It’s a new year and those Medigap Plan F changes you’ve been hearing about have gone into effect. The most common question I hear is, “Did Plan F go away?” The answer is, “Yes and No.” In 2015, President Obama signed into law the Medicare Access and CHIP Reauthorization Act (MACRA). One of the components of MACRA is that it prohibits insurance companies from selling plans, that cover the Medicare Part B deductible, to newly eligible beneficiaries.
Who Is Considered “Newly Eligible”?
Basically, anyone who turns 65 on or after 01/01/2020 and is not currently eligible for Medicare. In other words, if you have Medicare with an effective date prior to Jan 1, 2020, (even if due to a disability and you’re under age 65) OR you turned 65 prior to Jan 1, 2020, regardless of whether you have Medicare, you are still eligible to purchase these plans as long as the insurance company agrees to sell them to you.
Which Plans Are Affected?
Medigap Plan F
Medigap Plan F, which pays 100% of Part A deductibles, coinsurance, copays, hospice care coinsurance, skilled nursing coinsurance, Part B deductible, coinsurance, copays, * Part B Excess Charges and 80% for foreign emergency travel (limits).
Medigap Plan C
Medigap Plan C, which pays 100% of Part A deductibles, coinsurance, copays, hospice care coinsurance, skilled nursing coinsurance, Part B deductible, coinsurance, copays, and 80% for foreign emergency travel (limits). Medigap Plan C does not pay * Part B Excess Charges
The MACRA rules are clear but many industry people do not understand them and calling an 800 number often leads you to yet another person who does not understand. If you have questions, feel free to call me – after all, I’m always a “safe place to get information without the sales pressure.”
* Part B Excess Charges are what a physician may charge above and beyond Medicare-approved amounts. While Part B Excess Charges are not common, they can occur in some situations.
If you still find this confusing or are unsure, you are not alone. Feel free to give me a call. As always, I am the safe place to get information without the sales pressure.