No Plan G for You

somarco

GA Medicare Expert
5000 Post Club
36,601
Atlanta
Is a carrier allowed to play the "soup Nazi" roll and REFUSE to offer plan G on a GI basis?

Client Medicare effective dates for A & B was 2013. Carrier says only A, F or N is an option but not G.

I don't normally write GI business but I have placed folks in G before with a different carrier. Is this carrier being difficult or do other carriers operate the same way?
 
Is a carrier allowed to play the "soup Nazi" roll and REFUSE to offer plan G on a GI basis?

Client Medicare effective dates for A & B was 2013. Carrier says only A, F or N is an option but not G.

I don't normally write GI business but I have placed folks in G before with a different carrier. Is this carrier being difficult or do other carriers operate the same way?

They are required to follow "Choosing a Medigap pages 22-23" which has Plan G for each scenario as GI (assuming they are offering Plan G)
 
Same. If the person is eligible for Plan F, that's the GI in my experience.

So the bottom of the guide does say this: "However, if you were eligible for Medicare before January 1, 2020 but not yet enrolled, you may be able to buy Plan C or Plan F. People eligible for Medicare on or after January 1, 2020 have the right to buy Plans D and G instead of Plans C and F. "

I'm no constitutional scholar, but it sounds like someone age 70 today with a GI situation has the right to buy F, C, G, etc.

Those 65 today with GI can't get C/F.

No where does it state that the 70 yr old is excluded from the right to purchase G.

I'm sure the Supreme Court can define the word "may" for us and distinguish it from the word "must."
 
So the bottom of the guide does say this: "However, if you were eligible for Medicare before January 1, 2020 but not yet enrolled, you may be able to buy Plan C or Plan F. People eligible for Medicare on or after January 1, 2020 have the right to buy Plans D and G instead of Plans C and F. "

I'm no constitutional scholar, but it sounds like someone age 70 today with a GI situation has the right to buy F, C, G, etc.

Those 65 today with GI can't get C/F.

No where does it state that the 70 yr old is excluded from the right to purchase G.

I'm sure the Supreme Court can define the word "may" for us and distinguish it from the word "must."

That is exactly the case I laid out to the regional manager, complete with attached pages from the Choosing a Medicare Policy.

They are ALLOWED to get F but also G.

I hate it when I have to fight with a desk jockey who wants to reinterpret CMS guidelines. Choosing Medicare handbook is not the regs but it is an accurate representation of what you can and cannot do.

I doubt a carrier would risk a CMS inquiry over a matter such as this.
 
See the asterisk and note at the bottom of pages 22-23. Those who became eligible 1/1/20 or later have the GI right to buy Plans D and G.

State laws and carriers can be more generous and offer G as GI to older benes but it's not a federal requirement.

There is a nice chart on this page: MACRA 2020: What the Changes Mean for Insurance Agents

"2. What does MACRA require?
2. Makes Plans D and G the guarantee issue plans for "newly eligible" Medicare Beneficiaries that name C or F for current Medicare beneficiaries."

22.What changes are made to Guaranteed Issue requirements?
Since two of the current guaranteed issue plans, Plans C and F,will no longer be available for "newly eligible" Medicare Beneficiaries on or after January 1, 2020, Plans D and G will become two of the guaranteed issue plans for these individuals.

23.How does this change the way Plans C or F, and D or G, may be sold in the state?
Insurers would continue to sell Plans C or F to current Medicare Eligibles on a guaranteed issue basis. The “newly eligible” would be offered Plans D or G on a guaranteed issue basis instead.
-----------------------------

Source (pages 5-7): https://www.naic.org/documents/committees_b_senior_issues_170201_medigap_faq.pdf
 
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I know all of you are way smarter and way more knowledgeable about this than I. But here's also what I don't quite know how to interpret, perhaps you all can see it more clearly.

So the bottom of the guide does say this: "However, if you were eligible for Medicare before January 1, 2020 but not yet enrolled, you may be able to buy Plan C or Plan F. People eligible for Medicare on or after January 1, 2020 have the right to buy Plans D and G instead of Plans C and F. "

The words "may, and instead of" are good and arguable points, and the other passage highlighted begs the question in my mind at least..."but not yet enrolled" is this referring to Medicare itself or a Medigap plan? The booklet is about Medicare Supplements, but the subject of the sentence is Medicare.
So for this example specifically, if they have already enrolled in Medicare (effective dates of 2013), they may be limited to C,F, but the word may insinuates a choice, and doesn't close the door on D and G. And even though its widely known by now that those eligible for Medicare on or after 01/01/20 cannot choose Plan F, the wording in that same footnote suggests that they could also enroll in C and F in GI situation, because they have the right, but the word instead seems to suggest that Plans C,F are still on the table. So you go through 7-8 or whatever # of years of higher education and reading piles of prior laws to end up writing this inexact and unclear crap?
Its' been said that every mind is its own world. Perhaps I live in a different world than the one my mind lives in also :arghh:
 
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