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Originally Posted by Viperguy
Is this true? Qualify? How? I was under the impression that I can go back to original anytime in open season. Tell me more.
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You can not be denied Medigap (original Medicare Supplement Plan) when you turn 65 and sign up for Medicare based on preexisting conditions. Medigap costs more per month than Advantage plans, but provides way better catastrophic coverage if you have serious and expensive health issues. With most good Medigap plans, you pay a higher monthly premium, but after that you are only required to pay a small annual deductible (about $250) and 100% of everything else is covered (except prescriptions (part D,), hearing, vision, and dental). If you originally sign up for an Advantage plan because you are healthy, and don’t anticipate any significant health expenses, then you can be medically underwritten for preexisting conditions if you want to later switch to a Medigap plan.
Think about it, if there was no medical underwriting for switching, everyone who is healthy would sign up for an Advantage plan to save money. As people age and begin to develop expensive health issues they would simply switch to a Medigap supplemental plan to again save money. That’s not how insurance is designed to work, it’s to cover catastrophic costs. Allowing people to switch, without medical underwriting, would drive up the price of supplemental plans ridiculously high.
Plus, with Medigap, there is no network. You can see any doctor in the USA that accepts original Medicare without a referral. They should rename Medigap, “Snowbird insurance”. Birds don’t need to be worried about being out of network regardless of which of their homes they are currently at. Somehow, which I can’t understand, the Villages Health has managed to only accept Advantage plans. The only way I can figure how they get away with that is that they don’t accept original Medicare (parts A & B). This practice is extremely rare, and is shady at best for a region that theoretically caters to the best interest of senior citizens!
People need to be very careful about properly planning for the long term when turning 65 and not simply think about what their monthly premiums will be immediately. Deciding to go the Advantage plan route, versus a Medigap supplemental plan, can have negative long term financial implications as health needs change over time. There are several very well written books available that go into great detail about the Medicare decision tree one must navigate and how to maximize one’s benefits as well as minimize their risks. I highly recommend anyone nearing the age of Medicare eligibility read a couple of these books and very carefully consider the long term implications of their initial enrollment decision. Hope this helps.