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Medigap changes are coming in 2020

Medigap Changes Coming in 2020

When it comes to Medicare, change is practically a given. So, it comes as no surprise that there are some fairly significant Medigap changes coming in 2020. In short, two plans, C and F, won’t be available to new beneficiaries as of January 1. But what happens if you already have one of these Medicare Supplement plans? Keep reading to find out.

Why Medigap Plans C and F Are Going Away

In 2015, Congress passed H.R. 2, the Medicare Access and CHIP Reauthorization Act of 2015. One provision of this law forbids Medigap policies from covering the Medicare Part B deductible. Two Medigap plans, C and F, include the Part B deductible in their benefits. The law goes into full effect in 2020, which is why people turning 65 in 2020 will not be able to buy Plan C or F.

Although you can sign up for Medicare beginning three months before your 65th birthday, you are not eligible for Medicare Supplement Insurance until you are both aged 65 AND enrolled in Medicare Part B. This is why you cannot purchase Plan C or F if you turn 65 in 2020, even if you enroll in Medicare in 2019.

Can You Still Choose Medigap Plan C or F in 2019?

If you turn 65 before 2020, then yes, you may purchase Plan C or F in 2019. However, just because you can purchase one of these plans doesn’t mean that you should.

Although monthly premiums usually go up from one year to the next, history shows us they rise much higher after a plan goes away. The reason is that new people – i.e. people who are younger and healthier and therefore use the plan’s benefits less – are no longer joining. That regular influx of “new blood” is what helps keep costs down. Without new members, premiums tend to rise quickly.

Choosing a Medigap plan

What Happens if You Already Have Plan C or F?

If you already have Medigap Plan C or F, you get to keep your plan. However, you will probably experience the premium hikes referenced above.

You can change to another Medigap plan. However, please note that you will have to undergo the medical underwriting process. This allows the private insurance companies that offer Medicare Supplement plans to charge more or even refuse to sell you a plan altogether.

What Does Medigap Plan G Cover?

If Plan F is the “Cadillac plan” as many people claim, perhaps Medigap Plan G should be referred to as the “Mercedes plan.” It covers everything Plan F does (except the Part B deductible) but nearly always at a lower premium. That means that your total out-of-pocket costs are usually lower with Plan G than with Plan F.

Plan G covers the following items:

  • Part B co-insurance and co-pays
  • First three pints of blood in a transfusion
  • Part A co-insurance for hospice care
  • Co-insurance for care received in a skilled nursing facility
  • Part A deductible
  • Excess charge for Part B
  • 80 percent of care received in a foreign country

Like all Medigap plans, Plan G also covers your Part A co-insurance and gives you an additional 365 days of covered hospital care.

Medigap guaranteed issue rights

Medigap Guaranteed Issue Rights

If you want to avoid medical underwriting, you need to purchase your Medigap plan within the first six months you have Part B. However, you also avoid underwriting if you qualify for guaranteed issue rights. That link takes you to the full list of qualifying situations and rights. But we would like to explain trial rights. These apply if:

  • You had a Medigap plan and left it to join a Medicare Advantage plan for the first time. If you return to Original Medicare within 12 months, you can return to your previous Medigap plan if your previous insurance company still sells it.
  • You joined an Advantage or PACE plan when you first became eligible for Medicare AND you decide to switch to Original Medicare within the first year.

Again, the link above describes all of the situations, rights, and when you can apply for a Medigap policy.

What to Consider When Choosing a Medicare Supplement Insurance Plan

Please note that you can only purchase Medicare Supplement Insurance if you have Original Medicare (Parts A and B). Medigap is not available to anyone enrolled in a Medicare Advantage plan.

When comparing your Medigap plan options, don’t look at just the monthly premium. Instead, consider how often you use your healthcare benefits. This is because the plans with lower premiums cover fewer services. That means that, if you go to the doctor often, you’ll likely pay more out-of-pocket than you would have if you’d chosen a plan with a higher premium but better coverage.

Also remember the medical underwriting criteria. If you want to change to a more robust plan later, you may find it impossible to make the switch. Or, you may face higher premiums due to health issues.

This process can be incredibly confusing. The licensed agents at Medicare Solutions are here to help and it won’t cost you a penny. Call us toll-free at 855-350-8101 (TTY 711) to get started or look for a plan today.

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