{"id":2132,"date":"2024-11-11T19:23:11","date_gmt":"2024-11-11T19:23:11","guid":{"rendered":"https:\/\/friscotimes.org\/?p=2132"},"modified":"2024-11-13T07:14:08","modified_gmt":"2024-11-13T07:14:08","slug":"shopping-for-a-2025-medigap-policy-there-may-be-some-good-news-for-you","status":"publish","type":"post","link":"https:\/\/friscotimes.org\/?p=2132","title":{"rendered":"Shopping for a 2025 Medigap policy? There may be some good news for you"},"content":{"rendered":"\n

Medicare can be weird: Sometimes, bad news for beneficiaries can actually be good news. That\u2019s the case for certain people who\u2019ll be shopping for a 2025 Medigap<\/a> policy during Medicare\u2019s Open Enrollment Period, which ends December 7, 2024.<\/p>\n

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Here\u2019s why:<\/p>\n

Say you have a private insurer\u2019s Medicare Advantage plan in 2024 and have decided to switch to Original Medicare for 2025. Then, you\u2019ll likely also want to buy a Medicare supplemental policy (aka Medigap) to reduce out-of-pocket costs. That\u2019s where problems can begin.<\/p>\n

When Medigap applicants get rejected<\/strong><\/h2>\n

In all but four states\u2014Connecticut, Maine, Massachusetts and New York\u2014if apply for a Medigap policy after the first six months of Medicare eligibility, the insurer can reject you due to a pre-existing condition or charge you more because of it. (A pre-existing condition could be anything from high blood pressure to diabetes to Alzheimer\u2019s, according to a recent KFF health research group report<\/a>.)<\/p>\n

\u201cA Medigap insurer can generally turn you down for whatever reason they see fit,\u201d says Ryan Ramsey, associate director of health coverage and benefits at the National Council on Aging.<\/p>\n

That lack of guaranteed Medigap coverage is the bad news.<\/p>\n

The good news for some Medigap shoppers<\/strong><\/h2>\n

The good news, in a bizarre way, is that if your 2024 Medicare Advantage plan won\u2019t be offered in 2025, you\u2019ll be guaranteed acceptance when applying for a Medigap policy. That\u2019s because a Medicare Advantage plan termination is an exception to the Medigap guarantee rules, creating what\u2019s known as a Special Enrollment Period.<\/p>\n

Plan terminations have become increasingly common lately due to financial pressures on Medicare Advantage insurers.<\/p>\n

Mutual of Omaha is not selling standalone Medicare Part D plans in 2025 but is selling Medicare Advantage plans in select markets. Humana won\u2019t sell plans that currently cover 560,000 of its members and will leave 13 markets around the country. Aetna and Centene plan to exit a number of markets, too. People in some counties will have no Medicare Advantage options at all in 2025.<\/p>\n

\u201cThere is a likelihood that if people have Medicare Advantage plans that are no longer going to be offered, they will have this guaranteed-issue rights period with Medigap,\u201d says Ramsey.<\/p>\n

Not always, though.<\/p>\n

If your Medicare Advantage plan won\u2019t be offered and you\u2019ve been in what\u2019s called a consolidated plan, \u201cyou\u2019re automatically moved into another plan by the same insurer in your area,\u201d says Meredith Freed, senior policy manager for the Program on Medicare Policy at KFF.<\/p>\n

\u201cIn that case, you do not get a Medigap Special Enrollment Period because it\u2019s not actually considered a termination,\u201d Freed says.<\/p>\n

Which Medicare Advantage plans get cancelled<\/strong><\/h2>\n

Medicare Advantage plan terminations aren\u2019t uncommon. From 2011 to 2020, about one in five plans were cancelled.<\/p>\n

They tended to be ones with lower Medicare star ratings, $0 premiums and a greater proportion of black beneficiaries, according to a study<\/a> by Brown University School of Public Health professors David Meyers and Dr. Amal Trivedi.<\/p>\n

Trivedi thinks those plans may have been unprofitable for the insurers.<\/p>\n

\u201cPlans with $0 premiums tend to attract people with lower incomes,\u201d he told me. \u201cWith respect to having higher proportions of black beneficiaries, it is possible that the plans where people have more social risk factors [such as low incomes and being in racial ethnic minorities] may have greater than expected costs and been less profitable.\u201d<\/p>\n

Other ways to be guaranteed a Medigap policy<\/strong><\/h2>\n

Three other ways Medicare Advantage members can get guaranteed Medigap policies in 2025 when switching to Original Medicare:<\/p>\n