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Medicare with secondary/medigap
I know that if one is on a Medicare advantage plan, that they can switch to Medicare and a supplement (or medigap plan). Does anyone know if one can be turned down for a supplement due to health issues? Are the rates based on age AND health?
I helped someone with the application and no questions were asked about health. He was accepted and all is fine. But, what if someone who is in the midst of expensive cancer treatments....or a pending hip replacement, or ??? ......can they still get the supplement at the same rate as a healthy person, same sex, same age? I shall speak with a Medicare specialist, but just looking for others experiences. |
I was on a BCBS Advantage plan and switched back to regular Medicare with a supplement Plan F and had no issues.
I am disabled,hope this helps,I signed up through a Blue Cross representative recommended by a neighbor/friend. Good luck. |
Medicare with secondary/medigap
If you are on an advantage plan and wish to switch to a Medicare supplement, insurers providing those supplements are not obligated to offer you a plan. And they may ask you to provide information on your past and current medical history. If an insurer does offer you a supplemental plan, it is likely to be at a higher rate than another is paying who is the same age but has not been on an advantage plan.
Sent from my iPad using Tapatalk Pro |
When we switched from an employer plan some years ago, we had to answer some health questions and we went in at a higher $ rate than if we had joined when we turned 65.
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I believe there are "life event" exceptions that require an insurer to accept you if you transition from advantage to regular supplemental. For example if your advantage plan goes away or you move to an area not covered by it.
Medicare calls it "guaranteed issue rights"... here is a link guaranteed issue rights | Medicare.gov Quote:
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When I applied for a friend, the only questions that could have determined his rate was age, sex and current plan. I am thinking that possibly they research your current plan and are aware of health issues? So.....in other words , there is pre-existing with the secondary plans? He's in good health and ended up paying $190 for plan F.
But now, looking at switching myself......but waited too long, I think. |
You can also contact SHINE as they will have specific info for your case, here is the link:
SHINE - Home |
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Interesting! Thanks. I was reiterating what I was told by an insurer when I switched. The even provided a written copy. Your information is good news for those who could end up in an unplanned situation. Sent from my iPad using Tapatalk Pro |
People you need expert advice on this subject. Do not trust info given on this blog. Much of it is very wrong. How are you going to filter the right ones from the wrong ones ? In the few posts already responded many big misgivings. SHINE is a good place to start. I used United Health Care downtown Spanish Springs. They did a good job of identifying type of plan for my particular situation. Simplified differences between types of plans and answered all questions to my satisfaction. No high pressure to sign up with United Health Care or The Villages health care system.
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Medicare with secondary/medigap
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I have a United Healthcare supplement, but I would take insurance advice from a golden retriever before a United sales person. I dealt with health insurers for 40+ years. I understand health insurance plans. P.S. please do not take my comment above as a slam against Golden retrievers; at least they know what they’re talking about. [emoji41] Sent from my iPad using Tapatalk Pro |
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Medicare with secondary/medigap
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There are several very nice golden retrievers roaming about The Villages. As far as advice, I’d suggest SHINE if you are uncomfortable doing your own research. Health Insurance advice given by the sales staff of an insurer is not given objectively. Sent from my iPad using Tapatalk Pro |
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Jake agrees ! https://uploads.tapatalk-cdn.com/201...68043f2cc6.jpg Sent from my iPhone using Tapatalk |
Medicare with secondary/medigap
The latest AARP bulletin discusses the supplemental verses advantage plans with an easy to follow flow chart. It’s a great starting point for further research.
Best to start your research at least a year before you’re eligible. There are many twists and turns that can affect your coverage for life. Sent from my iPhone using Tapatalk |
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Jake obviously has good taste in owners, and you in pets. Sent from my iPad using Tapatalk Pro |
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Well done! Sent from my iPad using Tapatalk Pro |
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I meant to say “nicely done” to you, but I guess it works for Wiott as well. Sent from my iPad using Tapatalk Pro |
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He’s too young right now so we put him onto the ACA. Sent from my iPhone using Tapatalk |
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[emoji33][emoji23] Sent from my iPad using Tapatalk Pro |
I am a UHC Advantage member, and was hospitalized recently. I went to the UHC Customer Service agent, and the Sales Agent for United Health Care in Spanish Springs, those are two different departments. Neither one knows what the other one is doing. I was going over a complex billing invoice and all the Cust Service lady could do was to change the subject.... she did not have a clue as to how to access the hospital records, or the TVH records. Also, you cannot believe what the UHC Advantage toll free phone support tells you, they are dumber than a Basset Hound, I received conflicting info each time i called.
I'm going back to Orig Medicare and suppl plan F. I will miss The Villages Health Primary Care Dr, he seemed very competent. The Villages sells you on their Health Care SYSTEM, but it is not really a SYSTEM. That they delude you into thinking, it is a mess, a maze to select in-network vs out -of-network, and half of them dont even participate at The Villages Regional Hospital, which by the way is not part of The Villages Health, it is operated by the Central Florida Health Alliance (CFH) it is a locally owned and governed, 626-bed not-for-profit healthcare system. I will repeat; the Hospital is not part of TVH The Villages Health. TVH is part of the © Holding Company of The Villages, Inc. The Villages is a registered trademark of Holding Company of The Villages, Inc. And i will repeat, the TVH has almost nothing to do with the CFH Hospital. Be very careful. |
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Villages Health patients who go to TVH are cared for by Villages Health hospitalists, not TVH hospitalists. It makes for a much smooth transition to and from your PCP. Your PCP has direct access to all your TVH and Leesberg Hospital records. I doubt there is anyone one the planet who can explain a hospital bill. |
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Your decision to revert to traditional Medicare plus Plan F is a good one IMHO. There is no ownership link between CFHA and TVH. The folks you spoke with are salespeople not billing experts. Sent from my iPad using Tapatalk Pro |
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I feel very comfortable looking at hospital bills, although I will admit most have errors. And I’m not a member of TVH, but my PCP will be my Hospitalist any time I’m admitted. And my wife’s as well. TVH is not the end all. Remember that you, as an advantage member, are having TVH paid approx. $140 per month. You need to understand that if you have Medicare, your PCP needs to be your hospitalist if he/she is going to be reimbursed by Medicare. Sent from my iPad using Tapatalk Pro |
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I said TVH is part of the Villages Holding Company. TVH stands for The Villages HEALTH, the 'H' stands for Health, not Hospital. CFH Alliance owns the Hospital referred to as TVRH (The Villages Regional Hospital)( CENTRAL FLORIDA HEALTH, INC.) See the bottom of this link: Primary Care Accepted Insurance - The Villages Health |
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