Medicare Supplement question re Guarantee Issue

Non-investing personal finance issues including insurance, credit, real estate, taxes, employment and legal issues such as trusts and wills
Post Reply
Topic Author
LadyIJ
Posts: 533
Joined: Thu Mar 06, 2014 8:00 pm

Medicare Supplement question re Guarantee Issue

Post by LadyIJ » Thu Jul 19, 2018 9:24 am

If I take my Firm's Medicare supplemental plan (creditable), Firm requires me to sign up for Original Medicare Parts A & B at 65, when my Firm supplement ends in 2022 according to Medicare.gov's website, I would have Guaranteed Issue (GI) to various plans, including Plan F. My supplement ends in 2022 - Plan F goes away (along with C) in 2020.

I've had various answers from Medicare and agents as to whether I would still qualify for Plan F, because I turn 65 this year. One agent told me that because I have to sign up for Part B, I will not have GI to any plans. My concern is that when I d close my supplement (free but $500 deductible) in 2022, if I have any major health issues, I will not have GI to a good plan. Any Medicare experts out there understand this? I'm going to SHIP (Senior Health Insurance Program) tomorrow to see if I can get more info, and will share, but if anyone actually KNOWS, your knowledge would be appreciated. If I don't have GI for a good plan, I may forego my Firm's free supplemental for the 3 years. Thanks.

gtg970g
Posts: 104
Joined: Tue Mar 27, 2012 11:52 am

Re: Medicare Supplement question re Guarantee Issue

Post by gtg970g » Thu Jul 19, 2018 9:57 am

It is not clear what your Firm's medicare supplement plan is and why it would automatically terminate at the end of 2022. Plans C & F will not terminate, rather enrollees who are medicare eligible after 12/31/2019 will not be able to enroll in these plans.

User avatar
HueyLD
Posts: 6597
Joined: Mon Jan 14, 2008 10:30 am

Re: Medicare Supplement question re Guarantee Issue

Post by HueyLD » Thu Jul 19, 2018 11:47 am

"You have Original Medicare and an employer group health plan (including retiree or COBRA coverage) or union coverage that pays after Medicare pays and that plan is ending.

You have the right to buy Medigap Plan A, B, C, F, K, or L that’s sold by any insurance company in your state.

If you have COBRA coverage, you can either buy a Medigap policy right away or wait until the COBRA coverage ends.

You can/must apply for a Medigap policy no later than 63 calendar days after the latest of these 3 dates:

Date the coverage ends
Date on the notice you get telling you that coverage is ending (if you get one)
Date on a claim denial, if this is the only way you know that your coverage ends."

https://www.medicare.gov/supplement-oth ... lapse-4691

drawpoker
Posts: 2055
Joined: Mon May 19, 2014 6:33 pm
Location: Delmarva

Re: Medicare Supplement question re Guarantee Issue

Post by drawpoker » Thu Jul 19, 2018 2:38 pm

HueyLD wrote:
Thu Jul 19, 2018 11:47 am
"You have Original Medicare and an employer group health plan (including retiree or COBRA coverage) or union coverage that pays after Medicare pays and that plan is ending......
Yes, but that is not the scenario that the OP is describing. She does not have Original Medicare (Parts A and B) and will not have it for another four years.

Is that correct? Since you used the term "creditable" to describe your employer coverage, that means it takes the place of Medicare. Not a supplement to Medicare. Is that what you meant?

If so, she will be like anyone else who is joining Medicare for the first time regardless of age. She could be 75, actually. Or any other old age where she is signing up for Medicare for the first time because she is losing creditable coverage from another source (employer, union, etc) This only applies to firms with more than 20 employees, diff. rules for smaller than 20 companies, though.

The operative principle here is Guaranteed Issue. Assuming nothing in that section of the law is changed between now and the Year 2022, the OP should be fine. ( No one will be able to purchase a new PLan F or Plan C after Dec. 31 2019 regardless of how they are coming on to Medicare, putting that into the mix here is just making it more confusing, that is a separate issue entirely.)

By all means check with your state S.H.I.P. consultant. Just make sure you provide an accurate description of just what the employer retiree insurance actually is.
Last edited by drawpoker on Thu Jul 19, 2018 3:14 pm, edited 1 time in total.

drawpoker
Posts: 2055
Joined: Mon May 19, 2014 6:33 pm
Location: Delmarva

Re: Medicare Supplement question re Guarantee Issue

Post by drawpoker » Thu Jul 19, 2018 2:48 pm

robebibb wrote:
Thu Jul 19, 2018 9:57 am
It is not clear what your Firm's medicare supplement plan is and why it would automatically terminate at the end of 2022.....
Might have been written to offer benefits (coverage) only up to age 70.

This is a good time to remind everyone - when discussing Medicare topics - make absolutely sure you are using the correct terminology. Or you will run amok in misunderstandings.
The source of confusion here is "creditable" and "supplement". They mean entirely diff. things.


https://www.healthcare.gov/glossary/cre ... -coverage/


In another current thread, someone was asked what kind of Medicare coverage they had. The answer was "Original Medicare only, no Medigap, no Medicare Advantage". Naturally, several posters jumped on this, pointing how foolish and risky it was.

Sure enough, that poster came back and clarified that she had a retiree health package with BCBS that took the place of a regular Medigap policy.

Whew !

Topic Author
LadyIJ
Posts: 533
Joined: Thu Mar 06, 2014 8:00 pm

Re: Medicare Supplement question re Guarantee Issue

Post by LadyIJ » Thu Jul 19, 2018 4:44 pm

robebibb wrote:
Thu Jul 19, 2018 9:57 am
It is not clear what your Firm's medicare supplement plan is and why it would automatically terminate at the end of 2022. Plans C & F will not terminate, rather enrollees who are medicare eligible after 12/31/2019 will not be able to enroll in these plans.
My Firms' plan is a comprehensive supplement plan that is considered creditable coverage - it also includes drugs. It will terminate April 1, 2022 because that's the end of my benefit (based on years worked there). I guess the tricky question is "medicare eligible after 12/31/19 will not be able to enroll" - I am technically eligible in a few months. So if I wait until 4/1/2022, will I still be able to get guaranteed issue on Plan F. I've gotten a few different interpretations.

Topic Author
LadyIJ
Posts: 533
Joined: Thu Mar 06, 2014 8:00 pm

Re: Medicare Supplement question re Guarantee Issue

Post by LadyIJ » Thu Jul 19, 2018 4:50 pm

drawpoker wrote:
Thu Jul 19, 2018 2:38 pm
HueyLD wrote:
Thu Jul 19, 2018 11:47 am
"You have Original Medicare and an employer group health plan (including retiree or COBRA coverage) or union coverage that pays after Medicare pays and that plan is ending......
Yes, but that is not the scenario that the OP is describing. She does not have Original Medicare (Parts A and B) and will not have it for another four years.

Is that correct? Since you used the term "creditable" to describe your employer coverage, that means it takes the place of Medicare. Not a supplement to Medicare. Is that what you meant?

If so, she will be like anyone else who is joining Medicare for the first time regardless of age. She could be 75, actually. Or any other old age where she is signing up for Medicare for the first time because she is losing creditable coverage from another source (employer, union, etc) This only applies to firms with more than 20 employees, diff. rules for smaller than 20 companies, though.

The operative principle here is Guaranteed Issue. Assuming nothing in that section of the law is changed between now and the Year 2022, the OP should be fine. ( No one will be able to purchase a new PLan F or Plan C after Dec. 31 2019 regardless of how they are coming on to Medicare, putting that into the mix here is just making it more confusing, that is a separate issue entirely.)

By all means check with your state S.H.I.P. consultant. Just make sure you provide an accurate description of just what the employer retiree insurance actually is.
I WILL have original Medicare Parts A and B as in a few months. That's the tricky part. I had an agent tell me I would not qualify for any of the Guaranteed Issues in 2022. That could be someone trying to sell me a policy. It's complicated, I will bring all my information to SHIP tomorrow and if I don't get an answer I feel sure of, I will make an appointment with another SHIP.

drawpoker
Posts: 2055
Joined: Mon May 19, 2014 6:33 pm
Location: Delmarva

Re: Medicare Supplement question re Guarantee Issue

Post by drawpoker » Thu Jul 19, 2018 4:51 pm

LadyIJ wrote:
Thu Jul 19, 2018 4:44 pm

......So if I wait until 4/1/2022, will I still be able to get guaranteed issue on Plan F. I've gotten a few different interpretations.
Have you asked your benefits manager at your former firm? If it is a big company with lots of retirees surely this question has come up to them before?

drawpoker
Posts: 2055
Joined: Mon May 19, 2014 6:33 pm
Location: Delmarva

Re: Medicare Supplement question re Guarantee Issue

Post by drawpoker » Thu Jul 19, 2018 5:01 pm

LadyIJ wrote:
Thu Jul 19, 2018 4:50 pm


I WILL have original Medicare Parts A and B as in a few months. That's the tricky part. I had an agent tell me I would not qualify for any of the Guaranteed Issues in 2022. That could be someone trying to sell me a policy...... It's complicated, I will bring all my information to SHIP ......
As I understand it, no more new Plan F policies can be sold after Dec. 31, 2019. None. Zilch. And that would include You.
All Medicare beneficiaries who are already enrolled in a Plan F as of Jan 1, 2020 will be grandfathered in. No one who continues to pay their premiums can be cancelled.

I don't fully understand why the confusion. It should be the same procedure as to the years when the gumbmint did the same thing eliminating Plan E from the marketplace (and 3 others) back in 2010.

Edit: With your additional info now I get it. Is this the best way, crystal clear, to describe your situation:
"Am currently retired but not yet 65. So am continuing my existing health insurance plan with former employer. Once I turn 65, that coverage ends, and I must go on Medicare both Part A and Part B. If I want it, I can then take my former employer's retiree health benefits which will pay secondary to Medicare. Their plan also offers creditable prescription drug coverage, so I would have no need to buy a separate Part D plan. I could get a Part D plan with no penalty for late sign-up when my retiree benefits automatically terminate in 2022"

Is that correct?
Last edited by drawpoker on Thu Jul 19, 2018 5:22 pm, edited 1 time in total.

Topic Author
LadyIJ
Posts: 533
Joined: Thu Mar 06, 2014 8:00 pm

Re: Medicare Supplement question re Guarantee Issue

Post by LadyIJ » Thu Jul 19, 2018 5:17 pm

drawpoker wrote:
Thu Jul 19, 2018 4:51 pm
LadyIJ wrote:
Thu Jul 19, 2018 4:44 pm

......So if I wait until 4/1/2022, will I still be able to get guaranteed issue on Plan F. I've gotten a few different interpretations.
Have you asked your benefits manager at your former firm? If it is a big company with lots of retirees surely this question has come up to them before?
Unfortunately they are not on the ball for a huge firm. The one woman I spoke to said she's not really up on Medicare. lol. That's why the concern and confusion. I've had various answers from Insurance agents. I think I will have to rely on SHIP and the actual insurance companies. I understand I won't get into F in April of 2022; however, my concern is that since I will have signed up for Parts A & B in the next couple of months, would that preclude me from signing up as a "new enrollee" without penalties. Good grief, there are so many factors, and it IS difficult to get straight facts. To reiterate: the firm gives the benefit and they won't involve themselves on interpreting Medicare laws. I WILL get the answers, just was hoping there was some Medicare expert out here in BogleLand!

khh
Posts: 254
Joined: Sat Dec 27, 2008 10:31 pm

Re: Medicare Supplement question re Guarantee Issue

Post by khh » Thu Jul 19, 2018 5:27 pm

HueyLD wrote:
Thu Jul 19, 2018 11:47 am
"You have Original Medicare and an employer group health plan (including retiree or COBRA coverage) or union coverage that pays after Medicare pays and that plan is ending.

You have the right to buy Medigap Plan A, B, C, F, K, or L that’s sold by any insurance company in your state.

If you have COBRA coverage, you can either buy a Medigap policy right away or wait until the COBRA coverage ends.

You can/must apply for a Medigap policy no later than 63 calendar days after the latest of these 3 dates:

Date the coverage ends
Date on the notice you get telling you that coverage is ending (if you get one)
Date on a claim denial, if this is the only way you know that your coverage ends."

https://www.medicare.gov/supplement-oth ... lapse-4691
What happens after 2020 if your Plan F or Plan G insurer goes bankrupt or pulls out of your state? For guaranteed issue, it looks like you're stuck with a less comprehensive plan since Plan F will be gone and switching to another Plan G is not guaranteed issue.

Topic Author
LadyIJ
Posts: 533
Joined: Thu Mar 06, 2014 8:00 pm

Re: Medicare Supplement question re Guarantee Issue

Post by LadyIJ » Thu Jul 19, 2018 5:34 pm

khh wrote:
Thu Jul 19, 2018 5:27 pm
HueyLD wrote:
Thu Jul 19, 2018 11:47 am
"You have Original Medicare and an employer group health plan (including retiree or COBRA coverage) or union coverage that pays after Medicare pays and that plan is ending.

You have the right to buy Medigap Plan A, B, C, F, K, or L that’s sold by any insurance company in your state.

If you have COBRA coverage, you can either buy a Medigap policy right away or wait until the COBRA coverage ends.

You can/must apply for a Medigap policy no later than 63 calendar days after the latest of these 3 dates:

Date the coverage ends
Date on the notice you get telling you that coverage is ending (if you get one)
Date on a claim denial, if this is the only way you know that your coverage ends."

https://www.medicare.gov/supplement-oth ... lapse-4691
What happens after 2020 if your Plan F or Plan G insurer goes bankrupt or pulls out of your state? For guaranteed issue, it looks like you're stuck with a less comprehensive plan since Plan F will be gone and switching to another Plan G is not guaranteed issue.
It appears that Guaranteed issue for Plan F will be replaced with G. See my next post.

User avatar
HueyLD
Posts: 6597
Joined: Mon Jan 14, 2008 10:30 am

Re: Medicare Supplement question re Guarantee Issue

Post by HueyLD » Thu Jul 19, 2018 5:40 pm

khh wrote:
Thu Jul 19, 2018 5:27 pm
HueyLD wrote:
Thu Jul 19, 2018 11:47 am
"You have Original Medicare and an employer group health plan (including retiree or COBRA coverage) or union coverage that pays after Medicare pays and that plan is ending.

You have the right to buy Medigap Plan A, B, C, F, K, or L that’s sold by any insurance company in your state.

If you have COBRA coverage, you can either buy a Medigap policy right away or wait until the COBRA coverage ends.

You can/must apply for a Medigap policy no later than 63 calendar days after the latest of these 3 dates:

Date the coverage ends
Date on the notice you get telling you that coverage is ending (if you get one)
Date on a claim denial, if this is the only way you know that your coverage ends."

https://www.medicare.gov/supplement-oth ... lapse-4691
What happens after 2020 if your Plan F or Plan G insurer goes bankrupt or pulls out of your state? For guaranteed issue, it looks like you're stuck with a less comprehensive plan since Plan F will be gone and switching to another Plan G is not guaranteed issue.
The Medicare link provided above also says the following:

"Your Medigap insurance company goes bankrupt and you lose your coverage, or your Medigap policy coverage otherwise ends through no fault of your own.

You have the right to buy Medigap Plan A, B, C, F, K, or L that’s sold by any insurance company in your state.

You can/must apply for a Medigap policy no later than 63 calendar days from the date your coverage ends."

Topic Author
LadyIJ
Posts: 533
Joined: Thu Mar 06, 2014 8:00 pm

Re: Medicare Supplement question re Guarantee Issue

Post by LadyIJ » Thu Jul 19, 2018 5:45 pm

The Medicare link provided above also says the following:

"Your Medigap insurance company goes bankrupt and you lose your coverage, or your Medigap policy coverage otherwise ends through no fault of your own.

You have the right to buy Medigap Plan A, B, C, F, K, or L that’s sold by any insurance company in your state.

You can/must apply for a Medigap policy no later than 63 calendar days from the date your coverage ends."
[/quote]

Right, and after 2020 I believe F will be replaced with G.

cashmoney
Posts: 208
Joined: Thu Jun 29, 2017 11:15 pm

Re: Medicare Supplement question re Guarantee Issue

Post by cashmoney » Thu Jul 19, 2018 6:06 pm

LadyIJ wrote:
Thu Jul 19, 2018 9:24 am
If I take my Firm's Medicare supplemental plan (creditable), Firm requires me to sign up for Original Medicare Parts A & B at 65, when my Firm supplement ends in 2022 according to Medicare.gov's website, I would have Guaranteed Issue (GI) to various plans, including Plan F. My supplement ends in 2022 - Plan F goes away (along with C) in 2020.

I've had various answers from Medicare and agents as to whether I would still qualify for Plan F, because I turn 65 this year. One agent told me that because I have to sign up for Part B, I will not have GI to any plans. My concern is that when I d close my supplement (free but $500 deductible) in 2022, if I have any major health issues, I will not have GI to a good plan. Any Medicare experts out there understand this? I'm going to SHIP (Senior Health Insurance Program) tomorrow to see if I can get more info, and will share, but if anyone actually KNOWS, your knowledge would be appreciated. If I don't have GI for a good plan, I may forego my Firm's free supplemental for the 3 years. Thanks.


You really have nothing to worry about as long as your retiree health plan is considered an employer group health plan.The plan G will replace F as the most comprehensive guaranteed issue med supp available after 2020 .FYI those eligible for medicare before 2020 they can still buy F after 2020.Some companies like AARP/UHC will let you switch among their plans with no underwriting although that can change.Take what the SHIP people tell you about this with a big grain of salt.

Topic Author
LadyIJ
Posts: 533
Joined: Thu Mar 06, 2014 8:00 pm

Re: Medicare Supplement question re Guarantee Issue

Post by LadyIJ » Thu Jul 19, 2018 6:12 pm

cashmoney wrote:
Thu Jul 19, 2018 6:06 pm
LadyIJ wrote:
Thu Jul 19, 2018 9:24 am
If I take my Firm's Medicare supplemental plan (creditable), Firm requires me to sign up for Original Medicare Parts A & B at 65, when my Firm supplement ends in 2022 according to Medicare.gov's website, I would have Guaranteed Issue (GI) to various plans, including Plan F. My supplement ends in 2022 - Plan F goes away (along with C) in 2020.

I've had various answers from Medicare and agents as to whether I would still qualify for Plan F, because I turn 65 this year. One agent told me that because I have to sign up for Part B, I will not have GI to any plans. My concern is that when I d close my supplement (free but $500 deductible) in 2022, if I have any major health issues, I will not have GI to a good plan. Any Medicare experts out there understand this? I'm going to SHIP (Senior Health Insurance Program) tomorrow to see if I can get more info, and will share, but if anyone actually KNOWS, your knowledge would be appreciated. If I don't have GI for a good plan, I may forego my Firm's free supplemental for the 3 years. Thanks.


You really have nothing to worry about as long as your retiree health plan is considered an employer group health plan.The plan G will replace F as the most comprehensive guaranteed issue med supp available after 2020 .FYI those eligible for medicare before 2020 they can still buy F after 2020.Some companies like AARP/UHC will let you switch among their plans with no underwriting although that can change.Take what the SHIP people tell you about this with a big grain of salt.
Thank you - right you are - as my research has uncovered.

User avatar
LadyGeek
Site Admin
Posts: 51111
Joined: Sat Dec 20, 2008 5:34 pm
Location: Philadelphia
Contact:

Re: Medicare Supplement question re Guarantee Issue

Post by LadyGeek » Thu Jul 19, 2018 9:53 pm

This thread is now in the Personal Finance (Not Investing) forum (Medicare).
Wiki To some, the glass is half full. To others, the glass is half empty. To an engineer, it's twice the size it needs to be.

drawpoker
Posts: 2055
Joined: Mon May 19, 2014 6:33 pm
Location: Delmarva

Re: Medicare Supplement question re Guarantee Issue

Post by drawpoker » Thu Jul 19, 2018 9:56 pm

LadyIJ wrote:
Thu Jul 19, 2018 6:12 pm
cashmoney wrote:
Thu Jul 19, 2018 6:06 pm
You really have nothing to worry about as long as your retiree health plan is considered an employer group health plan.................

But - Very Important Detail Here - An employer group health plan that does Not require signing up for Medicare Part B at age 65. The OP does not fall into that category.
Thank you - right you are - as my research has uncovered.
[ quote fixed by admin LadyGeek]

Whoa, not so fast. ( See my post in your other thread here about Plan G being the new Plan F.)

User avatar
LadyGeek
Site Admin
Posts: 51111
Joined: Sat Dec 20, 2008 5:34 pm
Location: Philadelphia
Contact:

Re: Medicare Supplement question re Guarantee Issue

Post by LadyGeek » Thu Jul 19, 2018 10:01 pm

Wiki To some, the glass is half full. To others, the glass is half empty. To an engineer, it's twice the size it needs to be.

cashmoney
Posts: 208
Joined: Thu Jun 29, 2017 11:15 pm

Re: Medicare Supplement question re Guarantee Issue

Post by cashmoney » Fri Jul 20, 2018 11:53 am

LadyIJ wrote:
Thu Jul 19, 2018 6:12 pm
cashmoney wrote:
Thu Jul 19, 2018 6:06 pm
LadyIJ wrote:
Thu Jul 19, 2018 9:24 am
If I take my Firm's Medicare supplemental plan (creditable), Firm requires me to sign up for Original Medicare Parts A & B at 65, when my Firm supplement ends in 2022 according to Medicare.gov's website, I would have Guaranteed Issue (GI) to various plans, including Plan F. My supplement ends in 2022 - Plan F goes away (along with C) in 2020.

I've had various answers from Medicare and agents as to whether I would still qualify for Plan F, because I turn 65 this year. One agent told me that because I have to sign up for Part B, I will not have GI to any plans. My concern is that when I d close my supplement (free but $500 deductible) in 2022, if I have any major health issues, I will not have GI to a good plan. Any Medicare experts out there understand this? I'm going to SHIP (Senior Health Insurance Program) tomorrow to see if I can get more info, and will share, but if anyone actually KNOWS, your knowledge would be appreciated. If I don't have GI for a good plan, I may forego my Firm's free supplemental for the 3 years. Thanks.


You really have nothing to worry about as long as your retiree health plan is considered an employer group health plan.The plan G will replace F as the most comprehensive guaranteed issue med supp available after 2020 .FYI those eligible for medicare before 2020 they can still buy F after 2020.Some companies like AARP/UHC will let you switch among their plans with no underwriting although that can change.Take what the SHIP people tell you about this with a big grain of salt.
Thank you - right you are - as my research has uncovered.


If you are no longer working of course you want to take part B within 8 months of the coverage from active employment ending otherwise you will be penalized for part B.If coverage is based on your current employment no problem.

Topic Author
LadyIJ
Posts: 533
Joined: Thu Mar 06, 2014 8:00 pm

Re: Medicare Supplement question re Guarantee Issue

Post by LadyIJ » Mon Jul 23, 2018 3:56 pm

Thank you CashMoney, I know and will sign up for Parts A & B soon.

Post Reply