15,000 Losing Medicare Advantage

Over 15,000 Georgia seniors will lose their Medicare Advantage Plan (MAP) at the end of December. Some will choose to move to a different MAP while many will opt to return to original Medicare and purchase a Medicare Supplement (Medigap) plan.

Over the next 12 months we expect to see even more MAP's go the way of the dinosaur as CMS continues making Obamacare dictated cuts in funding for these popular plans. Most if not all Medicare PFFS (Private Fee For Service) plans will disappear by 2012 leaving only HMO plans that require you to use THEIR doctors instead of the doctor of your choice.

If you are losing your MAP through no fault of your own, you have a guaranteed right to a different MAP or to return to Medicare and a Medicare supplement. Even if you have a pre-existing medical condition, a new Medicare insurance plan cannot turn you down.

But if you are voluntarily withdrawing from a MAP or Med supp plan, you may be subject to new underwriting rules which can result in the new insurance plan rejecting your application.

Each Medigap carrier is different when it comes to underwriting, but here are some common "deal breakers" when applying for a Med supp plan outside of your guaranteed issue period. If you have any of the following medical conditions, you will most likely be turned down.

  • ESRD (end stage renal disease)
  • Organ transplant candidate
  • Internal cancer treated in last 5 years
  • COPD
  • Insulin dependent diabetic
  • Alzheimer's or dementia
  • Confined to a skilled nursing facility (SNF) or hospital

The list will vary by Medigap carrier but these are the ones almost guaranteed to result in a rejection.

From time to time one or more Medicare supplemental insurance carriers will relax their underwriting rules. At least one carrier is doing that now but only for Plan N. For a short while, Blue Cross of Georgia will be accepting Medicare supplement applicants with liberalized underwriting.

Ask about current options before applying with any Medigap carrier.

If you are disenrolling from a Medicare Advantage Plan and returning to original Medicare and a Medicare supplement plan, you will need to provide the following to your agent.

  • A copy of your letter to your current MAP carrier expressing your desire to disenroll
  • A completed Medigap application 
  • A completed HIPAA release form
  • A completed replacement form

In most cases you can only voluntarily disenroll from a MAP at the end of the calendar year with the change to be effective on January 1 of the following year. You do not have to wait until you have been accepted back in to Medicare to apply for your Med supp plan. Applications with the new Medigap carrier can be submitted up to 60 days in advance. Ask your agent for specifics.

Medicare Supplement Plans for Georgia Seniors

Georgia Insurance Shop has rates for all the major Medigap carriers in Georgia including AARP, Blue Cross of Georgia and more. We will be happy to provide you with list of affordable Medigap plans and explain the benefits of each. While Medicare supplement plan F is the most common plan many will like the savings that come with plan G or N.

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