Virginia Med/Supp Question, which OK with No Medicare B

[yorkriver1]

One is willing, and that is Anthem. I appreciate the information the rep provided, pages from the guidebook. Anthem pays their share of B related charges based on which supplement was chosen. They don't pay what Medicare B would have paid if in force.

My question is, does anyone have experience with any other carrier who will issue a supp to someone with Medicare A only?

This could be a help in some situations where someone has not taken Medicare B, and is waiting for open enrollment, waiting for Medicare to process their application after loss of employer coverage, etc.

I called the Bureau of Insurance to check if this is a requirement for all carriers in Virginia because I hadn't heard of this until mentioned by the rep, who also believes it's VA law. Three Bureau health policy analysts doing a search couldn't find any statutory basis for a mandatory issue of a Med/Supp when the beneficiary doesn't have both A & B. They were aware that at least one carrier does offer the expanded coverage.

 

[yogooglethis]

One is willing, and that is Anthem. I appreciate the information the rep provided, pages from the guidebook. Anthem pays their share of B related charges based on which supplement was chosen. They don't pay what Medicare B would have paid if in force.

My question is, does anyone have experience with any other carrier who will issue a supp to someone with Medicare A only?

This could be a help in some situations where someone has not taken Medicare B, and is waiting for open enrollment, waiting for Medicare to process their application after loss of employer coverage, etc.

I called the Bureau of Insurance to check if this is a requirement for all carriers in Virginia because I hadn't heard of this until mentioned by the rep, who also believes it's VA law. Three Bureau health policy analysts doing a search couldn't find any statutory basis for a mandatory issue of a Med/Supp when the beneficiary doesn't have both A & B. They were aware that at least one carrier does offer the expanded coverage.

I always thought the consumer must have or will have part B on med sup effective date . So how would the 20% claims be triggered if nothing is filed by the provider to Medicare first?

 

[WCMason]

One is willing, and that is Anthem. I appreciate the information the rep provided, pages from the guidebook. Anthem pays their share of B related charges based on which supplement was chosen. They don't pay what Medicare B would have paid if in force. My question is, does anyone have experience with any other carrier who will issue a supp to someone with Medicare A only? This could be a help in some situations where someone has not taken Medicare B, and is waiting for open enrollment, waiting for Medicare to process their application after loss of employer coverage, etc. I called the Bureau of Insurance to check if this is a requirement for all carriers in Virginia because I hadn't heard of this until mentioned by the rep, who also believes it's VA law. Three Bureau health policy analysts doing a search couldn't find any statutory basis for a mandatory issue of a Med/Supp when the beneficiary doesn't have both A & B. They were aware that at least one carrier does offer the expanded coverage.

No Part B, no med supp. No exceptions. Go hospital indemnity.

From medicare.gov: 8 things to know about Medigap policies
1. You must have Medicare Part A and Part B.
2. If you have a Medicare Advantage Plan, you can apply for a Medicap policy, but make sure you can leave the Medicare Advantage Plan before your Medigap policy begins.
3. You pay the private insurance company a monthly premium for your Medigap policy in addition to the monthly Part B premium that you pay to Medicare.
4. A Medigap policy only covers one person. If you and your spouse both want Medigap coverage, you'll each have to buy separate policies.
5. You can buy a Medigap policy from any insurance company that's licensed in your state to sell one.
6. Any standardized Medigap policy is guaranteed renewable even if you have health problems. This means the insurance company can't cancel your Medigap policy as long as you pay the premium.
7. Some Medigap policies sold in the past cover prescription drugs, but Medigap policies sold after January 1, 2006 aren't allowed to include prescription drug coverage. If you want prescription drug coverage, you can join a Medicare Prescription Drug Plan (Part D).
8. It's illegal for anyone to sell you a Medigap policy if you have a Medicare Medical Savings Account (MSA) Plan.

 

[somarco]

States have exceptions that can override federal (Medicare) laws with regard to supps. Someone in GA used to (maybe still does) write Medigap without B. Can't recall who it was, maybe Woodman or Sterling Investors. Comes up so infrequently and it seems like that carriers rates were not competitive I filed it in my fageddaboudit file.

As River suggested, the carrier(s) that are willing to write a gap plan without B treat the claim as if Part B was in effect. Claim does have to be filed with Medicare and passed on to the carrier.

Any state that has their own rules for Medigap can be more liberal if the want but they have to at least follow federal guidelines with regard to plan design.

If a carrier, in this case Anthem, wants to write Medigap with A only that is their prerogative. I doubt they write a lot of it.

If Anthem wants the business, write it with them and don't waste time trying to find someone else. Take the app and move on.

I doubt there would be a big enough market to justify staking out your niche there.

 

[WCMason]

States have exceptions that can override federal (Medicare) laws with regard to supps. Someone in GA used to (maybe still does) write Medigap without B. Can't recall who it was, maybe Woodman or Sterling Investors. Comes up so infrequently and it seems like that carriers rates were not competitive I filed it in my fageddaboudit file. As River suggested, the carrier(s) that are willing to write a gap plan without B treat the claim as if Part B was in effect. Claim does have to be filed with Medicare and passed on to the carrier. Any state that has their own rules for Medigap can be more liberal if the want but they have to at least follow federal guidelines with regard to plan design. If a carrier, in this case Anthem, wants to write Medigap with A only that is their prerogative. I doubt they write a lot of it. If Anthem wants the business, write it with them and don't waste time trying to find someone else. Take the app and move on. I doubt there would be a big enough market to justify staking out your niche there.

Good point. I did know states can add to, but not take away from, federal benefits, but never heard of this one. This is an odd one.

 

[somarco]

I understand there are a few states that also allow GI on plans other than A, B, C, F, K or L.

And some carriers that consider Hi F to be a kissing cousin to F (for GI purposes) which makes more sense to me than some of the other rules.

A lot of this stuff is almost impossible to find. You stumble across it. In my case it is usually because I did something stupid and found out by accident.