Health
Making Medicare Easier
The world of Medicare and Medical Insurance can often be a complicated and confusing one , but SBHIS Insurance Services offers expert advice and guidance . Ania Chrostowska from SBHIS shares her expertise and dives into some of the current aspects of medical coverage , and discusses the opportunities offered by Medi-Gap Policies .
According to a 2023 AHIP report , 33 % of Californians who use traditional FFS Medicare have a Medi-Gap Policy . In San Diego , that comes to almost 70,000 people ! Most of them are high income retirees , but almost half of them have income between $ 50,000 and $ 300,000 a year .
For a monthly premium , Medi-Gap covers deductibles and co-insurance and allows patients the freedom to see any provider who accepts original Medicare . The most popular Supplements are Plans F ( 41 %), G ( 32 %) and N ( 10 %).
For many , Medi-Gap is part of a retirement package offered by a former employer , but a majority purchase a policy from a local agent or financial planner and pay their own monthly premiums . If you are one of those members you should know a few things :
1 . The biggest mistake is not to review Medi-Gap policy every few years . All Supplements cover the same benefits but have varying monthly premiums . Those premiums are always lower for new members than existing clients . One change without underwriting is allowed every year under the California Birthday Rule .
26 GBSAN . COM | AUGUST 2023
Ania Chrostowska
2 . The most common misconception lies in underwriting . The law states that applicants must go through underwriting , unless they qualify for guaranteed-issue periods , which is the time when insurance companies must sell Medi-Gap policies at the best price for an applicant ’ s age , without a waiting period or health screening . Many people believe that “ Guaranteed- Issue ” is only available during the first 6 months after the Part B effective date . That is not true ! Some of the SEP ’ s ( Special Election Periods ) that allow for easy enrollment at a later time are SEP65 for Medicare Advantage members who have been with a plan for less than a year , SEP for MAPD Plans leaving the county , or SEP for Advantage Plans making substantial changes to their network . All of these trigger “ Guaranteed-Issue ” for members who otherwise would have to go through the underwriting process .
As you can see , the requirements and opportunities are quite varied ! For more information about underwriting , plan benefits or other questions related to Medicare , please contact Ania Chrostowska , Director of Business Development at SBHIS Insurance Services at ( 619 ) 888-8189 .