age related cost rating price structures medigap per Ins. agent

[Ariadne22]

CA Birthday Rule applies to equal or lesser benefits. Therefore, you can switch between identical plans, or move down in coverage.

Order of benefits is:

• F - 100% includes excess fee coverage
• G - 100% after payment of $198 deductible, includes excess fee coverage
• N - 100% after payment of $198 deductible, up to 20% copay dr. visit, $50 ER; no excess coverage
• HD - Medicare pays 80%, you pay 20% up to $2,340 deductible; thereafter plan pays 100%, includes excess coverage

[GreggT]

Originally Posted by Ariadne22

CA Birthday Rule applies to equal or lesser benefits. Therefore, you can switch between identical plans, or move down in coverage.

Order of benefits is:

• F - 100% includes excess fee coverage
• G - 100% after payment of $198 deductible, includes excess fee coverage
• N - 100% after payment of $198 deductible, up to 20% copay dr. visit, $50 ER; no excess coverage
• HD - Medicare pays 80%, you pay 20% up to $2,340 deductible; thereafter plan pays 100%, includes excess coverage

Does this vary state to state or are these rules pretty uniform?

[Ariadne22]

Originally Posted by GreggT

Does this vary state to state or are these rules pretty uniform?

Ability to switch Medigap or buy a Medigap without health underwriting after the IEP varies by state, few states give that GI right:

Medigap state variation

Some states have implemented legislation that makes it easier for seniors to switch from one Medigap plan to another, and for people under age 65 to enroll in Medigap plans.

In New York and Connecticut, Medigap plans are guaranteed-issue year-round.

Massachusetts has a two-month window each year (February through March) during which Medigap plans are guaranteed-issue.

California and Oregon both have “birthday rules” that allow Medigap enrollees a 30-day window following their birthday each year when they can switch, without medical underwriting, to another Medigap plan with the same or lesser benefits.

In Maine, Medigap enrollees can switch to a different Medigap plan with the same or lesser benefits at any time during the year, and all carriers must designate one month each year when Medigap Plan A is available on a guaranteed issue basis to all enrollees.

Missouri has an Anniversary Guaranteed Issue Period; anyone with a Medigap plan has a 60-day window around their plan anniversary each year during which they can switch to the same plan from any other carrier, guaranteed issue.

https://www.medicareresources.org/states/

[GreggT]

Originally Posted by Ariadne22

Ability to switch Medigap or buy a Medigap without health underwriting after the IEP varies by state, few states give that GI right:

Thanks! Here in Alabama we are stuck!

[Ariadne22]

Correction: Plan N should be corrected to read:

N - 100% after payment of $198 deductible, up to $20 copay dr. visit, $50 ER; no excess coverage