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Once you are covered on a G plan from insurance company A, you can switch each year to a G plan from insurance company B. There is no restriction. Or that is my understanding.
That is not correct, unless you live in one of the eight States that do not allow underwriting.
In most states, you would be subject to underwriting to switch from one Plan G company to another (unless you were subject to Guaranteed Issue Rights in the case of your insurer going bankrupt, etc.).
The states that do allow you to switch from one Plan G company to another without underwriting usually allow you to do it around your birthday each year.
I'm 44 but my mom turns 65 in 3 months and 1 week.
I'll be helping her apply for her Medicare coverage.
I'm still researching options but I can say off the bat I really prefer she have as much flexibility as possible. She's one year post stroke and prior to that event she never had any established PCP or care team ever. So it's highly possible she may go through a 'trial and error' period of docs for a bit as we find who to establish future care with.
I'm currently thinking Part A/B + D + G.
I know no one individual can advise me as to exactly what to do, but any tips on how to select the right plan for her?
Of note, she is pending both Medicaid and disability fyi which I do (prayerfully) believe she will eventually get.
I like your plan. D, plus either G or N should suit your objectives. I forget the difference between G and N, but we opted for N, and both my husband and I have had multiple surgeries, and the specialists of our choice, with or without referrals, at no charge. We get billed for a $20. copay for certain things, and there is an annual deductible of about $200.@
Are you using a Medicare insurance specialist? It’s costs nothing, but there are people who know every nook and cranny, and keep up with the changes. We have a person who wades through it every year to make sure we have the best option.
Our N Supplemental hasn’t changed for years, but our D changes every so often.
Last edited by gentlearts; 08-24-2023 at 08:48 AM..
In most states, you would be subject to underwriting to switch from one Plan G company to another (unless you were subject to Guaranteed Issue Rights in the case of your insurer going bankrupt, etc.).
The states that do allow you to switch from one Plan G company to another without underwriting usually allow you to do it around your birthday each year.
Boomer Benefits has a pretty good page on GI rights in various states - right now it appears to be 14 states, most recent additions being Illinois, Idaho and Nevada.
Quote:
Some states have additional Guaranteed Issue enrollment periods that go beyond federal law, including California, Oregon, Missouri, and more.
Guaranteed Issue States
Some states have laws that go beyond the federal laws for guaranteed issue. Here’s a run-down of those states and their rules:
In California and Oregon, there is a birthdayrule. Each year around your birthday, you can switch from a Medigap plan to another Medigap plan of equal or lesser benefits without underwriting — the timeframe to make this change varies by insurance carrier. Switching Medigap plans allows residents to stay insured at the lowest possible premiums continually.
In Washington, residents with a Plan A may switch to a Plan A without underwriting. However, residents with any other plan may switch to any other plan with greater or lesser coverage without underwriting.
In New York and Connecticut, Medigap policies are guaranteed issue year-round.
In Vermont,some Medigap carriers offer guaranteed issue year-round.
In Massachusetts, Medigap carriers are required to offer guaranteed issue from February 1st – March 31st each year. However, carriers can choose to participate in continuous guaranteed issue year-round.
In Missouri, you can change your policy once per year on its anniversary. This allows you to switch to any other carrier offering the same Medigap plan for a lower price.
In Maine, you have the guaranteed right to change your policy to one of equal or lesser benefits IF you haven’t had any gaps in coverage longer than 90 days since you first enrolled in Medigap. Furthermore, insurance companies in Maine must offer Plan A to anyone that applies during a 30-day window each year.
In Illinois, Medigap enrollees at least 65 years old but not older than 75 years old have 45 days after their birthday to change their Medigap policy with no health questions. They must purchase a Medigap policy with equal or lesser coverage from their current Medigap carrier.
In Nevada, Medigap enrollees can change their Medigap policy to another one of equal or lesser coverage with no health questions around their birthday. This window starts on the 1st of their birthday month and lasts at least 60 days after.
In Idaho, effective March 2022, Medicare beneficiaries enrolled in a Medigap plan can use the birthday rule to change to another Medigap plan with equal or lesser coverage. The window starts on their birthday and ends 63 days after.
In Louisiana, Medigap enrollees at least 65 years old can change their Medigap policy to another one within 45 days after their birthday.
In Maryland, Medigap policyholders can change to a policy of equal or lesser coverage with no underwriting within 30 days after their birthday.
That is not correct, unless you live in one of the eight States that do not allow underwriting.
Quote:
Originally Posted by CharlieAllnut
Ged_782 is correct.
Thank you both for correcting me. (And also thanks to Ariadne22 also for correcting me.)
I live in one of the guarantee issue states - I didn't know some states do not allow this.
A google search reports:
Quote:
There are 12 states that provide guaranteed issue protections at least once per year to switch to Medigap or change Medigap plans: California, Connecticut, Idaho, Illinois, Maine, Massachusetts, Missouri, Nevada, New York, Oregon, Rhode Island and Washington.
In most states, you would be subject to underwriting to switch from one Plan G company to another (unless you were subject to Guaranteed Issue Rights in the case of your insurer going bankrupt, etc.).
The states that do allow you to switch from one Plan G company to another without underwriting usually allow you to do it around your birthday each year.
I appreciate the clarification regarding this. Very good to know.
I like your plan. D, plus either G or N should suit your objectives. I forget the difference between G and N, but we opted for N, and both my husband and I have had multiple surgeries, and the specialists of our choice, with or without referrals, at no charge. We get billed for a $20. copay for certain things, and there is an annual deductible of about $200.@
Are you using a Medicare insurance specialist? It’s costs nothing, but there are people who know every nook and cranny, and keep up with the changes. We have a person who wades through it every year to make sure we have the best option.
Our N Supplemental hasn’t changed for years, but our D changes every so often.
I have not been using a specialist; sounds like I need to find one stat!
I like your plan. D, plus either G or N should suit your objectives. I forget the difference between G and N, but we opted for N, and both my husband and I have had multiple surgeries, and the specialists of our choice, with or without referrals, at no charge. We get billed for a $20. copay for certain things, and there is an annual deductible of about $200.@
Are you using a Medicare insurance specialist? It’s costs nothing, but there are people who know every nook and cranny, and keep up with the changes. We have a person who wades through it every year to make sure we have the best option.
Our N Supplemental hasn’t changed for years, but our D changes every so often.
Plan F is the most comprehensive, pay higher premium but have $0 MOOP, Need to be insured by 2020 to have this.
Plan G has slightly lower premium but have $226 deductible with $226 MOOP.
Plan N has lowest premium of the 3 but have $20 doctor co-pay, Could be higher MOOP with more doctor visits + other items.
Could save enough premium from F to G to pay the $226 deductible. From G to N maybe cover the $20 co-pay.
Could get Barklays/AARP charge card to get 2% back on doctor charges. Good for Doctor, Dentist, etc.
Big changes in Part D plans coming depending on the prescriptions you use. So far in 2023 changes in $35 insulin for diabetics.
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