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Medigap Changes Take Effect — Premiums Expected to Climb
Staff Writer
Changes
to Medicare supplements that took effect on June 1 of this
year could leave many seniors with steeply rising premiums,
warns The Senior Citizens League (TSCL), one of the nation’s
largest nonpartisan seniors groups.
“The situation is adding to worry and confusion about the rising cost of
Medicare health plans,” says Daniel O’Connell, chairman of TSCL. “Although
the changes don’t immediately affect seniors currently enrolled in the
plans, they could see steeper increases in premiums by as early as next year.”
“Seniors may wonder if they should switch to a different Medigap or Medicare
Advantage plan,” O’Connell says. “Switching Medicare plans
is often confusing, complicated, and can be full of pitfalls for the unwary,” he
observes.
“Four of 12 standard Medicare supplement plans E, H, I and J are no longer
offered to new customers. Seniors in the plans may keep them, but premiums are
expected to skyrocket because no new people are coming into the plans,” O’Connell
explains. “As people in the plans get older and need more health care,
these plans will have higher payouts, and that will cause premiums to climb,” he
adds.
Two new standardized plans have been added, each with a different coverage than
the previous supplements. In addition, benefits for home recovery have been eliminated
from all Medigap plans.
“The changes, part of the 2008 Medicare Improvements for Patients and Providers
Act, come as a surprise to seniors because there was virtually no publicity about
them,” notes O’Connell. “Seniors with serious health conditions,
like cancer or heart conditions, may need to think very carefully before attempting
to switch Medigap plans,” he says.
“They may also be eligible for newer Medicare Advantage plans, but those
plans are also in the midst of major changes that may increase costs under recently
enacted healthcare reform,” O’Connell adds.
Seniors have special “guarantee issue” rights to enroll in Medigap
health plans during the six-month period surrounding the time when they first
turn age 65 and become eligible for Medicare. Medigap plans cannot put an exclusion
on pre-existing health conditions. During open enrollment, insurance companies
must sell seniors any Medicare supplement they offer and cannot make them wait
for the coverage to begin, even for pre-existing conditions. They cannot add
extra charges because of any health problems.
After open enrollment, other rules apply.
“Seniors may need to wait and make a decision during their next open enrollment
period,” O’Connell says. “We strongly recommend that seniors
in Medigap plans E, H, I and J get the assistance of a State Health Insurance
Medicare Counselor.”
Medicare benefits counselors provide free personalized assistance to help seniors
understand which Medicare health plan is their best choice and to guide them
through the process of switching coverage. Many of the programs operate through
local Area Agencies on Aging or senior departments.
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Metropolitan News Company, Inc.
