|
Post by habsui on Feb 13, 2023 16:54:12 GMT
Nope. "New York State law and regulation require that any insurer writing Medigap insurance must accept a Medicare enrollee's application for coverage at any time throughout the year. Insurers may not deny the applicant a Medigap policy or make any premium rate distinctions because of health status, claims experience, medical condition or whether the applicant is receiving health care services." www.dfs.ny.gov/consumers/health_insurance/information_for_medicare_beneficiariesYes, for the initial enrollment. But, From www.medicalnewstoday.com/articles/when-can-i-change-my-medicare-plan-2#costs"It usually costs nothing to switch Medicare plans. However, people who switch plans may face higher premiums. Some people may also face penalties for switching to certain plans after the IEP. People who opt out of Part B and then enroll later may pay 10% more on their premiums for every year they opt out." Ask an agent from the company you plan to switch to in the future. They can tell you quickly. medicarewire.com/medigap/plan/aarp-medigap-plans-new-york/And please note on the site above. The exact same coverage can be priced differently by company!!! State Farm wanted to charge me a lot more than United Health Care - AARP. I asked my agent why she was going to charge so much more. She smiled and said, "Because you get me." That is all she could say because the policy is dedicated by the government. I said I already have a good UHC agent, so sorry. Generally you don't need an agent because you deal directly with the insurance company and the doctors clerks. I once had a doctor tell me the wrong thing about coverage. He ultimately decided not to charge me for his mistake. I have a GP now who knows everything about what is covered. Switching plans after initial enrollment is state dependent. Here in Washington State, one can switch at almost any time. Also, premiums are community rated, i.e. not age based. So, check your state..
|
|
|
Post by anovice on Feb 13, 2023 17:41:08 GMT
Nope. "New York State law and regulation require that any insurer writing Medigap insurance must accept a Medicare enrollee's application for coverage at any time throughout the year. Insurers may not deny the applicant a Medigap policy or make any premium rate distinctions because of health status, claims experience, medical condition or whether the applicant is receiving health care services." www.dfs.ny.gov/consumers/health_insurance/information_for_medicare_beneficiariesYes, for the initial enrollment. But, From www.medicalnewstoday.com/articles/when-can-i-change-my-medicare-plan-2#costs"It usually costs nothing to switch Medicare plans. However, people who switch plans may face higher premiums. Some people may also face penalties for switching to certain plans after the IEP. People who opt out of Part B and then enroll later may pay 10% more on their premiums for every year they opt out." Ask an agent from the company you plan to switch to in the future. They can tell you quickly. medicarewire.com/medigap/plan/aarp-medigap-plans-new-york/And please note on the site above that the exact same coverage (actual government defined policy) can be priced differently by the provider (insurance company)!!! State Farm wanted to charge me a lot more than United Health Care - AARP for the government plan I chose (Plan F at that time.) I asked my agent why she was going to charge so much more. All Plan Fs are the same. She smiled and said, "Because you get me." That is all she could say because the policy is dedicated by the government. I said I already have a good UHC agent, so sorry. Generally you don't need an agent because you deal directly with the insurance company (perhaps via AARP initially for sign-up only) and the doctors clerks. I once had a doctor tell me the wrong thing about coverage. He ultimately decided not to charge me for his mistake. I have a GP now who knows everything about what is covered. marquay was the one who posted and asked "Any opinions?". His query was specific to New York. The law in New York is clear: "New York State law and regulation require that any insurer writing Medigap insurance must accept a Medicare enrollee's application for coverage at any time throughout the year. Insurers may not deny the applicant a Medigap policy or make any premium rate distinctions because of health status, claims experience, medical condition or whether the applicant is receiving health care services."
|
|
|
Post by bobfl on Feb 14, 2023 1:31:25 GMT
Yes, for the initial enrollment. But, From www.medicalnewstoday.com/articles/when-can-i-change-my-medicare-plan-2#costs"It usually costs nothing to switch Medicare plans. However, people who switch plans may face higher premiums. Some people may also face penalties for switching to certain plans after the IEP. People who opt out of Part B and then enroll later may pay 10% more on their premiums for every year they opt out." Ask an agent from the company you plan to switch to in the future. They can tell you quickly. medicarewire.com/medigap/plan/aarp-medigap-plans-new-york/And please note on the site above that the exact same coverage (actual government defined policy) can be priced differently by the provider (insurance company)!!! State Farm wanted to charge me a lot more than United Health Care - AARP for the government plan I chose (Plan F at that time.) I asked my agent why she was going to charge so much more. All Plan Fs are the same. She smiled and said, "Because you get me." That is all she could say because the policy is dedicated by the government. I said I already have a good UHC agent, so sorry. Generally you don't need an agent because you deal directly with the insurance company (perhaps via AARP initially for sign-up only) and the doctors clerks. I once had a doctor tell me the wrong thing about coverage. He ultimately decided not to charge me for his mistake. I have a GP now who knows everything about what is covered. marquay was the one who posted and asked "Any opinions?". His query was specific to New York. The law in New York is clear: "New York State law and regulation require that any insurer writing Medigap insurance must accept a Medicare enrollee's application for coverage at any time throughout the year. Insurers may not deny the applicant a Medigap policy or make any premium rate distinctions because of health status, claims experience, medical condition or whether the applicant is receiving health care services." Does that apply to both new enrollment and if you switch when you become seriously ill? I cannot find switching in the New York law. So if you switch when you are 85 and require renal care, stage 4 cancer or hospice do you get the same rate as you were paying with the company you signed up at age 65. Doubtful. The link I posted is for New York. medicarewire.com/medigap/plan/aarp-medigap-plans-new-york/It is specific to New York.
|
|
|
Post by anovice on Feb 14, 2023 11:33:20 GMT
marquay was the one who posted and asked "Any opinions?". His query was specific to New York. The law in New York is clear: "New York State law and regulation require that any insurer writing Medigap insurance must accept a Medicare enrollee's application for coverage at any time throughout the year. Insurers may not deny the applicant a Medigap policy or make any premium rate distinctions because of health status, claims experience, medical condition or whether the applicant is receiving health care services." Does that apply to both new enrollment and if you switch when you become seriously ill? I cannot find switching in the New York law. So if you switch when you are 85 and require renal care, stage 4 cancer or hospice do you get the same rate as you were paying with the company you signed up at age 65. Doubtful. The link I posted is for New York. medicarewire.com/medigap/plan/aarp-medigap-plans-new-york/It is specific to New York. "Does that apply to both new enrollment and if you switch when you become seriously ill? I cannot find switching in the New York law." While I post the NY law yesterday, here is another link. "Additionally, since you are eligible to change plans at any time, many New York residents enroll in Medigap Plan N until their health deteriorates and they require a higher level of coverage. This is a major perk of living in New York as a Medicare beneficiary." www.medicarefaq.com/medicare-supplements/medigap-by-state/new-york-medigap-plans/#:~:text=Additionally%2C%20since%20you%20are%20eligible,York%20as%20a%20Medicare%20beneficiary.
|
|
|
Post by bobfl on Feb 14, 2023 13:00:27 GMT
Does that apply to both new enrollment and if you switch when you become seriously ill? I cannot find switching in the New York law. So if you switch when you are 85 and require renal care, stage 4 cancer or hospice do you get the same rate as you were paying with the company you signed up at age 65. Doubtful. The link I posted is for New York. medicarewire.com/medigap/plan/aarp-medigap-plans-new-york/It is specific to New York. "Does that apply to both new enrollment and if you switch when you become seriously ill? I cannot find switching in the New York law." While I post the NY law yesterday, here is another link. "Additionally, since you are eligible to change plans at any time, many New York residents enroll in Medigap Plan N until their health deteriorates and they require a higher level of coverage. This is a major perk of living in New York as a Medicare beneficiary." www.medicarefaq.com/medicare-supplements/medigap-by-state/new-york-medigap-plans/#:~:text=Additionally%2C%20since%20you%20are%20eligible,York%20as%20a%20Medicare%20beneficiary. From your link, this is what I am suggesting should be checked, if a person plans to switch later after they get a major illness. In your link:"... plans may include a pre-existing condition waiting period". In my state getting the initial plan is just like your state, easy. When you go to switch, which can be easily done, there can be issues. For example, a person finds out they have an aggressive cancer and will be in the hospital for potentially months, but they want more coverage or want to go to a hospital out of their network. They switch plans. They check in the hospital. Then they find out that the plan they switched to has a 90 day waiting period for pre-existing conditions. (Why because everyone would get the cheapest policy and want to switch when they get seriously ill and put the burden on another insurer.) I am simply saying, check it. www.dfs.ny.gov/node/155301
|
|
|
Post by anovice on Feb 14, 2023 14:23:29 GMT
From your link, this is what I am suggesting should be checked, if a person plans to switch later after they get a major illness. In your link:"... plans may include a pre-existing condition waiting period". In my state getting the initial plan is just like your state, easy. When you go to switch, which can be easily done, there can be issues. For example, a person finds out they have an aggressive cancer and will be in the hospital for potentially months, but they want more coverage or want to go to a hospital out of their network. They switch plans. They check in the hospital. Then they find out that the plan they switched to has a 90 day waiting period for pre-existing conditions. (Why because everyone would get the cheapest policy and want to switch when they get seriously ill and put the burden on another insurer.) I am simply saying, check it. www.dfs.ny.gov/node/155301Any particular reason that you only quoted part of the sentence? "While plans may include a pre-existing condition waiting period, it generally only applies if you did not have creditable coverage in the last 63 days. However, if you did have creditable coverage, the waiting period could be waived."
|
|
|
Post by marquay on Feb 14, 2023 20:22:47 GMT
Plan G & N (No HD)offered by United Healthcare AARP Plan G ( w HD) low rate offered by Emblem Health. I can save more than a hundred dollars each month.
Between Plan N & HD+G I say I may not use all my annual deductible of $2700 (including the Medicare Part B deductible toward meeting the Plan deductible).
Plan N Part B Excess charges not covered.
I'm leaning toward HD+ G and will later switch to UnitedHealthcare Plan G if I have to.
Thanks a lot for the links and your time spent here.
|
|
|
Post by anovice on Feb 14, 2023 20:58:16 GMT
Plan G & N (No HD)offered by United Healthcare AARP Plan G ( w HD) low rate offered by Emblem Health(GHI & HIP merged). I can save more than a hundred dollars each month. Between Plan N & HD+G I say I may not use all my annual deductible of $2700 (including the Medicare Part B deductible toward meeting the Plan deductible). Plan N Part B Excess charges not covered. I'm leaning toward HD+ G and will later switch to UnitedHealthcare Plan G if I have to. Thanks a lot for the links and your time spent here. marquay, if you do not think that you are going to use up the annual $2,700 deductible for HD-G, you may want to take a closer look at Plan N. $20 copayment for some office visits and $50 copayment for the ER if you are not admitted. Regarding provider excess charges, the maximum is 15% more than Medicare allows. I have friend who has Plan N and it has worked very well. The premiums have run approximately $50/month less than Plan G and they have not run into any excess charges. I have read that excess charges are rare, and in 2022, 98% of Medicare doctors and providers accepted Medicare assignment. Here is a good piece on Plan N. boomerbenefits.com/medicare-supplemental-insurance/medicare-supplement-plans/medicare-plan-n/
|
|
|
Post by marquay on Feb 14, 2023 22:15:48 GMT
Anovice,
Plan N $215.00/mo x12= 2580.00 excluding tiny amount copays
Plan HD+G $ 68.00/mo x12 = 816.00 and 2700.00 = 3516.00
Im saving a lot by staying in HD+ G, maybe I will switch to Plan N or G later when situation changes.
I have an appointment with a broker next week, will find out
|
|
|
Post by anovice on Feb 14, 2023 23:10:42 GMT
Anovice, Plan N $215.00/mo x12= 2580.00 excluding tiny amount copays Plan HD+G $ 68.00/mo x12 = 816.00 and 2700.00 = 3516.00 Im saving a lot by staying in HD+ G, maybe I will switch to Plan N or G later when situation changes. I have an appointment with a broker next week, will find out That is a substantial difference between HD-G and N. Frankly, I am surprised. I am unfamiliar with New York Medicare prices. What I do know is that the prices tend to be higher than other states because of the versatility/luxury to change plans without underwriting. On the face of it, this seems to be a no brainer. If someone in New York can afford the $2,700 deductible, go with HD-G and change to Plan G at the "appropriate" time (chronic illness). Your broker should know if there are any pitfalls with this concept.
|
|
|
Post by anovice on Mar 30, 2023 12:50:56 GMT
|
|
|
Post by retiredat48 on Mar 30, 2023 21:28:20 GMT
|
|
|
Post by marquay on Mar 31, 2023 11:24:34 GMT
|
|
|
Post by fritzo489 on Mar 31, 2023 14:00:16 GMT
"The courts found that penalty violated a local law requiring the city to provide its retirees with premium-free coverage for life." Wow , I wish I had that benefit. We all pay for medicare via deduction of SS. I for one also paid for supplement by payment taken from pension. This changed in 2022 when retirement insurance switched to an Advantage plan.
|
|
|
Post by anovice on Jun 26, 2023 13:18:40 GMT
|
|
|
Post by anovice on Aug 23, 2023 17:15:16 GMT
|
|
|
Post by anovice on Aug 24, 2023 12:52:31 GMT
|
|
|
Post by anovice on Sept 25, 2023 23:23:21 GMT
|
|
|
Post by FD1000 on Sept 28, 2023 19:11:27 GMT
Yep, I have been calling the double D (delay+deny) and why I have original Medicare + Plan D and pay more. In the last 2 years I had many procedures, all were done very quickly, never denied. I remember very well my insurance prior to Medicare which is similar to Advantage. Each time the procedure was a bit expensive I had to deal with delays and denials and the excuses were ridiculous.
|
|
|
Post by Chahta on Oct 3, 2023 2:42:05 GMT
Yep, I have been calling the double D (delay+deny) and why I have original Medicare + Plan D and pay more. In the last 2 years I had many procedures, all were done very quickly, never denied. I remember very well my insurance prior to Medicare which is similar to Advantage. Each time the procedure was a bit expensive I had to deal with delays and denials and the excuses were ridiculous. Medicare has requirements for all medical procedures just as all insurance companies do. But you have free choice of all doctors and facilities, as long as they accept Medicare. My mother needed a pacemaker. Medicare required her doctors to prove her heart function was below a certain level, over a period of time, to pay for it. Nothing is for sure with any insurance.
|
|
|
Post by FD1000 on Oct 3, 2023 3:51:18 GMT
|
|
bd1
Ensign
Posts: 20
|
Post by bd1 on Oct 3, 2023 5:41:55 GMT
Would like to point out that only 81% of doctors accept Medicare . So 1 out of 5 do not. The bigger problem is hospitals who will not accept medicare.
|
|
|
Post by archer on Oct 3, 2023 6:04:01 GMT
Perhaps if more medical providers stop accepting medicare the current system will change. I understand the polarized views regarding single payer, or socialized medicine, and can't really argue with either side. I do see medical services as kind of a monopoly no matter how many drs, hospitals, insurance companies etc there are, due to we as consumers are often not in a position to shop around when we need the services. Also, the business model is different than other businesses in that medical providers assume we have no choice. It often isn't an easy matter to get costs for procedures, and I have never known drs to openly volunteer costs. As a patient my experience from the provider is that price is irrelevant because you NEED the procedure. Some of this is not the fault of the provider. With medical services it is often a matter of do or don't. It's not like buying a car or building a house where little choices can be made for different options. Like, OK I'll go with the open heart surgery but I'll pass on the stiching me back up when you're done, or maybe I'll come back for that after I get some more money.
Anyway, I'm rattling on here, but I would be happy if the entire business model changed in a way where I as a consumer felt there was more on my side rather than take it leave it. And a lot of people do leave it which is unfortunate.
|
|
|
Post by anitya on Oct 3, 2023 7:10:57 GMT
I am not on Medicare for sometime but trying to learn as much as feasible before I get there and also to help my parents make their choices. Does Original Medicare mean, one just has Part A and B and pays the necessarily deductibles and co-insurance required under those plans? If so, does one forgo a supplemental insurance and uses the saved premiums from not having supplemental insurance to pay for the deductibles and co-insurance?
|
|
|
Post by anovice on Oct 3, 2023 11:06:47 GMT
|
|
|
Post by Chahta on Oct 3, 2023 11:22:13 GMT
Would like to point out that only 81% of doctors accept Medicare . So 1 out of 5 do not. The bigger problem is hospitals who will not accept medicare. I have never run into a doc or medical facility that does not accept Medicare, in 6 years. But my hospital experience is low.
|
|
|
Post by Chahta on Oct 3, 2023 11:44:57 GMT
I am not on Medicare for sometime but trying to learn as much as feasible before I get there and also to help my parents make their choices. Does Original Medicare mean, one just has Part A and B and pays the necessarily deductibles and co-insurance required under those plans? If so, does one forgo a supplemental insurance and uses the saved premiums from not having supplemental insurance to pay for the deductibles and co-insurance? Part A (no premium), hospital coverage and Part B ($164/month), doctor coverage, have deductibles. Part A is $1600. Part B is $230. However Part B pays only 80% so a supplemental plan is advisable to pick up the 20%. Additionally some supplemental plans cover the Part A deductible and some other costs. Generally Part B deductible is paid by the patient but I am sure there are plans that pay that as well. It can be complicated where hospitalization is concerned. I have not (knock on wood) spent Medicare time hospitalized. But on a normal yearly basis I spend only premiums and $230. Also required is Part D, prescriptions. Overall original Medicare is top-notch insurance with excellent coverage vs. cost. Far better than private insurance. Bottom line I pay less than $300/month with only the yearly $230 and about $4/month prescriptions extra for Parts A, B and D.
|
|
|
Post by anovice on Oct 3, 2023 12:00:59 GMT
|
|
|
Post by anovice on Oct 3, 2023 12:07:54 GMT
I am not on Medicare for sometime but trying to learn as much as feasible before I get there and also to help my parents make their choices. Does Original Medicare mean, one just has Part A and B and pays the necessarily deductibles and co-insurance required under those plans? If so, does one forgo a supplemental insurance and uses the saved premiums from not having supplemental insurance to pay for the deductibles and co-insurance? "If so, does one forgo a supplemental insurance and uses the saved premiums from not having supplemental insurance to pay for the deductibles and co-insurance?" No, no, no! You do not want to be responsible for 20% of a hospital bill.
|
|
|
Post by anitya on Oct 3, 2023 15:55:23 GMT
People with Supplemental insurance + part D are paying more and thus should theoretically get better service / convenience. If there is no discernible benefit to this extra cost, given there are so many insurance companies offering this insurance, the premiums would have been competed down to a nominal amount.
I used to think I would go with Medicare Advantage plan. I am not so sure anymore.
What still bothers me is charging a part B premium to people who live overseas where Medicare does not cover. Is this one that falls under the tyranny of the majority or is there a coherent (no B.S.) policy reason for it?
|
|