Medicare Supplement Plans N and M

Medicare supplement insurance Plans M and N will be available for purchase with effective dates of June 1, 2010 and beyond.  These two new plans offer attractive coverage for those willing to exchange lower monthly premiums for higher out of pocket expenses.

Both M and N are cost sharing plans. The insured will be responsible for additional out of pocket expenses when compared to Plans C, D, F and G. In this way, they will work somewhat like Medicare Advantage coverage, but unlike Advantage plans there are no network restrictions for the insured.

This means that you are free to visit any doctor or hospital that accepts Medicare patients.  The freedom from having to operate within a small network of health care providers will be a distinct advantage for Plans M and N.

Plan N Offered on a Guaranteed Issue Basis

The good news is that at least one insurance company will offer Plan N on a guaranteed issue basis in most states. This will be very beneficial for those who live in a state that does not offer a yearly open enrollment window and have tried unsuccessfully to be medically underwritten for a new Medicare supplement.  Plan M may require underwriting with most companies.

Plan N Medicare Supplement Highlights:

• Fully Covers All Medicare Basic Benefits
• $20 Copayment for Office Visits
• $50 Copayment for ER visits
• Fully Covers Part A Deductible
• Does Not Cover Part B Deductible
• Does Not Cover Part B Excess Charges
• Issued on a Guaranteed Basis w/ Some Providers

Plan M Medicare Supplement Highlights:

• Fully Covers All Medicare Basic Benefits
• No Copayments for Office or ER Visits
• Cover 50% of Part A Deductible
• Does Not Cover Part B Deductible
• Does Not Cover Part B Excess Charges

Part B Excess Coverage

It is important to note that many states (Ohio and Pennsylvania for example) do not allow doctors to charge for Part B excess.  If you live in one of these states and plan on maintaining a residence there, then you need not worry about this benefit.  If you live in a state that does allow for these charges, then be aware that you could have higher out of pocket expenses should you choose a supplement that does not cover Part B excess charges.

Insurance Companies Offering Plan M and N Medicare Supplements

There are several supplemental providers offering either Plan M, N, or both through independent agents. Depending on your state and zip code of residence there will be a handful of competitive providers in your area.  As of now, Mutual of Omaha, Assured Life, Family Life, Gerber Life, Loyal American, Anthem, United Healthcare AARP, and a few others are offering affordable coverage in several states.

In summary, both Medicare supplement plans M and N will be cost effective ways to cover most of what Original Medicare Parts A and B do not.  When coupled with a prescription Part D drug plan, you will have all four components needed for complete coverage.  And should you decide that you would like a Medigap plan with less or no cost sharing, then Plans C, D, F, and G will still be available after June 1, 2010.

Request Medicare Supplement Information

Hyers and Associates, Inc. is an independent agency offering Medicare supplements direct to consumer from several highly rated insurance companies.  Using our services, you can compare the plans available in your area in order to find the most affordable coverage.  We work in several states including AZ, CA, FL, GA, IL, IN, MO, OH, NC, NJ, PA, and TN & TX.
 

Contact us to compare the lowest rates on Medicare supplements in your area.

Category: Medicare Supplements

New Medicare Supplement Plans For 2012

The recent passing and implementation of the Medicare Modernization Act created permanent changes to the Medicare supplement plans insurance companies can offer after June 1, 2010.  All plans are still in effect for 2012.

Plans A, B, C, D, F, G, K and L offer nearly the same benefits as before with Plan F now being the most comprehensive. Plans E, H, I, and J have been eliminated. Plans M and N have been introduced as lower priced alternatives requiring some cost sharing for the insured.

New Medicare Supplement Coverage Chart 2012

Supplements E, H, I and J Phased Out In 2010

As of June 2010, you will no longer be able to purchase Plans J, E, H, and I. They are being phased out and will no longer be for sale by any insurance company as mandated by the Centers for Medicare and Medicaid Services. If you have enrolled in one of these four plans prior to June 1st, then you can keep it if you wish. However, all insurance companies will allow you to convert to any of the new Medicare supplements they offer – like Plan F for instance.

It may be wise to strongly consider this conversion opportunity. When your existing coverage (J for instance) is no longer offered, then there will be no new premiums coming in from future customers. This may very well translate to higher than normal renewal premiums for those who choose to keep a discontinued plan.

If you wish to convert to a new Modernized plan after your conversion opportunity has passed, then you may have to go through medical underwriting and you could be denied coverage because of poor health. This would not be an issue in California and Missouri as those states offer an open enrollment window each year. However, most other states do not provide this opportunity.

New Medicare Supplements M and N Introduced

Medicare Plans M and N  will have more out of pocket expenses for the insured if claims arise. In turn, monthly premiums will be lower for these two plans as compared to some others offering more comprehensive coverage – like Plan F for example.

Plans M and N do not cover the Part B deductible or Part B excess amounts. (Not all states allow doctors to charge for Part B excess – Ohio is one such state.) Plan M covers 50% of the Part A deductible while Plan N pays for 100% of this amount. Like Plan M, Plan N pays Part B Coinsurance at 100% except up to a $20 copay for office visits and $50 copay for emergency room visits.

Plans K, L, M and N most closely resemble Medicare Advantage insurance coverage. They require more cost sharing for the insured, but they cannot be packaged with prescription Part D drug coverage. As with all Medicare supplements, Part D drug coverage must be purchased as a stand alone product. Should Congress pass health care reform that limits Medicare Advantage coverage, then Plans K, L, M and N may be suitable low cost alternatives.

Medicare Insurance Benefit Changes

When compared to supplements available prior to June 1st, there are three significant changes to the benefits offered – depending on the coverage you choose. Preventive care not covered by Medicare and at home recovery benefits will no longer be available with the phasing out of Plans E, H, I and J. The rational behind their removal is both benefits were limited in scope, difficult to administer, and not often used by consumers.

In their stead, The CMS introduced an added Part A hospice coinsurance benefit that is a  core component  of all new plans. This is also a limited benefit as hospice coverage was already part of the basic benefits offered by Medicare, but it does close the small gap in coverage.

Lower Rates on New Medigap Supplements

Not all companies have been approved to offer new Medigap supplemental coverages yet in the states where they do business. However, one of the advantages associated with the Modernization Act should be lower monthly rates for those who choose a conversion plan and for those who are healthy enough to be underwritten for new insurance coverage.

When new plans are introduced they will almost always offer lower rates than their predecessors. There are a couple of factors that account for this, but the primary issue is there are no claims associated with a brand new plan. The longer a plan has been in existence, the more claims the insurance company will experience, and in turn they will increase rates for the pool of insured customers.

Contact Us For Quotes

In summary, the Medicare supplement insurance changes are not dramatic in nature, but may provide an opportunity for you to change plans if you are already insured. If you are new to Medicare coverage, then you should speak to a knowledgeable agent about your options pre and post June 2010.

Hyers and Associates, Inc. is an independent insurance agency offering affordable supplement coverage from several insurance companies. Our agents can answer your questions and assist you with your search for suitable supplemental insurance.

Category: Medicare Supplements

Assured Life Medicare Supplements in Ohio and Arizona

It is quite common for new carriers to enter the Medicare supplement marketplace every year. One of the newest entrants is Assured Life.  These plans are underwritten by Mutual of Omaha. The monthly premiums are very competitive in the states where they currently offer coverage.  Arizona and Ohio residents over age 65 will find their rates to be very competitive for new and existing coverage.

Assured Life Medicare Supplement Plans and Premiums

Supplemental plans offered by Assured Life include A, B, C, D, F, and G.  Plan F is the most comprehensive coverage offered, but popular alternative includes Plans D and G as they are slightly less expensive on a monthly basis. You can pay your premiums by monthly bank draft or by check either quarterly, semi-annually, or annually.

This is an attained age supplemental plan.  That means that your rates will increase each year as you grow older. Multi-insured discounts are not offered to couples who apply together, but you will still find their rates to be more affordable than most others that do offer such savings.

Guaranteed Issue and Medicare Supplement Underwriting

Underwriting for this new supplemental plan is reasonable as is the case with most Medicare plans. If you are applying during a period of guaranteed issue, then you will not have to answer any health related questions. If you are shopping for better rates on your existing coverage, then there will only be a handful of questions you need to answer. A doctor’s physical is not required for acceptance into any plan.

We are an independent agency offering plans direct from Assured Life/Woodmen of the World.  If you are interested in a personal Medicare insurance quote, please contact us today.

Category: Medicare Supplements

Retired Delphi Employee Health Insurance Options

A bankruptcy judge recently approved Delphi Corporation’s reorganization and subsequent request to terminate life and health insurance benefits to many of its retired employees.  Benefits could be lost as soon as April 1st for the affected retirees. Former salaried employees will need to explore all available options in order to maintain medical coverage.

Medicare Supplement Coverage

Fortunately, many retirees will have guaranteed enrollment options available to them.  Those over age 65 will be eligible to apply for a Medicare supplement plan without underwriting taking place by the chosen insurance company. There are no health questions to be asked or answered.  This period of guaranteed issue for former Delphi employees will vary between states, but  will not last long – usually one to three months. If the open enrollment window is missed, then retirees can be turned down by the insurance company due to poor health.

-Contact Us for Medicare Supplement Information-

Prescription Drug Coverage

If former employees choose a Medicare supplement plan to compliment Parts A and B offered by original Medicare, then they will also want to consider prescription Part D coverage. Part D monthly premiums and prescription co-payments will vary between companies, but will lower overall drug costs for Medicare recipients.  Retired employees will also be guaranteed eligible for rx coverage.

Health Insurance Options

Employees under the age of 65 who are not eligible for Medicare will need to seek insurance in the individual and family markets.  There are several companies that will consider them for coverage, but underwriting will need to take place.  United Healthcare, Anthem, Aetna, Assurant, American Community, and Medical Mutual are reputable health providers in Michigan and Ohio where many retirees currently reside. Knowledgeable agents can narrow down available options depending on the needs of the insured.

-Contact Us for Health Insurance Information-

Life Insurance Options

The need for life insurance typically decreases for retired employees, but still may be a necessity for a number of reasons.  Term policies will be most affordable while whole life coverage will cost more.  Life insurance, when properly structured, can circumvent federal and state inheritance taxes while also passing income tax free to beneficiaries.  If needed, a new life policy will be available for most retirees.

In summary, Delphi workers should work with an agent to determine a reasonable course of action to maintain health and/or life insurance coverage by April 1st.  Those over age 65 should have little trouble enrolling as long as they take advantage of the guaranteed issue time period.  Those under age 65 will need to pursue plans in the individual and family market if a new employer sponsored plan has not been located.

Category: Medicare Supplements

Medicare Supplement Insurance Benefit Chart, Copays & Deductibles

Medicare has many gaps and will not pay for all of your health care related claims. For this reason, many Medicare recipients purchase a supplemental plan to fill in all or the most common gaps.

The chart below details ten standardized Medigap plans and explains the different available coverages. It is important to note that private insurance carriers cannot adjust the coverages below in any way. The only difference between carriers is the price for the chosen plan.

New Medicare Supplement Coverage Chart 2014

–Request a Medicare Supplement Quote Here–

Medicare Supplement Insurance Explained

Medicare supplements are offered by private insurance companies through independent agents. Traditional Plan F offers the same coverage no matter the company.  First year premiums and renewal premium increases are what differ from company to company. Experienced agents like ours can help consumers choose a suitable plan based on these variables.

Medicare Basic Benefits

Basic benefits are covered by all Medicare Plans A-F. After the hospital deductible has been reached, Medicare pays for hospital costs up to 60 days. After 60 days, Plans A-F pay for days 61-90. After 90 days, Plans A-F pay $608 (in 2014). If all 150 days are used, then all Medigap plans pay for 365 more lifetime hospital days.

After the Part B deductible has been reached, all supplemental plans cover 20% of the Medicare approved amount for doctors services, 50% for mental health services, and 100% for some preventive care services. Additionally, Plans A-F cover the first three pints of blood.

Medicare Part A Hospital Deductible

Medigap Plans B-F pay the hospital deductible ($1,216 in 2014) for each benefit period.

Skilled Nursing Facility Care

Original Medicare pays for the first 20 days of skilled nursing care and a portion of days 21-100. Plans C-F cover the remaining portion not covered by Medicare during days 21-100 ($152 per day in 2014). It is important to note that neither Medicare nor supplemental insurance pays for care beyond day 100. Consequently, many seniors purchase a long term care insurance policy.

Medicare Part B Deductible

Plans C and F cover the Part B deductible for doctor and other medical related services.

Part B  Excess Charges

Plans F and G pay 100% of  doctors charges above and beyond the Medicare approved amount. Doctors who do not accept assignment can charge up to 15% more than what is normally approved.

Foreign Travel Emergency

Medicare will not cover health care services received outside of the United States. Plans C, D, F, and G cover emergency care outside of the U.S. once a $250 deductible has been reached by the insured. This benefits pays 80% of the emergency care expenses up to a $50,000 lifetime maximum.

At-Home Recovery

Older plans D, G, I and J cover at-home health care if skilled home health care covered by Medicare has also been received. Plans cover medical assistance for up to eight weeks after skilled care is no longer needed.

Visits up to $40 a day, seven days a week, up to $1,600 a year is the maximum amount covered. Again, long term care insurance is the best hedge against expensive home health care visits that primarily involve custodial, intermediate or skilled care.

Preventive Care

Original Medicare covers some preventive care services, but older Plans E and J cover up to $120 a year in additional services not already covered. An example could be a routine physical.

Prescription Drug Part D Benefits

After changes to existing law, Medigap plans no longer cover prescription drugs. Part D prescription drug coverage is now a separate insurance purchased from private health insurance companies.

Not all plans are exactly alike and monthly premiums, drug co-pays, and plan deductibles can very between companies. Typically, private insurers offer three plans to choose from. The federal government offers comparison services at their website www.medicare.gov so consumers can locate a suitable drug plan.

Category: Medicare Supplements

When to Purchase Medicare Supplement Insurance Coverage

There are several events that guarantee a consumer’s right to purchase Medicare supplement insurance coverage. It is important for seniors to take advantage of these periods or they may no longer qualify medically for enrollment.

Listed below are the most common occurrences that allow for guaranteed eligibility into a supplemental plan as well as rules and regulations unique to a few different states. Request a quote today!  

Seniors Turning Age 65

The most common event is simply turning age 65 and enrolling in Medicare Parts A and B. Government mandates allow for a three month eligibility window on either side of your 65th birthday. Usually this is the best time to purchase Medigap coverage. There will be no medical underwriting necessary for the insured and all plans are available for purchase.

Losing Employer Sponsored Group Coverage

Involuntary loss of employer sponsored group coverage is also a qualifying event. The proposed insured needs to be age 65 or above, but will have most plans available. If the insured previously enrolled in Parts A and B, then Plan F will only be available through medical underwriting. All other plans are guaranteed for the insured, including popular Plan G.

Dis-enrolling From A Medicare Advantage Plan

Consumers who discontinue a Medicare Advantage plan within one year of acceptance can purchase a supplemental policy. Due to the complexity of Advantage plans, government mandates allow consumers one year to opt out and return to traditional Medicare and Medigap coverage. If the insured has participated in the coverage for longer than a year, then medical underwriting may be necessary for plan purchase.

Changing Service Areas

If the insured changes service areas, then he or she will most likely be eligible for a new policy. Moving from state to state or into an area where the previous insurance company does not provide benefits allows consumers to enroll with a new insurance company.

Acceptance into Medicare Disability

In some states, Illinois, Missouri and Pennsylvania for example, those under age 65 and accepted into Medicare disability are eligible to purchase a supplement plan. Very few states require insurance companies to offer plans for those under age 65, thus it is wise to explore this option if it’s available. This can be a very small window of opportunity – one to three months in some cases.

What also make some states unique is they allow for Medicare open enrollment every year. If the insured is unhappy with rates or claims handling, then a new plan can be purchased during the insured’s specific enrollment period.   This rule is true for Missouri and California.

Medical Underwriting and Good Health

Finally, if the insured is healthy enough, he or she can simply research a plan with an insurance provider offering better rates. Medical underwriting will be necessary, but many carriers offer rating classes depending on the health and build of the insured. Those in good health will have all options available to them.

In summary, there are several circumstances that guarantee a consumer’s right to purchase a Medicare supplement plan. Those eligible for open enrollment should work with a knowledgeable agent (like us) who offers policies from several insurance companies. Please contact us today to learn more about your options.

Category: Medicare Supplements

G.M. Retirees Health Insurance Options

The bankruptcy of General Motors Corporation has forced the cancellation of health insurance coverage for many retirees. The changes will be effective January 1, 2008 for former employees. The good news for G.M. retirees over the age of 65 is that they will be in a “guaranteed issue” period for Medicare supplement and prescriptions Part D coverage. Contact us for insurance quotes today!

Medicare Supplement and Medigap Coverage

Most retired employees use Medicare as their primary coverage and their G.M. health insurance functions as their supplemental coverage. Due to the involuntary loss of the G.M. plan, all those age 65 and above can enroll in a Medicare supplement plan without answering any health questions. All plans, except plan J, require no health underwriting. If the insured would like to enroll in a Plan J and they have previously enrolled in Medicare Part B, then they will have to complete medical underwriting. Fortunately, Plans C, F, G and others provide comprehensive coverage as well.

Prescription Part D Drug Coverage

In addition to Medigap coverage, retirees will also need to choose a prescription Part D plan. These plans are separate from the supplemental coverage mentioned above. Plan costs for Part D coverage usually range from $20-$45 per month. This cost does not include the co-payment amounts associated with most prescriptions. Prescriptions will fall into different tiers (there are usually four tiers) and thus have a separate co-payment above and beyond the monthly plan cost.

Medicare Advantage Plans

Retirees can also consider enrolling in a Medicare Advantage plan in lieu of a Medicare supplement and a Part D plan. When choosing a Medicare Advantage plan, consumers must realize that they are dis-enrolling from government funded Medicare. Instead, a private insurance company, United Healthcare, Anthem, or Humana for instance, covers the insured’s expenses for medical and prescription claims. Typically Advantage plans are low to no premium plans and have extensive co-payment amounts for the insured. The caveat is if the insured wishes to opt out of the Advantage plan, and he or she has been a participant for over a year, then the insured will no longer be guaranteed eligible for a Medicare supplement.

Dental and Vision Insurance

G.M. retirees may also wish to purchase dental and/or a vision plans. Typically dental and vision plans require no underwriting. The insured can enroll at any time. Most individual and family dental plans will have a waiting period before they cover major services. Due to waiting periods, it is usually wise to enroll in a dental plan sooner rather than later.

In summary, former General Motors employees will have several options available to them including Medicare supplements and Part D coverage, Medicare Advantage plans, dental and/or vision insurance. Most will opt for the straight forward, no-network coverage offered by a Medigap plan, but it is helpful to work with a knowledgeable agent who is familiar with the offerings in the insured’s place or residence. If you are a concerned retiree, contact us to discuss your options today.

Category: Medicare Supplements

Medicare Supplement Ratings Types

When researching Medicare supplement insurance policies, you may have questions about the various ratings classes. There are three to choose from: Attained Age, Issue Age and Community Rated. We will examine all three and discuss the nuances of each below.

It’s important to note that each class has it’s own pros and cons. There is not one type that is better than the other two in every situation. In many cases, it boils down to state regulations and historical increases of the insurance company.

Medicare Supplement Issue Age Plans

Consumers can purchase plans A through N based on their age at issue. This means the insurance provider cannot increase premiums each year based on the fact you’re a year older, but they can increase the rates based on other factors like changes to Medicare or claims experience.

In essence, you’re locking-in a rate based on your age when the policy is issued. However, insurance providers can raise premium rates by class for all policies issued in their state once approved by the Department of Insurance.

An insurance company might increase rates due to significant claims experiences or several other factors. In other words, your rates can (and will) likely still increase each year, but not because of a birthday.

There are some states where all plans must be sold as Issue Age, like Missouri and Florida for example. In most other states, there are only a small handful of carriers still offering this class of supplements – most are Attained Age.

In general, Issue Age Medicare supplement plans will be more expensive at onset. In the long run, you hope to pay less in premiums by avoiding rate increase with each birthday. This isn’t always the case however – so it’s wise to ask you agent about renewal history.

Medicare Supplement Attained Age Plans

Attained Age supplements usually increase in price each year as you grow older, but not always. There are some insurance companies using age banding – which means you will not receive a rate increase until you reach the next band. In other words, your attained age rate could stay the same from ages 65-68.

When banding is not used, your rates will likely increase a small percentage each year.  Attained Age plans are usually less expensive than Issue Age Medigap plans. You’re hoping the less expensive premiums in the beginning will offset future increases when compared with an issue age plan.

Like Issue Age plans, premiums can also increase based on changes to the Medicare program as well rising health care inflation. Put another way, there are two factors that can increase your rates. While this sounds daunting, we’ve seen smaller premium hikes for our clients with many Attained Age plans when compared to Issue Age. Again, renewal history can help to separate the good from the bad.

Community Rated Medicare Supplement Insurance Plans

Only a few companies offer Community rated supplements depending on where you live. United Healthcare (AARP) is one of the more popular Community rated providers. You premiums will not differ by gender or zip code, only the age and maybe the health of the applicant. In large states, you might see different community rates fro different sections of the state – like Pennsylvania for instance.

Community rated Medicare supplements can be beneficial for those who live in expensive areas – like Cleveland and southern Florida, but not ideal for those in rural areas or less expensive sections of large states. This ratings class may not be ideal for women as their premiums tend to be lower than men’s when separated out. There is usually no good argument for a woman in Columbus, Ohio to pay the same as a man in Cleveland in our opinion – so shop wisely.

Which Plan is Right for You?

It is difficult to predict which plan might be most beneficial to you over several years, but it always helps to analyze the trends. Some consumers will like less expensive plans from the onset while others will want to lock-in a seemingly more stable rate. It’s also wise to ask about the various premium discounts available as well.

When choosing a supplemental insurance provider, renewal history is one of the most important metrics in our experience. There is no absolute method of predicting future rate increases, but past experiences can be a good barometer for what may be ahead.

No matter the ratings class, all insurance companies will increase your premiums over time. There is no silver bullet, but certainly some decisions will save you more money over others in the long run. We help our clients examine all of their options so they can find the Medigap plan that best suits their needs.

Compare Medicare Supplement Quotes Today  →

Category: Medicare Supplements

Understanding The Medicare Open Enrollment Window At Age 65 And Beyond

Your Medicare open enrollment period is a seven month window. It includes the three months prior to, the month of and the three months after your 65th birthday.

It is advantageous to consider purchasing a supplemental plan during this window of time. That might be a Medicare Supplement, Part D drug plan, or Medicare Advantage insurance.

Most importantly, an applicant cannot be denied supplemental coverage during the open enrollment window due to poor health. There is no health underwriting necessary. You will have all supplemental plans offered in your state available for purchase. And there are no waiting periods for preexisting conditions.

Advantages of Enrolling in Medicare at Age 65

There are a few supplemental insurance providers who provide discounts during open enrollment. In some cases, the discount can be as much as 30% to the applicant. The savings will carry over into subsequent years helping to keep premiums lower as you grow older.

Additionally, some insurance companies will require underwriting for popular supplements, like Plan N, if the applicant is more than six months past their 65th birthday. Applying during the seven month window will require no underwriting for Plan N.

Your Medicare Part B eligibility is the gatekeeper. You may be able to defer Part B enrollment if you have qualifying group health coverage (more than 20 employees) at work.

Other Guaranteed Periods of Eligibility For Medicare Supplement Insurance

There are other time periods of guaranteed eligibility for a Medigap policy if you’re outside you seven month period. Consumers age 65 or older and who are involuntarily losing group health insurance coverage will also be guaranteed a supplemental policy. However, they may have to go through underwriting for certain plans, like Plan N, and they might not be afforded any discounts on their plan choice.

If you are enrolling in Medicare part B for the first time after age 65, you can still purchase any plan without medical underwriting. Medicare Part B eligibility determines your course of action. If you’re not sure, then call us and we can walk you through your options.

Medicare Disability and Open Enrollment

In some states, acceptance into Medicare disability is a qualifying event. Consumers under age 65 who are approved for government disability also have a seven month window to purchase a Medicare supplement regardless of health history. California, Florida, Missouri, Illinois and Pennsylvania are all such states.

It is very advantageous for those who are eligible to enroll in a plan during this opening. Otherwise, they will have to go through medical underwriting and it is unlikely that they would qualify for supplemental coverage due to their health concerns.

Should you wish to discuss your options about enrolling in a Medicare supplement policy, please contact us today. It can be difficult to find coverage if you miss your open enrollment window. Don’t wait to investigate your options!

Category: Medicare Supplements

Ohio Medicare Advantage Plans, Quotes and Coverage

Medicare Advantage plans are relatively new products in the insurance marketplace. In a nutshell, they allow consumers to opt out of traditional government provided Medicare coverage, forgo Medicare Supplement coverage and enroll in a Medicare Advantage plan with a private insurance company like Anthem Blue Cross, Aetna, Humana or United Health Care.

Advantage plans are designed to provide Medicare type coverage while also filling in some of the uncovered gaps. Typically, plans will have small co-pay amounts due for certain services. (It is our opinion that Medicare eligible consumers who qualify for and can afford a Medicare supplement will have superior coverage to those on an Advantage plan.)

Medicare Disability Insurance Coverage For Those Under Age 65

However, there are consumers who cannot qualify for supplemental insurance. They might be on Medicare disability and under age 65. Most insurance companies will not underwrite a disabled person under age 65 for a Medicare Supplement*. This will vary by state however. While Ohio and Indiana will not sell Medicare supplements to those under age 65, Pennsylvania and California will.

A Medicare eligible consumer living in a state that does nor offer supplemental plans to those under age 65 will likely be better off with an Advantage plan than without. An Advantage plan might be the only option available to help fill some of the uncovered gaps.

And there are those who will not be able to afford a supplemental plan. In these cases, popular Medigap plans such as F, G & N are financially out of reach for consumers on a tight budget. Additionally, a select few seniors might not have enrolled in a Medigap plan during their open enrollment period. If their health has significantly deteriorated, private insurers will not underwrite them for a supplement.

Compare Medicare Insurance Plans and Quotes

Your options will depend on where you live. Some consumers will prefer a Medicare Advantage plan to a supplement based on price and some will prefer a Medicare supplement based on benefits. One size does not fit all. Fortunately, we offer both supplements and Advantage plans and can help you compare and contrast both. Contact us for quotes today!

*It is important to note that upon attaining age 65, almost all consumers are eligible for a Medicare Supplement plan regardless of health history.

Category: Medicare Supplements

Medicare Supplements for Individuals Under Age 65 On Disability

Currently there are only a few states allowing insurance companies to offer Medicare Supplements to those under the age of 65. Due to legislative changes, California, Georgia, Florida, Illinois, Missouri, Pennsylvania, Texas, and Tennessee are such states.

Just like those reaching age 65, those who qualify for Medicare due to disability will have an open enrollment window available to them where most supplemental plans can be purchased without medical underwriting. It is wise to purchase a plan during this period.

Likewise if you are losing credible coverage (like a group health insurance plan), then you may also qualify for a supplement without underwriting. In very few states, Tennessee for example, losing Medicaid (TennCare) is also a qualifying event.

Medicare Disability Insurance Offerings

So long as you are in your open enrollment window (three months before or after your acceptance into Medicare Part A and B) then you can purchase most supplemental policies.

Rates will vary between insurance companies so it is wise to speak with an independent agency like ours to compare rates. In most states, Medigap insurance providers are allowed to charge higher premiums for someone who is under age 65.

Two states where this is not the case are Pennsylvania and Tennessee.

In states like Missouri and California, those on Medicare disability and under age 65 can switch to like or lesser coverage on their anniversary or birthday respectively. This does not mean that the insurance can be upgraded, just that similar or lesser coverage can be obtained without underwriting.

Medicare Supplement Insurance Medical Underwriting

If you miss your open enrollment window, then you will need to go through underwriting with most companies. This can be very difficult for someone on Medicare Disability with ongoing health concerns.

Thus, it is wise to explore all of your options as soon as you have been accepted into Medicare due to disability or if you are involuntarily losing credible (group) coverage from an employer or elsewhere.

Medicare Advantage Insurance Coverage

In states where Medicare supplement insurance is not available to those under age 65 (like Arizona, Indiana and Ohio for instance) you may want to consider Medicare Advantage insurance coverage. These are private insurance plans offered by companies like Aetna, Anthem Blue Cross and Blue Shield, Humana, United Healthcare and others.

Typically Medicare Advantage plans have the potential for higher out of pocket expenses than a traditional supplement, but they are less expensive and can be a better alternative to Medicare alone. And most MA plans also include prescription drug coverage as part of the overall policy. Our agency can help you better understand MA policies.

Contact Us For Quotes & Information

We are an independent Medicare supplement insurance provider working in several states including California, Florida, Illinois, Missouri, Pennsylvania, Tennessee and elsewhere. We can help you apply for Medigap insurance as well as Part D prescription coverage direct and at no additional cost.

Category: Medicare Supplements