Switiching medigap plans question

[policy doctor]

Aye....there were clients who wanted to change Med supps but because of Parkinsons, or a recent cancer surgery, My carriers would not accept them. I'm talking Mutual of Omaha, Pacificare, Cont, others.


Some carriers actually call the client first to confirm their meds/usage/and health history before approval. True underwriting.

And changing med supps from Plan F with old co and buying a Plan G with New Co ( for example) imposes waiting period on those benefits not included in old plan. That's your creditable coverage.

Yeah i read posts hastily too and mis-inform myself....getting flamed now on another board for a mistake.

LOL

 

[senior-advisor-indiana]

THere is absolutely no way someone has to wait for pre ex on a med supp. They either get full coverage or none at all. If they do not have a med supp prior to signing up for a new one then they still have creditable coverage because of medicare.

 

[policy doctor]

SAI...don't you use United World and Continental Life? Do you have your brochures handy?

My brochures have a pre-existing paragraph addressing under what circumstances there is a limitation of coverage. Keep in mind different states have different rules, but I'm going by what is here in Ga.

Look...we all know Medicare supps are not guaranteed issue unless first turning 65 or losing employer coverage. Once your time is up you have to qUALIFY.

 

[policy doctor]

I cut myself off to quickly.

Mutual of Omaha/United World....Pass or Fail app....no pre-ex if accepted.

Cont Life....Pass or Fail....3months on pre-ex

New Era...Pass or Fail...6 mos on pre-ex

Conseco used to have no Pre-ex...If accepted. Don't know now.

Pacificare and United American...If accepted....pre-ex was 6 mos.
(dropped them)...

Don't know about Sterling Life or Standard life & Accident, or BC & BS.

 

[senior-advisor-indiana]

All of mine are pass or fail. Must be Indiana.

 

[policy doctor]

Let me clarify.....this applies to clients who only have Orig Medicare, or plans A or B or any other where they wish to upgrade.

 

[Winter_123]

Again, the answer is no. No, unless it's a minor pre-ex like HBP or diabetic controlled by pills/diet. What does your application/company say? I always talked with the underwriters, (and still do) whenever I had a doubt, or to get clarification. They will teach you quickly, and let you know your states mandate. What state are you in? (besides confusion)

Methinks that you are the one confused on whether companies need to take pre-existing on a replacement which is what I asked about. I think that they can decline the applicant based on pre-existing or health history but if they take them and are doing a replacement then they have to cover everything immediately. If that is not so, then I am all ears.

Winter

 

[Winter_123]

THere is absolutely no way someone has to wait for pre ex on a med supp. They either get full coverage or none at all. If they do not have a med supp prior to signing up for a new one then they still have creditable coverage because of medicare.

Not in my state. They dont have to satisfy pre-ex on a medicare supp replacement but they can be required to satisfy pre-ex on a first time enrollment even if it is in the guaranteed issue period when the policy cannot be denied.

Winter

 

[retread]

This thread brings up the issue of "Where are you?" again. If everyone would simply list the state you write in, it would make responses to posts like these more intelligible.

I write in both Kansas and Missouri. There is a huge difference between the insurance regs of these states. I can't speak to many issues raised on this forum because I know how much the regs may vary. To make a quick rush to judgment on someone's question is not wise.

Everyone... Please update your profile to indicate at least one state you write. You can't be that paranoid, can you?

 

[Frank Stastny]

Methinks that you are the one confused on whether companies need to take pre-existing on a replacement which is what I asked about. I think that they can decline the applicant based on pre-existing or health history but if they take them and are doing a replacement then they have to cover everything immediately. If that is not so, then I am all ears.

Winter

Both you and Senior are correct! There are no individual state laws that impose a waiting period for pre-existing conditions when a person is moving from a Med Supp to another Med Supplement.

The original question was, "If a person is already in a medigap plan and has some health issues can they switch over to another medigap carrier without underwriting and are pre-existing conditions covered?"

An AARP policy is the only one I know of that does not require health questions other than the kidney thing. With all others the applicant will have to answer health questions. (Exceptions in California and Missouri)
The rules state that if a person already has a Med Supp and wants to change to another one and successfully answers the health questions on the app then the company cannot impose a waiting period for any pre-existing conditions. This is not a state law, it is federal.

If someone is taking a Med Supp for the first time it is at the discretion of the company if they want to issue the policy and impose a waiting period for any pre-existing conditions. Regardless if the person has prior coverage. However, most companies today will cover pre-existing conditions if the applicant has had credible coverage in the last 63 days.

However, as I have stated before, if one is in doubt do not rely 100% on what is written here, especially if it will put your income or license in jeopardy. Call the company.