us or someone else, we recommend having an agent’s free services on your side. If you have questions or need help getting a plan lined up, please visit our website or call us at 877.506.3378.

Qualifying for a Medigap Plan – When and How Do Medigap Companies Use Underwriting?

Qualifying for a Medigap plan is extremely easy to do when you are in a valid open enrollment (When Is the Medicare Open Enrollment Period?) or guaranteed issue period. During these time periods, there is no underwriting, no pre-existing condition restrictions or exclusions, and there is not a possibility of a company turning you down for coverage based on your health. However, when you are NOT in one of these enrollment periods, you do have to qualify medically by answering medical questions on the application. So what does that mean for you?

First of all, do not be intimidated by this. Although you do have to go through underwriting and many people have heard horror stories about medical underwriting and having to pay higher rates based on pre-existing conditions, this is not usually the case with Medigap plans. In almost all cases, Medigap plans are accept/decline applications, meaning that everyone pays the same rate. And, if you go through underwriting, you are either approved or declined based on your health.

The 2nd point to understand is that the underwriting varies greatly from company to company. Some companies use very limited underwriting, accepting nearly everyone who applies and is not currently in the hospital. Other companies are more stringent on underwriting. Obviously, it stands to reason that the more stringent a company is on underwriting, the more likely they are to be rate-stable over time (i.e. on average, if a company has healthier insureds, they will have fewer, or smaller, rate increases). Some of the major things that the more stringent companies ask about on Medigap applications are: insulin-dependent diabetes, cancer (usually last 2 or 5 years), heart attack/stroke (last 2 or 5 years), dementia/alzheimer’s, recent hospitalizations (number and frequency varies by company). This is certainly just a partial list – the things that companies ask about varies greatly and their “lookback” period can vary a good bit.

If you do have some pre-existing conditions and are comparing Medigap plans, it is highly advisable to use a broker who is familiar with the various underwriting practices of the different companies. This will allow you to compare the plans and have the experience and knowledge of a broker who can advise you on which companies would be your best options for getting approved.

Keep in mind, too, that when you are applying for an underwritten Medigap plan (this means when you are applying outside of an open enrollment or guaranteed issue period), you should allow a month for the underwriting process to be complete. It usually does not take nearly this long, but it can. So you want to allow enough time. Also, make sure you do not cancel your current coverage until you have confirmation from the agent or the company that the new plan is approved.

If you have a unique health situation or a question about whether you would qualify for a Medigap plan, please contact us online or call us at 877.506.3378.

What is the California “Birthday Rule”?

The California “birthday rule” is an annual “open enrollment” period available to California residents during which they can change their Medicare Supplement plans. This open enrollment period is specific to CA residents – most other states don’t have this stipulation.

Below, I’ve listed some important criteria/things to remember about the CA “birthday rule” and how it works:

  • To be eligible to use this open enrollment period, you must already have a Medigap plan.
  • You can switch to another plan, as long as it is of equal of lesser coverage level. In other words, if you have Plan F (the top level of coverage), you can switch to any plan with any company. If you have one of the lower level plans (Plan N, for example), you would have to stay with the plan that you have. NOTE: This is somewhat more of an incentive to take a higher level plan when you are first eligible for Medicare, as it could be difficult to go “up” in coverage later.
  • Keep in mind that you can change Medigap plans at any time of the year. There is not a restriction on WHEN you can change, just HOW the change takes place. If you change outside of your “birthday rule” open enrollment, you would have to qualify medically (i.e. answer medical questions, etc.). During the annual “birthday rule” open enrollment, though, you do NOT have to answer medical questions when you change plans.
  • The time period for this annual open enrollment period is 30 days following your birthday. So you can apply at any time (up to 30 days) leading up to your birthday extending through 30 days after your birthday, but the policy must take effect on your birthday or in the 30 days after your birthday.

To reiterate, this “birthday rule” is specific to California residents and existing Medicare Supplement policyholders. For more information about California Medicare Supplement plans, visit California Medigap or call us at 877.506.3378.

When Is the Medicare Supplement Annual Enrollment Period? (Trick Question)

Medicare Supplements are plans that are designed to fill in the gaps in Medicare A & B (“original Medicare”). These plans are also called Medigap plans because they fill in the Medicare ‘gaps’. If you are on Medicare A & B (must be on both) and live in an area where supplement plans are offered, you can sign up for a Medicare Supplement plan.

The common question is just when exactly you can sign up for a plan. Contrary to popular belief, you can sign up for a plan at any time of the year. There are NO annual enrollment periods, like there are with other types of plans, such as Medicare Advantage plans and Medicare Part D (prescription drug coverage) plans. There are, however, some enrollment periods that pertain to Medicare Supplement plans. It is essential that you are familiar with these and how they do or do not apply to your specific situation.

  1. Open Enrollment. Open enrollment for Medicare Supplement plans is not an annual occurrence. Instead, it is a period that revolves around your 65th birthday or when you sign up for Medicare Part B (i.e. if you delay enrollment in Part B due to having some other type of insurance, such as employer group coverage). This initial open enrollment period starts the first day of the month you turn 65 and lasts for six months. Or, if you are enrolling in Part B, after the point at which you turned 65, it starts the day your Part B starts and lasts for six months.
  2. Guaranteed Issue. There are a handful of “guaranteed issue” periods that apply for those on Medicare wanting to sign up for a Medicare supplement plan. These periods are very diverse, but here are the most common examples: if you are losing Advantage plan coverage due to a plan termination or moving out of the plan’s service area or if you are losing employer coverage. During these time periods, you have approximately two months to sign up for a Medicare Supplement plan on a guaranteed issue basis. This just means that you cannot be declined for coverage or made to pay more, for any reason at all, including poor health.

It is crucial that you sign up for a plan during these periods, if they apply to you. These periods have expiration dates, so to speak, and if you are not in one of these enrollment periods, you may not be eligible to sign up for a plan at all (depends on health, etc.).

If you have any questions about Medicare Supplement enrollment periods or want to get more information, visit Medicare-Supplement.US.

Medicare Supplement Open Enrollment – When Is It and How Does It Work

Medicare Supplement open enrollment is the name given to the time when you are BOTH 65 or older AND enrolled in Medicare Part B. This time period, which begins on the first day of the month that you meet these criteria (65 or older and enrolled in Medicare Part B), lasts for 6 months.

During this time period, insurance companies cannot use medical underwriting. This just means that they cannot make you pay more for pre-existing conditions, deny your coverage, or restrict the coverage based on your health. Because this is the case, it is essential that if you are going on Medicare, you sign up for a plan during this time period.

At a later time period, the insurance companies use medical underwriting to determine your eligibility for coverage. This can cause you to be denied coverage or made to pay more because of your health. The individual companies set their own unique underwriting guidelines. These can vary by state and according to state-specific restrictions and variations.

The only way to avoid this uncertainty, altogether, is to sign up during this open enrollment period, when you are first eligible for Medicare.

One consideration that may affect when you sign up is if you plan to work past the age of 65. There are other enrollment rights, called “guaranteed issue” rights, which would allow you to sign up for a Medigap plan later when you retire, if you have been covered by employer insurance.

However, you may want to also consider delaying enrollment in Medicare Part B, if you plan to work past the age of 65. Since both conditions must be met in order to trigger your open enrollment period, being 65 or older AND having Part B, your open enrollment period can also be delayed until the time of your retirement. You should discuss this with your benefits person at your current employer or insurance plan, so that you can understand the implications of how their plan will work with Medicare Part A only. If their coverage is primary to Medicare, delaying Medicare Part B is likely the most advantageous choice.

During open enrollment, you can easily compare Medicare supplement plans, get Medigap quotes from an independent brokerage and make a sound decision on the plan that makes the most sense for you. When you apply, you will not be made to disclose anything about your health, answer medical questions, or take any sort of physical examination to obtain coverage. You simply fill out some general personal information, sign the application to apply, and wait for your card and policy to come in the mail.

On a regular basis, we deal with cases where someone has waited to buy a Medigap plan until after their open enrollment period is up. In many cases, waiting can cause someone to be “stuck” in a situation where they cannot get a plan, or atleast not get the plan they want.

This makes getting a plan during your open enrollment period, no matter what company or broker you get it from, of utmost importance. If we can assist in comparing the plan options, we are happy to do so. We can send quote information by email. To get this information, visit Medicare-Supplement.US or call us at 877.506.3378.

Medigap Plan N – No Longer Guaranteed Issue, But Still a Smart Choice

Medigap Plan N has only been out for a little less than a year – it came out June 1, 2010. During a good part of the time since then, it was offered on a “guaranteed issue” basis by at least one insurer (Mutual of Omaha). Now, that company is no longer offering “guaranteed issue” Plan N; however, there is still limited underwriting which makes it a good choice for those who have some pre-existing conditions or health problems.

Even notwithstanding your health, Medicare Supplement Plan N can be a very good choice for your Medigap coverage. Premiums are usually 15-25% lower than Plan F premiums. The differences in the two plans are significant; however, they may not offset the premium savings that you cna gain with a Plan N.

Plan differences between the F and N plans are:

  • Coverage of the Medicare Part B deductible ($162/year)
  • The co-pays that Plan N has – $20 at the doctor’s office, $50 at the emergency room
  • Coverage of the Part B excess charges – this rarely happens but is when a doctor charges more than the Medicare-approved amount

Other than these three benefit differences, the two plans (F and N) are identical. With that in mind, you can easily do a comparison to see which one makes the most sense for you.

If you are in good health and/or are on a fixed income, you may find that Plan N just makes sense. The coverage is still good, and it still works just like any other Medigap plan. You can go to any doctor or hospital that takes Medicare, nationwide. There are no network restrictions. Additionally, benefits are Federally-standardized and do not change at all on an annual basis.

When it comes down to comparing plan options, the main thing to look at is which plan fits your unique health and financial needs. From there, it is easy to compare “apples to apples” and see which company offers the least expensive plan for the plan option that you are looking for. To get more information or Medigap Plan N quotes, please contact us on our website.

Medicare Supplement Facts – Top 10 Things You Need to Know

Medicare Supplement insurance can be overwhelmingly complex. Many people get confused or frustrated to the point of making a hasty decision or just forgetting it altogether. We’ve distilled the top 10 things that can help you avoid that frustrated feeling into ten facts that you must know if you have a Medicare Supplement plan.

  1. Medicare Supplements can be purchased at any time of the year. Contrary to popular belief, there is NOT an annual enrollment period for Medicare Supplement plans.
  2. Medicare Supplements are individual policies. There are no family policies or husband-wife combo policies. There are, however, many companies who offer a husband-wife “household” discount, when two policyholders have the same residence.
  3. Medicare Supplement plans are Federally-standardized. The coverage is the exact same from company to company. You can view the Medigap coverage chart to see what all of the plans must cover.
  4. Medicare Supplement plans and rates vary by your age, gender, zip code and tobacco usage.
  5. If you are in an open enrollment or “Guaranteed Issue” period, you will not have to answer any medical questions on a Medicare supplement application. This is the best time to apply for a Medicare Supplement plan.
  6. Medicare Advantage plans are NOT Medicare Supplements. Advantage plans pay INSTEAD of Medicare A & B, whereas supplement plans pay AFTER Medicare A & B.
  7. Medicare supplement plans do NOT cover prescription drugs. You must have a Medicare Part D plan to have coverage for prescription drugs.
  8. Supplement plans also do not cover routine dental or vision. You would have to purchase a separate stand-alone plan to have coverage for these things. The best dentist I have seen are in denture services lexington ky.
  9. Medigap plans are the same as Medicare Supplements. The two terms are interchangeable.
  10. Medicare Supplements are “guaranteed renewable”. They cannot be canceled by the insurance company for any reason, other than if you do not pay your premium.

Overall, there are many aspects to Medicare Supplement insurance and it certainly can be a confusing thing, particularly when you are first going on to Medicare. However, by understanding the basics first, you too can have a grasp on exactly what Medicare Supplements cover, how they work and which one is right for you.

If you have specific questions, you can contact us or request a Medicare Supplement quote on our website.