submit ?s on Medicare [Bogleheads Live]

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Jon Luskin
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submit ?s on Medicare [Bogleheads Live]

Post by Jon Luskin »

'Bogleheads® Live' is where the do-it-yourself investor community asks questions to financial experts – live on Twitter.

For the Thursday, February 2nd episode, we'll have not one - but two - guests answering your questions about Medicare: Diane Gaswirth and Lauren Rabe.

Here are a couple of resources on Medicare basics you can check out before the show:

www.MedicareMadeClear.com

https://buff.ly/3ZP23tJ

We'll be going live at 11:00 AM Pacific / 2:00 PM Eastern.

You can submit your questions below. (I may include your question in the episode. No guarantees.) Or, you can ask your questions live by joining us on Twitter Spaces.

https://twitter.com/i/spaces/1vOxwMRBjqoGB?s=20

While anyone can listen to a live Twitter Space event on desktop, you'll need to be using the Twitter app from a mobile device to ask questions (if you’d like to participate in the Q&A).

If you're not already signed up for Twitter, you can do so here: https://twitter.com/. You can sign up with your Google or Apple account, or via phone, or by email.

Looking forward to seeing you there.

Thank you,
Jon Luskin
Host
Bogleheads® Live

P.S. Listen to past episodes of Bogleheads® Live via the podcast: https://boglecenter.net/category/bogleheads-live/

The Bogleheads® Live series is hosted by me, Jon Luskin, CFP®, a long-time Boglehead®. This podcast is supported by the John C. Bogle Center for Financial Literacy, a non-profit organization approved by the IRS as a 501(c)(3) public charity on February 6, 2012.
When there are multiple solutions to a problem, choose the simplest one. ~Jack Bogle
mhalley
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Re: submit ?s on Medicare

Post by mhalley »

Should you go with a cheaper part B plan (ie medigap plan G for cheaper plan G) each year if you have been satisfied with your current plan? If so, what yearly or monthly discount makes it worth the hassle of switching? (Assuming you can pass underwriting)
Last edited by mhalley on Sat Jan 21, 2023 2:24 am, edited 3 times in total.
ModifiedDuration
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Re: submit ?s on Medicare

Post by ModifiedDuration »

mhalley wrote: Thu Jan 19, 2023 6:38 pm Should you go with a cheaper part B plan each year if you have been satisfied with your current plan? If so, what yearly or monthly discount makes it worth the hassle of switching?
There is only one Part B plan.
TravelforFun
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Re: submit ?s on Medicare

Post by TravelforFun »

I wish you had done this show before the annual enrollment ended last month.

TravelforFun
mhalley
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Re: submit ?s on Medicare

Post by mhalley »

Perhaps I should have been clearer, ie part b plan such as part G for cheaper part G plan. I didn’t mean switching from G to F etc. I’ll edit original.
buckeye7983
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Re: submit ?s on Medicare

Post by buckeye7983 »

Under what conditions might one expect better medical care, broader provider access, or quicker access to specialists with Medicare Advantage as compared to Original Medicare?
AlwaysLearningMore
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Re: submit ?s on Medicare

Post by AlwaysLearningMore »

Any general thoughts on skipping Medicare Part B to supplement FEHB Federal Blue Cross PPO (best BC plan) for HNW couple (MFJ, both covered by FEHB for many years through one spouse's workplace) with retirement income that will place them in highest one or two IRMAA brackets?
Retirement is best when you have a lot to live on, and a lot to live for. * None of what I post is investment advice.
Nahtanoj
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Re: submit ?s on Medicare

Post by Nahtanoj »

According to the Medicare website, if I have coverage after age 65 through my job or my spouse’s job, I can sign up for Part B when my employer-provided coverage ends, and I will not have to pay a late enrollment penalty for Part B so long as I enroll within eight months after the employer-provided coverage ends. To avoid the late enrollment penalty in Part B, do I need to show any kind of documentation to prove I had the employer-provided coverage?

Similar question for Part D. If my employer-provided insurance after age 65 includes prescription drug coverage, the Medicare website indicates I can sign up for Part D without a penalty so long as I do it within 2 months after the employer-provided coverage ends and so long as the coverage I had was “creditable coverage.” What documentation will I need to provide to prove I had “creditable coverage” in this situation?

If the answer is that employer plans are required to report these details to Medicare (or to the Part D plan providers), so the employee doesn’t have to worry about it, that would be great, but I haven’t seen anything to suggest that is the case.
Last edited by Nahtanoj on Sat Jan 21, 2023 5:43 am, edited 1 time in total.
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WoodSpinner
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Re: submit ?s on Medicare

Post by WoodSpinner »

Considering using a Kaiser Advantage plan for Medicare. We don’t travel for extended periods and are longtime Kaiser members. Any insights on the Kaiser plan vs. Traditional Medicare?

WoodSpinner
epictetus
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Re: submit ?s on Medicare

Post by epictetus »

I would suggest the following link as a resource re: Medicare. It is the US Govt website re: Medicare.

https://www.medicare.gov/
Focus on what you can control
placeholder
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Re: submit ?s on Medicare

Post by placeholder »

mhalley wrote: Thu Jan 19, 2023 7:13 pm Perhaps I should have been clearer, ie part b plan such as part G for cheaper part G plan. I didn’t mean switching from G to F etc. I’ll edit original.
In many states you'd have to go through underwriting to change provider.
mhalley
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Re: submit ?s on Medicare

Post by mhalley »

Should have mentioned assuming you pass underwriting. Edited ?
kd2008
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Re: submit ?s on Medicare

Post by kd2008 »

Nahtanoj wrote: Fri Jan 20, 2023 8:19 am According to the Medicare website, if I have coverage after age 65 through my job or my spouse’s job, I can sign up for Part B when my employer-provided coverage ends, and I will not have to pay a late enrollment penalty for Part B so long as I enroll within eight months after the employer-provided coverage ends. To avoid the late enrollment penalty in Part B, do I need to show any kind of documentation to prove I had the employer-provided coverage?

Similar question for Part D. If my employer-provided insurance after age 65 includes prescription drug coverage, the Medicare website indicates I can sign up for Part D without a penalty so long as I do it within 2 months after the employer-provided coverage ends and so long as the coverage I had was “creditable coverage.” What documentation will I need to provide to prove I had “creditable coverage” in this situation?

If the answer is that employer plans are required to report these details to Medicare (or to the Part D plan providers), so the employee doesn’t have to worry about it, that would be great, but I haven’t seen anything to suggest that is the case.
You request CMS L564 form from the employer and submit it to the government.

https://www.cms.gov/Medicare/CMS-Forms/ ... -L564E.pdf

You fill out Section A, employer fills out Section B.

The form has very clear instructions.

My employer has one click request button on it's benefits website for this form.
Nahtanoj
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Re: submit ?s on Medicare [Bogleheads Live]

Post by Nahtanoj »

That is very helpful. Thank you.
McDougal
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Re: submit ?s on Medicare [Bogleheads Live]

Post by McDougal »

Is there a reason why you are able to switch from original Medicare to advantage without underwriting, but not the reverse? (In most states)
Big Dog
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Re: submit ?s on Medicare [Bogleheads Live]

Post by Big Dog »

McDougal wrote: Sat Jan 21, 2023 12:59 pm Is there a reason why you are able to switch from original Medicare to advantage without underwriting, but not the reverse? (In most states)
That one is easy: adverse selection. In other words, a healthy 65-year old signs up for the cheaper Advantage plan and then maybe 5 years later needs a hip replacement so wants to switch to Original Medicare (Part B) so they can go to the top PPO orthopedist in the area. Or swap out orthopedist for oncologist and getting into a cancer drug trial.

btw, transferring rules fall under state laws as Medigap policies are all state-approved.
ModifiedDuration
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Re: submit ?s on Medicare [Bogleheads Live]

Post by ModifiedDuration »

One can switch from Medicare Advantage to Part B without underwriting in all states.

However, in most states underwriting would be required for a Medicare Supplement plan (with some exceptions, such as Trial Rights).

Switching to a Part B plan without a Medicare Supplement would expose someone to 20% of all Medicare Part B expenses with no cap.
TravelforFun
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Re: submit ?s on Medicare

Post by TravelforFun »

buckeye7983 wrote: Thu Jan 19, 2023 7:17 pm Under what conditions might one expect better medical care, broader provider access, or quicker access to specialists with Medicare Advantage as compared to Original Medicare?
None.

The only advantage Medicare Advantage has over Original Medicare is financial. Advantage plans have maximum out of pocket cost for hospitalization (mine is $8K) while Original Medicare has no cost limit.

TravelforFun
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Jon Luskin
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Re: submit ?s on Medicare

Post by Jon Luskin »

mhalley wrote: Thu Jan 19, 2023 6:38 pm Should you go with a cheaper part B plan (ie medigap plan G for cheaper plan G) each year if you have been satisfied with your current plan? If so, what yearly or monthly discount makes it worth the hassle of switching? (Assuming you can pass underwriting)
Great question! It's going on the list!

:happy
When there are multiple solutions to a problem, choose the simplest one. ~Jack Bogle
cashmoney
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Re: submit ?s on Medicare

Post by cashmoney »

TravelforFun wrote: Sat Jan 21, 2023 3:29 pm
buckeye7983 wrote: Thu Jan 19, 2023 7:17 pm Under what conditions might one expect better medical care, broader provider access, or quicker access to specialists with Medicare Advantage as compared to Original Medicare?
None.

The only advantage Medicare Advantage has over Original Medicare is financial. Advantage plans have maximum out of pocket cost for hospitalization (mine is $8K) while Original Medicare has no cost limit.

TravelforFun

MA plans are pro active in getting their members to complete their preventive screenings which is good for people who may otherwise skip it and MA does not require 3 day hospitalization to qualify for skilled nursing facility stay as original Medicare does .
cashmoney
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Re: submit ?s on Medicare

Post by cashmoney »

kd2008 wrote: Sat Jan 21, 2023 6:25 am
Nahtanoj wrote: Fri Jan 20, 2023 8:19 am According to the Medicare website, if I have coverage after age 65 through my job or my spouse’s job, I can sign up for Part B when my employer-provided coverage ends, and I will not have to pay a late enrollment penalty for Part B so long as I enroll within eight months after the employer-provided coverage ends. To avoid the late enrollment penalty in Part B, do I need to show any kind of documentation to prove I had the employer-provided coverage?

Similar question for Part D. If my employer-provided insurance after age 65 includes prescription drug coverage, the Medicare website indicates I can sign up for Part D without a penalty so long as I do it within 2 months after the employer-provided coverage ends and so long as the coverage I had was “creditable coverage.” What documentation will I need to provide to prove I had “creditable coverage” in this situation?

If the answer is that employer plans are required to report these details to Medicare (or to the Part D plan providers), so the employee doesn’t have to worry about it, that would be great, but I haven’t seen anything to suggest that is the case.
You request CMS L564 form from the employer and submit it to the government.

https://www.cms.gov/Medicare/CMS-Forms/ ... -L564E.pdf

You fill out Section A, employer fills out Section B.

The form has very clear instructions.

My employer has one click request button on it's benefits website for this form.


1.Form CMS L564 allows you to enroll in penalty free part B in other start dates outside of the annual General Enrollment Period that runs from 1/1-3/31 - as long as employer has 20 or more employees.

2. Delayed part B enrollment or loss of employer coverage are events that will allow for you to enroll in a MA or PDP outside of the Annual Enrollment Period that runs from 10/15-12/7 and are also events that may give you a guarantee right to buy a Medicare supplement with no underwriting

3.The prior creditable drug coverage issue for part D is only addressed after you enroll in part D plan. About 2 weeks after enrollment the insurance carrier will send a letter where you will attest to what creditable drug coverage you had to avoid the Late Enrollment Penalty .The form L564 has nothing to do with this.

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kd2008
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Re: submit ?s on Medicare

Post by kd2008 »

cashmoney wrote: Mon Jan 23, 2023 8:41 pm
kd2008 wrote: Sat Jan 21, 2023 6:25 am
Nahtanoj wrote: Fri Jan 20, 2023 8:19 am According to the Medicare website, if I have coverage after age 65 through my job or my spouse’s job, I can sign up for Part B when my employer-provided coverage ends, and I will not have to pay a late enrollment penalty for Part B so long as I enroll within eight months after the employer-provided coverage ends. To avoid the late enrollment penalty in Part B, do I need to show any kind of documentation to prove I had the employer-provided coverage?

Similar question for Part D. If my employer-provided insurance after age 65 includes prescription drug coverage, the Medicare website indicates I can sign up for Part D without a penalty so long as I do it within 2 months after the employer-provided coverage ends and so long as the coverage I had was “creditable coverage.” What documentation will I need to provide to prove I had “creditable coverage” in this situation?

If the answer is that employer plans are required to report these details to Medicare (or to the Part D plan providers), so the employee doesn’t have to worry about it, that would be great, but I haven’t seen anything to suggest that is the case.
You request CMS L564 form from the employer and submit it to the government.

https://www.cms.gov/Medicare/CMS-Forms/ ... -L564E.pdf

You fill out Section A, employer fills out Section B.

The form has very clear instructions.

My employer has one click request button on it's benefits website for this form.


1.Form CMS L564 allows you to enroll in penalty free part B in other start dates outside of the annual General Enrollment Period that runs from 1/1-3/31 - as long as employer has 20 or more employees.

2. Delayed part B enrollment or loss of employer coverage are events that will allow for you to enroll in a MA or PDP outside of the Annual Enrollment Period that runs from 10/15-12/7 and are also events that may give you a guarantee right to buy a Medicare supplement with no underwriting

3.The prior creditable drug coverage issue for part D is only addressed after you enroll in part D plan. About 2 weeks after enrollment the insurance carrier will send a letter where you will attest to what creditable drug coverage you had to avoid the Late Enrollment Penalty .The form L564 has nothing to do with this.

licensed agent
Thank you for clarifying. Very helpful.
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Jon Luskin
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Re: submit ?s on Medicare

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TravelforFun wrote: Thu Jan 19, 2023 7:11 pm I wish you had done this show before the annual enrollment ended last month.

TravelforFun
That is good feedback, thank you. :happy

Perhaps we'll do another Medicare episode at the end of the year.

Best,
Jon
When there are multiple solutions to a problem, choose the simplest one. ~Jack Bogle
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Jon Luskin
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Re: submit ?s on Medicare

Post by Jon Luskin »

buckeye7983 wrote: Thu Jan 19, 2023 7:17 pm Under what conditions might one expect better medical care, broader provider access, or quicker access to specialists with Medicare Advantage as compared to Original Medicare?
Thanks for a great question. It's going on the list!

Best,
Jon
When there are multiple solutions to a problem, choose the simplest one. ~Jack Bogle
DetroitRick
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Re: submit ?s on Medicare [Bogleheads Live]

Post by DetroitRick »

For those buying a medigap policy in states where future changes require medical underwriting (most states), one of the more difficult things to evaluate is future policy premiums. Today's cheapest provider can become relatively expensive almost overnight. Beyond age, for attained age policies, do you have any recommendations for things to look at to assess an insurers' relative premium stability over time? So beyond looking purely at rate history, which is often hard to evaluate because of closed pools and such, what other factors might we look at to help with our choice?
MarkVH0518
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Re: submit ?s on Medicare [Bogleheads Live]

Post by MarkVH0518 »

Jon

I'm going onto Medicare in May. I will be choosing a Medi-gap plan.
The one concern I heard about is Medi-gap companies that create dead-pools.
Because the premiums allowed are dependent upon the insurance pool's medical expenses,
some companies close off pools to newer subscribers.
This keeps the premiums of new subscribers to be advertised as low,
and the previous subscribers are pooled with subscribers whose medical expenses are increasing thereby increasing those premiums.

Is this true (I have read posts from Bogleheads that claim first hand experience)?
Are there companies that have a reputation for doing this such that I may wish to avoid?

Thanks
Mark
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Jon Luskin
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Re: submit ?s on Medicare

Post by Jon Luskin »

AlwaysLearningMore wrote: Thu Jan 19, 2023 7:19 pm Any general thoughts on skipping Medicare Part B to supplement FEHB Federal Blue Cross PPO (best BC plan) for HNW couple (MFJ, both covered by FEHB for many years through one spouse's workplace) with retirement income that will place them in highest one or two IRMAA brackets?
This question is going on the list. :happy

Thank you,
Jon
When there are multiple solutions to a problem, choose the simplest one. ~Jack Bogle
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Jon Luskin
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Re: submit ?s on Medicare

Post by Jon Luskin »

Nahtanoj wrote: Fri Jan 20, 2023 8:19 am According to the Medicare website, if I have coverage after age 65 through my job or my spouse’s job, I can sign up for Part B when my employer-provided coverage ends, and I will not have to pay a late enrollment penalty for Part B so long as I enroll within eight months after the employer-provided coverage ends. To avoid the late enrollment penalty in Part B, do I need to show any kind of documentation to prove I had the employer-provided coverage?

Similar question for Part D. If my employer-provided insurance after age 65 includes prescription drug coverage, the Medicare website indicates I can sign up for Part D without a penalty so long as I do it within 2 months after the employer-provided coverage ends and so long as the coverage I had was “creditable coverage.” What documentation will I need to provide to prove I had “creditable coverage” in this situation?

If the answer is that employer plans are required to report these details to Medicare (or to the Part D plan providers), so the employee doesn’t have to worry about it, that would be great, but I haven’t seen anything to suggest that is the case.
Great case study question. It's going on the list.

:happy
When there are multiple solutions to a problem, choose the simplest one. ~Jack Bogle
cashmoney
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Re: submit ?s on Medicare [Bogleheads Live]

Post by cashmoney »

MarkVH0518 wrote: Wed Jan 25, 2023 5:06 pm Jon

I'm going onto Medicare in May. I will be choosing a Medi-gap plan.
The one concern I heard about is Medi-gap companies that create dead-pools.
Because the premiums allowed are dependent upon the insurance pool's medical expenses,
some companies close off pools to newer subscribers.
This keeps the premiums of new subscribers to be advertised as low,
and the previous subscribers are pooled with subscribers whose medical expenses are increasing thereby increasing those premiums.

Is this true (I have read posts from Bogleheads that claim first hand experience)?
Are there companies that have a reputation for doing this such that I may wish to avoid?

Thanks
Mark

In the insurance biz its called the Omaha shuffle - Mutual of Omaha to United World to United of Omaha to Omaha Insurance Company to Mutual of Omaha. MOO and Aetna are the worse offenders with up to 5 different baby carriers opening new blocks of business at a time but most of the carriers do it to some degree other than UHC and the Blues. With that said UHC has been rolling out their lowered priced UHICA Medicare supplements without the extra benefits like gym memberships in more states' and IMO in the states were UHICA is available you may start seeing the rates of the UHC plans have bigger increases than in the past as the lower priced plans attract the younger healthier members.

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Jon Luskin
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Re: submit ?s on Medicare

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WoodSpinner wrote: Fri Jan 20, 2023 9:55 am Considering using a Kaiser Advantage plan for Medicare. We don’t travel for extended periods and are longtime Kaiser members. Any insights on the Kaiser plan vs. Traditional Medicare?

WoodSpinner
Thanks for the question. It's going on the list!

:happy
When there are multiple solutions to a problem, choose the simplest one. ~Jack Bogle
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celia
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Re: submit ?s on Medicare [Bogleheads Live]

Post by celia »

Q1: When should we know the 100 drugs for which Medicare will be negotiating a lower price and the timetable when the lower price will take effect for each drug?

Q2: Some of the expensive meds have already lowered their price (like insulin). Why did the lower prices kick in early for them? Were they trying to avoid being one of the 100 in the “negotiation group”?

Q3: Will the lower drug prices on the 100 selected drugs apply to Medicare Advantage patients at the same time or at a later time than for those who have a Part D drug plan?

Q4: We’ve been in drug plans where the plan’s phone rep looks at which of the 4 phases we are in and tells us how much a drug will cost us, but when we get to the pharmacy an hour later, the price is higher. It is like the phone rep is looking at one computer but the pharmacy computer links to a different computer of theirs. This has happened to us with more than one drug plan. Why does this happen?
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celia
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Re: submit ?s on Medicare [Bogleheads Live]

Post by celia »

Nahtanoj wrote: Fri Jan 20, 2023 8:19 am According to the Medicare website, if I have coverage after age 65 through my job or my spouse’s job, I can sign up for Part B when my employer-provided coverage ends, and I will not have to pay a late enrollment penalty for Part B so long as I enroll within eight months after the employer-provided coverage ends.
To clarify, this is only true If you or your spouse is employed there at the time you leave their plan to start Medicare. If you (or your spouse) is a retiree of the employer, you are only eligible if you lose coverage through no fault of your own (such as they no longer offer that insurance plan), else you will have to go through medical underwriting.
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