Medigap Underwriting-are these Restrictions?

Oct 3, 2016

  1. LostDollar
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    Age 72, but making first medigap policy decisions.

    If there will be a need for Cataract and Hip Surgeries-say 7 years out and one wanted to make an initial purchase of HDF and switch to G at a later date, would those conditions cause an underwriting for a conversion to G to fail?

    (I know HDF may be controversial, but I will ask a separate question about that when I can figure out how to word it. I would like the comments for my consideration here to just focus on the issues I might face in passing underwriting tests to convert from some other type of medigap policy to a G policy.)
    Thanks. LD
     
  2. goillini52
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    goillini52 MAGA...Eat More Bacon & BUILD THAT WALL!!!

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    That would be a yes on UW. CSI/CSI Life will let you go from Plan F (not HDF) to Plan G with no UW...not sure if UHC will as I don't write them. Other than that a GI company (like BCBS in my state) would be the only other alternative.

    Some companies are ok with surgeries that have been recommended and not performed as long as it's been over 12 months or 2 years since recommended.
     
  3. LostDollar
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    Cataracts have been in my eye records for at least 4 years. I think I am at least another 4-6 years away from an actual surgery recommendation. The hip has just been mentioned by me as a piece of arthritis problems. As long as I can walk, I can control when it gets done.

    However, your comments above would suggest to me that if I don't do a G plan now in my open 6 months, the only reasonable expectation I can have later is a plan that would be far more expensive than any savings I could make by taking something else for a few years now. Is that a fair assessment of how you see my position?

    Thanks.
    LD
     
  4. goillini52
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    goillini52 MAGA...Eat More Bacon & BUILD THAT WALL!!!

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    Yes. I know you said you'd ask a seperate question later, but I'll comment on you getting a HDF now.

    While you might be able to pass the Underwriting for those 2 conditions if wanting to get a better policy later on, personally I wouldn't recommend going that route. You might develop other health conditions later on that would keep you from qualifying for something later on...like being on oxygen, diabetes combined with a heart condition, Alzheimer's, etc.

    I'd take the Plan G now, because you don't know that you'll be able to change in the future. If you're not wanting to spend much money on your Medicare Supplement, you might want to consider Plan N. It's roughly twice the price as HDF, and good coverage...possibly the best buy of all the Supplements.
     
  5. LostDollar
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    I asked questions about the plan N in another thread. I don't believe I want to consider it as an option. But I think now I have a better sense of the reasons why, which I would not have had had you not forced me to consider it.

    My first issue was excess charges-whether they were an issue when evaluating medigap policies. I got some responses that gave me three considerations about that.

    1) The agents responding had each only seen 1 instance of a provider billing excess charges-and this was over a fairly long period of selling policies.

    2) That providers did not like the process of billing excess charges because of something to do with assignments. I did not fully understand this one and will have to do some reading-but at the moment-as a consumer and not a supplement sales person- it is enough to know the excess charge billing process is complex enough that it is unamenable to providers.

    The other issue was costs of service:

    1) I cannot remember the precise details, but it seems like the past few years have been; good years: no more than 3 dr visits, maintenance meds and a flu shot; bad years: no more than 5 dr visits, maintenance meds, a one time med, and a flu shot; one or two really bad years: no more than 8 dr visits, maintenance meds, multiple one time meds and a flu shot. I don't think even in my really bad cancer period i had over 15 visits in an 18 month period.

    All that is to say, I have relatively good health and no frame of reference for extreme medical situations. Kgmom posted a vignette describing her grandmother going to the dr EVERY DAY for analysis/treatments. Depending on whether that was business days or really every day, we're talking over $5k to over $6k in $20 COPAYS!!!!!!!!! because plan N has no cap. Does that make N approach Medicare advantage plans in costs, at least in certain situations?

    At any rate, an HDF plan does have a cap.$2180. I understand that will go up.
    If I say it went from $1500 to $2200 in 15 years, and will go to $3500 in another 15 years, that is still a considerable reduction from a possible open ended situation which kgmom described for plan N.

    Thank you for pushing me into that process. But I think at the other end my choice is HDF or G.
     
  6. goillini52
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    goillini52 MAGA...Eat More Bacon & BUILD THAT WALL!!!

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    I'd say her grandmother is an exception to the rule. I recommended Plan G, but thinking you were worried about price because you were looking at HDF, I thought you should look at Plan N. I'll be getting a Med Supp myself next year and I'll go with Plan G. I'd buy N before I'd go with HDF. Good luck with your purchase.
     
  7. LostDollar
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    Does raynaud's syndrome = peripheral vascular disease?
     
  8. goillini52
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    goillini52 MAGA...Eat More Bacon & BUILD THAT WALL!!!

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