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Yes, You Can Switch To A More Comprehensive Plan

Question: I have a Medicare Supplement Plan K because right now I am very healthy, but what if I get sick? Can I move to Plan F? I have been told that Plan F is the best.

Answer: This is a question that I get asked a lot. It is also a question whose answer has been evolving over the last year or so. We now have what I believe to be the final answer.

The laws regarding Medicare Supplement Plans have changed a number of times since 1965, when Medicare first began and they also were offered. The last major change was 2010, when a number of plans were no longer going to be offered (E, H, I, and J). Also at that time the plans K, L, M and N were added.

Let’s first briefly talk about what Medicare Supplement Plans (Medigaps) are exactly. Medicare Supplements (Medigap) are plans that can be purchased to work with Original Medicare to help pay for your medical expenses. These Supplements are highly regulated plans that are available in a variety of levels of coverage. Medigap insurance policies would be secondary to Medicare A & B. Medigap is literally designed to “fill the gaps” left by Medicare. The Plans were regulated many years ago into lettered plans. This was done to protect consumers and allow you to compare plans in a comprehensive way. Letters of the alphabet delineate the levels of coverage. Currently there are eleven levels of coverage available (A, B, C, D, F, HDF, G, K, L, M, and N).

The following is a link to the Medicare webpage illustrating Medicare Supplement policies– medicare.gov/supplements-other-insurance/how-to-compare-medigap-policies. Each letter delineates a different level of coverage after Original Medicare has paid its portion of the bill. These Medigap plans work with Medicare to cover and pay for your Medical care. When you are comparing the plans, you decide on the level of coverage you wish to have (letter), and the company you choose should be influenced by the price of the premiums.

With Medigap plans, the coverage is exactly the same between companies for each letter. So once you decide which plan you want, a Plan F or Plan N or a Plan G, you should consider cost as one of the main factors for comparisons.

Currently the most comprehensive plans are Plan C and F. With Plans C and F, Original Medicare is primary and the remainder of the medical bill is covered and paid for by the Medigap Plan C or F whichever you choose. For this reason these two plans tend to be very popular.

Beginning in January of 2020 anyone who is new to Medicare will be unable to purchase a Medicare Supplement Plan C or F at all. Now that sentence seems pretty clear, but let me clarify further. This change only impacts those individual who age into Medicare after Jan. 1, 2020, (turn 65 after Jan. 2, 2020, are born after Jan. 1, 1955), or become eligible for Medicare due to a disability after Jan. 1, 2020.

If you have turned 65 or have Medicare due to a disability prior to Jan. 1, 2020 even if you have not signed up for Medicare Part A or B you could still purchase a Medicare Supplement Plan C or F. This means that if you have Medicare already as you do, you can purchase a Medicare Supplement Plan C or F whenever you wish.

A further clarification that has just been announced, is that if a company is currently selling Medigap Plan C or F, it must always sell Medigap Plan C or F. This means as you look at this chart of Medigap plans ALL the companies sell Plan F, and most sell Plan C, that means they must continue to sell those plans to anyone who is Medicare eligible as of Jan. 1, 2020. If you have Medicare already you are grandfathered into the possibility of purchasing a Medigap Plan C from most companies and Plan F from all companies selling them in New York in your part of the state.

The rule change eliminating Medigap Plan C and F that impacts anyone new to Medicare on Jan. 1, 2020, will not impact those who are already eligible for Medicare, even if they are not enrolled in Medicare. If you are working and have employee coverage, but are over 65 on Jan. 1, 2020, you could purchase a Plan C or Plan F when you retire and enroll in Medicare. If you are over 65, retired and have retiree coverage, and of course have Medicare, you could enroll in a Medigap Plan C or Plan F if and when you ever decided to leave your retiree coverage.

This is an interesting addendum to what we previously knew. We previously knew that those eligible for Medicare and who already HAD a Medigap Plan C or Plan F could always keep it. We were unsure whether or not the insurance companies would be required to continue to sell it. We now know that yes, the insurance companies will be required to sell Plan C and Plan F if they are selling those plans now.

It is important to remember that Medicare Supplement Plans (Medigap Plans) are always renewable. That means once you purchase a Medigap policy you can keep that policy for life as long as you continue to pay the premiums.

For those that are born after Jan. 1, 1955 or become elibilble for Medicare due to a disability after Jan. 1, 2020, they will still be allowed to buy Medigap Policies, they will have Plans A, B, D, G, K, L, M, and N to choose from.

The closest plan available to Plan F is Plan G, the only difference being the Part B deductible is not covered by Plan G, which means you pay the Part B deductible, which in 2019 is $185. The closest plan to Plan C is Plan D, the only difference being the Part B deductible is not covered by plan D, which in 2019 is $185.

You could also review the other plans available and you might find one of the other letters a better fit for what you need.

Remember that each state has different rules regarding enrollment and renewal for Medicare Supplements. In New York state, Medicare Supplement (Medigap) Plans always have open enrollment. You can change the letter of the Medigap plan you have and the company you have every single month. I certainly do not recommend changing your insurance that often, but you are allowed to do that if you want.

Many individuals like you did, enroll in a Medigap plan that is less expensive and has higher co-pays when they are younger, and then when they have serious medical problems will switch to a more comprehensive plan. You can keep the plan you have now and maybe change to a different plan later in your life based on the plans available at that time.

So to answer your question, “Yes you can switch to a more comprehensive plan, like Plan F if wish later on in your life. It will always be available to you as long as you live. If you continue to live in New York state, you can make that switch anytime you wish.”

I must also mention that the Fall Open Enrollment Period, is Oct. 15 to Dec. 7, when you look at your Prescription Drug Coverage (Part D).

That may be the best time to look at your overall situation and decide what makes the most sense for you at that time. So be sure to be thinking about your Prescription Drug Coverage as well in the upcoming weeks.

To contact Janell Sluga, GCMC with questions or concerns, please call 716-720-9797 or e-mail her at janells@lutheran-jamestown.org.

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