Medicaid Ending Question

[vic120]

G plus drug cov is what $200 per month, $2400 per year not only a saving of $1,000 per year from HMO

But if this guy at all travels Med supp will be so much easier to deal with

My MIL has Kidney disease and travels FL and NY and now here supp is over $250 and even though there is some saving MA the being able to go different dialysis anywhere without issues seamless is worth it

 

[LostDollar]

Caveat, not an agent.

How about HDG plus PDP?

ScottS will say I am doing my "one trick pony" routine again, but

2023 Medigap HD plan deductible is $2,700 plus whatever issues come along with the PDP. Would that savings plus original medicare provider access be enough to offset "free" MAPD and lower MAPD drug costs? (I can say free since I am not an agent, just pretend I am one of your difficult engineers. )

For plan F, posts in the forum going all the way back to comments by @MBSC have said that HDF is supposed to qualify for GI, along with regular F.

If that is true, and G is the replacement for F, it seems like HDG should qualify for GI when G does. I don't know if that would be a battle worth fighting here.

(Oh, and payments on the part B deductible are supposed to count as part of the HDG deductible, so (excluding some very early part a charges) the real HDG deductible should just be the $2,700, not the $2,700 plus the Part B deductible.)

 

[LostDollar]

You're correct but you're thinking Federal. Each state has their own rules concerning eligibility. Since she listed G as an option I'm assuming it's available.

Caveat, NOT an agent.

But don't states have to accept the Federal rules as a minimum requirement?
They can only expand the Federal rules, not contract them?

 

[rmhaire]

Caveat, NOT an agent.

But don't states have to accept the Federal rules as a minimum requirement?
They can only expand the Federal rules, not contract them?

Yep. They can add but can't subtract.

Probably the most liberal state as far as expansion would be MA. They have a lot of funky stuff they've added on.

Same as the alphabet plans. Carriers can add basically whatever they want. As long as the plan meets the minimum standard.

 

[mickeyma]

Throwing this out here for discussion.


I know what I am recommending, but want to hear other people's ideas.

Client is losing Medicaid due to PHE. Client makes $2700 per month and has $0 savings. Kidney failure is an issue, as is heart problems and while I don't have a drug list, I do know Eliquis is on it.

 

[mickeyma]

He is ineligible for any Med Supp plan due to kidney failure which will put him on dialysis.
Just had a similar situation and he was not eligible for Med Supp with UHC, Anthem, Blue Shield and Wellcare. I was forced to place him in a Med Adv HMO.

If you do place him in the HMO, please make sure the plan is accepted by the doctor performing the kidney dialysis. This is more important than his PCP.

 

[rmhaire]

He is ineligible for any Med Supp plan due to kidney failure which will put him on dialysis.
Just had a similar situation and he was not eligible for Med Supp with UHC, Anthem, Blue Shield and Wellcare. I was forced to place him in a Med Adv HMO.

If you do place him in the HMO, please make sure the plan is accepted by the doctor performing the kidney dialysis. This is more important than his PCP.

But she said her client was GI. Was yours? And why an HMO instead of PPO?

 

[somarco]

"Mom" said he was eligible for supp via GI in Texas. She lives there. I put my money on her being right.

 

[mickeyma]

But she said her client was GI. Was yours? And why an HMO instead of PPO?

Even though my client was eligible for a GI, the applications for a Med Supp from several companies stated that he would be declined if he was on kidney dialysis. I confirmed this with phone calls to broker services with UHC, Anthem, Blue Shield & Wellcare.

 

[somarco]

Even though my client was eligible for a GI, the applications for a Med Supp from several companies stated that he would be declined if he was on kidney dialysis. I confirmed this with phone calls to broker services with UHC, Anthem, Blue Shield & Wellcare.

Then that is not GI . . .

Guaranteed issue is just that, regardless of medical conditions.

If you have a guaranteed issue right, an insurance company:

Must sell you a Medigap policy
Must cover all your pre-existing health conditions
Can't charge you more for a Medigap policy because of past or present health problems