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Medicare Supplement Quoting softwareAre you trying to navigate the complex world of Medicare but overwhelmed by the sheer number of options available? Enter the Medicare supplement quoting tool – your secret weapon to unlocking the power of Medicare. This article will explore how this innovative tool can help you get the most out of your Medicare coverage.

A Medicare supplement quoting tool effortlessly compares plans, costs, and benefits from various insurance carriers. Instead of spending hours on research and guesswork, this user-friendly tool gives you a comprehensive overview of available options, helping you make informed decisions about your healthcare coverage.

Whether new to Medicare or looking to switch plans, this digital tool simplifies the process. It offers personalized quotes based on your specific needs and budget, allowing you to find the perfect Medicare supplement plan that suits you best.

Understanding Medicare and Medicare Supplements

Medicare is a federal health insurance program in the United States that primarily covers individuals aged 65 and older, as well as some younger individuals with certain disabilities. While Medicare provides essential coverage, it doesn’t cover all healthcare costs. There are big gaps in coverage.  That’s where Medicare supplements, also known as Medigap plans, come in.

Medicare supplements are private insurance plans designed to fill the gaps in Medicare coverage. These plans help cover out-of-pocket expenses, such as deductibles, co-payments, and coinsurance. However, with numerous insurance carriers offering a wide range of Medigap plans, choosing the right one can be overwhelming.

The Importance of Comparing Medicare SupplementMedicare supplement quoting tool

Comparing Medicare supplement policies is crucial to ensure you get the coverage that best meets your needs and budget. Each plan offers different benefits, and the costs can vary significantly between carriers. Without a clear understanding of the available options, you may end up paying more for coverage that doesn’t align with your healthcare requirements.

Medicare supplement plans are standardized, meaning the benefits for each type of plan are the same across carriers. However, the prices can differ; some carriers may offer additional benefits or discounts. By comparing plans, you can identify the most cost-effective option that provides the coverage you need.  Why pay more for the exact same coverage?

Introducing Medicare Supplement Quoting Tools

Medicare supplement quoting tools are online platforms that allow you to compare and evaluate different Medigap plans, costs, and benefits from various insurance carriers. These tools simplify the process of finding the right plan by providing you with personalized quotes based on your specific needs and budget.

Instead of manually researching and contacting multiple insurance carriers for quotes, Medicare supplement quoting tools streamline the entire process. With just a few clicks, you can access a wealth of information and make informed decisions about your healthcare coverage.

How Medicare Supplement Quoting Tools Work

Medicare supplement quoting softwareMedicare supplement quoting tools draw their information from insurance companies’ filings with the state insurance commissioner.  Each insurance company must file its policy with the commissioner, and the commissioner’s office must approve it.  When changes are made to the policy, including price and premium changes, those changes must be updated with the commissioner’s office.  All quoting software pulls from this one source.

Typically, you’ll need to input details such as your age, location, gender, and tobacco usage into the software. Some tools may have the ability to see underwriting guidelines.  Usually, it is better to go to the actual insurance company website and their quoting software to get more detailed and accurate quotes.  The multi-company software, however, enables you to narrow down the pool of likely policies, but it cannot get into the particulars of the company’s underwriting and application process.  The individual insurance company website software can.

Once you’ve entered the necessary information, the quoting tool will analyze the data and present you with a list of Medigap plans available in your area. You can then compare the benefits, costs, and ratings of each plan side-by-side.

Market Insights

Depending on the sophistication of the software, the quoting instrument can get very granular.  You can see age increase pricing, history of rate increases, and the number of policies by state and nation for each company.  The loss ratio and percentage of market share may even be listed.  This type of information will not be very helpful to most people because it is unfamiliar.  A professional who understands the data and is trained to interpret it accurately will need to provide context.

This information and insight allow you to evaluate your options and choose the plan that offers the best combination of coverage and affordability.

The more important consideration is the future increases.  As you age, the cost of a Medicare Supplement goes up.  There are rate increases because medical costs go up.  The number and size of claims ultimately determine how much the insurance company increases the premium to offset expenses.  That is all in the future and hard, if not impossible, to predict.  The information from the Medicare Supplement quoting software does give some insight, but does not predict the future.

Access to Medicare Supplement Quoting Tool

Computer software is usually not free.  The Medicare Supplement software we are talking about is not cheap.  Most people will not pay the price to have access to the software to do one orPicking the best medigap plan in Omaha Nebraska two quotes.  You usually get access to the software through an insurance agent.  Most independent insurance agents or brokers who offer many different companies use quoting tools.  At Omaha Insurance Solutions, we use the CSG Actuarial software.

I attended a Medicare Supplement conference over a decade ago in Florida.  In the main hall, where all the vendors gathered, I ran into CSG.  I had been looking for a good Medicare Supplement quoting software.  In the course of the conversation, I found out a number of the owners and employees were from Mutual of Omaha.  Then I asked where the company was located–Omaha, Nebraska.  I had to fly to Florida to find software that was in my own backyard.

While there are other quoting tools out there, CGS is the industry standard and widely used.  I have found them superb.

For those who do not work with an experienced insurance professional, you can get access to a quoting tool on your MyMedicare.gov personal account.  Inside the account, you can run your own quotes.  The tool is very rudimentary, but it certainly gives you prices and can narrow down the number of companies you may wish to consider.

Benefits of Using a Medicare Supplement Quoting Tool

Using a Medicare supplement quoting tool offers several benefits.

Time-Saving

Instead of manually researching and contacting insurance carriers, the quoting tool provides instant access to personalized quotes from multiple providers.  In Nebraska and Iowa, there are over 40 insurance companies offering more than 300 Medicare Supplements.  That’s a lot to sort through.  The software does it in an instant.

Comprehensive Overview

The tool presents you with a comprehensive overview of available Medigap plans, allowing you to compare benefits, costs, and ratings in one place.  Reseaching a company and policy would take hours.  With the tool, the information is at your finger tips.

Informed Decisions

By having all the necessary information at your fingertips, you can make informed decisions about your healthcare coverage, ensuring you choose the plan that best suits your needs and within your budget.  I find so many people who over pay for the same coverage because they did not effectively shop.

Cost-Effective

Medicare supplement quoting tools help you identify the most cost-effective plan by comparing prices from different insurance carriers side-by-side.

Factors to Consider When Using a Medicare Supplement Quoting Tool

While Medicare supplement quoting tools can simplify the process of finding the right plan, there are a few factors to consider.

Medicare supplement Plan G vs Plan NAccuracy of Quotes

While the tool provides personalized quotes, the actual premiums may vary based on additional factors such as your health conditions or the insurance carrier’s underwriting guidelines.

On rare occasions, the quoting software is different from the company website.  The new prices may not be reflected immediately.  The software has the potential to show the different underwriting classes, but you will not know the client’s underwriting class until you make the application and it is confirmed by the insurance carrier.  The agent always needs to let the client know that she could be denied or rated.  Most agents initially show the lowest rate, which is preferred.

The only way to guarantee the best rating is during a person’s initial enrollment into Medicare.  After that, they are subject to underwriting.

A few years ago, I ran a quote for a lady.  I only showed the preferred health category.  It was an awesome price compared to what she was paying on her current Medicare Supplement.  When we started the application process, however, she was subject to the insurance company’s underwriting guidelines.  She was not tall enough for her size.  Consequently, she went from a preferred rating to a standard rating.  The Medigap price went up, but the price was still significantly less than what she was currently paying.  She asked why the price was higher than what I initially quoted.  I explained it was because of her weight.  She was so offended that she would not consider switching to the lower-cost supplement even though it would have saved her $700 a year.

Coverage Options

The quoting tool may not include all available Medigap plans in your area. It’s essential to research and verify the options presented by the tool to ensure you have a comprehensive understanding of the available plans.

Some agents may not show all of the companies and policies in your area. They may not write a particular carrier for various reasons. They could be prohibited from writing a company.  The agent may consider the company to be inferior, so they exclude it from the list.  The agent, or agency, may have a sweetheart deal with a handful of companies.  Those are the only ones they show.

Additional Benefits

Some insurance carriers may offer additional benefits or discounts not included in the quoting tool. It’s worth exploring the carrier’s website or contacting them directly to learn more about their offerings.  A couple of Medicare Supplements offer a free gym membership.  Almost all have in-house discount programs.  But I would say it is rare they offer anything more of substance without additional premium.

Knowing Data Is Different Than Understanding Data

Many people will look at a spreadsheet of Medicare supplement prices and think they understand what it means.  They may even have very detailed information on the company and its policies.  Someone could have told them what the terms and categories all mean.  Why is it that with all the data and the Ivy League-educated analysis, stock pickers still get it wrong and lose money in the market?

Knowing information is not the same as understanding what the data means.  I’ve watched the Medicare Supplement landscape for over a decade.  It shifts like the sands of the desert.  Tools are helpful, but there is a lot that goes into interpreting the data.  And none of it guarantees the future.  Personal experience as an agent with thousands of clients and years in the industry helps me understand the Medicare Supplement universe.  A company’s track record gives the best idea, as long as the CEO or ownership doesn’t change, but at best, choosing a Medicare Supplement, even with sophisticated instruments, is an educated guess.

Bottom Line: Use The Tools to Improve Your Odds

The Medicare Supplement quoting tools more quickly and easily enable you to accurately evaluate many Medicare Supplements in your area.  The side-by-side comparisons reduce the chance of overlooking a policy or making a mistake trying to recall a price.  The tools sift and narrow down your choices, but they don’t make the choice.  The tools do not predict future premiums or guarantee success.

The exercise of running a Medicare Supplement quote will improve your chances of picking a good plan.  An experienced and trustworthy insurance professional will increase your

omaha Nebraska medicare insurance agent

Christopher J. Grimmond

odds of success even more.

Give us a call at 402-614-3389 for a free consultation with a licensed insurance agent professional about your Medicare Supplement plan.

 

Medicare Advantage or Medicare Part C is another way to receive Medicare.  “Original Medicare” is a combination of Medicare Part A and Part B.  It is called “Original Medicare” because that was its first plan in the late 60’s.  Medicare Part A was hospital insurance and Medicare Part B was added later.  It included doctor visits and outpatient procedures.  Some people call it traditional Medicare.  It became “Original Medicare” when a new form of Medicare was created–Medicare Advantage, also called Medicare Part C.  What is the advantage of Medicare Advantage over Original Medicare?

The Advantage of Medicare Advantage vs Original Medicare

Let’s explain “Original Medicare” first.  Medicare Part A covers hospital stays.  The Part A has a deductible.  It is currently $1,340 for every hospital stay for the same event in a 60 day period.  If a completely unrelated event lands you in the hospital, e.g., car accident, heart attack, stroke, etc., even within the first events 60-day period, you will still pay the $1,340 deductible for those unrelated events.  That kind of deductible schedule could add up to a significant cash outlay in a year.  Likewise, Medicare Part B exposes you to a great deal of risk.    While Medicare Part B pays 80% of doctor and outpatient costs, your 20% co-insurance has no cap on it.  There is no maximum out-of-pocket.  Sky is the limit.  If you have a million dollars worth of bills under Part B, 20% is $200,000.

Advantage of Medicare AdvantageMaximum Out-Of-Pocket

The Advantage of Medicare Advantage is a maximum out-of-pocket.  The highest maximum out-of-pocket for Medicare Advantage plans in 2018 is $6,700.  Some plans maximum out-of-pocket are much less, depending on the area, the company, and the type of plan.  However, the easiest and clearest difference between Original Medicare and Medicare Advantage is a definite limit on what you pay out of your pocket.  Medicare Advantage has a maximum out-of-pocket.  Original Medicare does not.

Minimum Co-Payments

Each Medicare Advantage Plan has its own schedule of co-pays, deductibles, and co-insurance.  One co-pay that is standardized in all plans is the emergency room visit.  In 2018, the emergency room visit co-pay is $80.  I would rather pay $80 with a Medicare Advantage plan rather than 20% of any amount on Original Medicare.  I broke my arm a number of years ago biking.  My emergency room visit was $3,000.  The advantage of Medicare Advantage I think is an $80 co-pay rather than 20% bill–$3,000 x 20% = $600.

Advantage of Medicare AdvantagePart D Prescription Drug Included

With Original Medicare, you still need to get a Medicare Part D prescription drug plan, even if you don’t take any medications.  Otherwise, you will be penalized when you eventually do enroll in a Medicare Part D plan.  The Part D plan is generally included in a Medicare Advantage plan at zero or little cost.  If you purchase a Part D plan, you may pay between $21–$100 per month.  The advantage of Medicare Advantage is paying zero or very little for your drug plan.

Vision and Dental

MoAdvantage of Medicare Advantagest Medicare Advantage plans have additional benefits, such as vision, dental, and over the counter items.  How would you like to get your teeth cleaned twice a year at zero cost?  That is all most people are interested in when it comes to dental usually.  They don’t want to spend $50 a month on a dental plan when cleanings are all they really want or need.

Compared to Original Medicare, the advantage of Medicare Advantage makes complete sense.  It limits your maximum out-of-pocket, combines Part D at little or no cost most times, includes extra benefits, like dental and vision.  There are usually many plans in your area.  Here is Omaha there are eleven Medicare Advantage plans among five insurance companies.  You should be able to find something that fits your needs among that variety.  Call us to find out 402-614-3389.

What is Medicare?  A basic question.  Or rather, why should anyone care about Medicare?   The reason people should care is that most bankruptcies are medical bankruptcies.  In other words, if you wish to protect your retirement nest egg from bill collectors, Medicare is important to know about.  There are few things that are more disturbing than a pile of medical bills sitting on the kitchen table.  The golden years could be tarnished with worrying about actual or potential medical expenses.  Medicare–if implemented proper–will protect you from a potential catastrophe.  It is critical for people entering into retirement to understand what is Medicare.

What is Medicare?

What is MedicareMedicare is a Federal health insurance program for people who are 65 and older (or on Social Security disability).  It began in 1965 when President Johnson signed it into law.  It was designed to provide medical covered to the elderly at a reasonable price.  In 1965, few people had health coverage once they stopped working.  As a result, many seniors fell into poverty because of burdensome medical expenses.  Medicare was a solution to a national problem.

Medicare Part A

Medicare is divided into two parts: Medicare Part A and Medicare Part B.  Medicare Part A has everything to do with the hospital.  It doesn’t cost anything because you paid for it during your working years.  It was one of the deductions in your payroll taxes.  Medicare Part A covers a 100% of the medical expenses incurred in the hospital, but there is deductible that many people are not aware of.  The Medicare Part A deductible is currently $1,288.  This is NOT an annual deductible.  It is a deductible per benefit period, and a benefit period is 60 days.  So each event has a deductible, and the time for the event is 60 days.  In other words, you could have multiple events and pay multiple deductibles because the event is not limited to just a 60 day period.  Each new event, even if it overlaps with another event, has its own 60 day timeline.  While rare, it could happen, and probably more importantly, you could pay the Part A $1,288 deductible more than once in any given year.

Medicare Part B

Medicare Part B, however, does cost something.  For most people going on Medicare and Social Security in 2016, the Medicare Part B premium is $121.80 per month.  It is generally taken out of your Social Security check.  Medicare Part B covers doctors’ visits and outpatient procedures, such as X-rays, blood work, emergency room visits, etc.  Medicare Part B covers 80% of the cost.  Your portion is 20%.  The 20% coinsurance, however, is unusual.  There is no cap.  There is no maximum out-of-pocket.  Most group plans you were ever on probably had a maximum out-of-pocket.  It may have been $1,000, $2,000, even $10,000, but at some point, you stopped paying and the insurance company covered everything.  Medicare Part B does not have that, so 20% of a big number will be a big number.  You keep paying your 20% coinsurance as long as the bills come in.

These are the basic building blocks to what is Medicare.  You must understand Medicare, Medicare Part A, and Medicare Part B to understand the rest that follows.  In the next blogs and videos, we will cover how to get Medicare, how to cover the Part A deductible, and how to fill the unlimited 20% gap in Part B coverage.

More Than Medicare Supplement Plans

I help people sign up for Medicare Part A and Medicare Part B.  We go to Medicare.gov and run their medications.  I check to make sure their doctors and hospitals are in network for the Medicare Advantage plans.  I explain their Medicare eligibility and show All the Medicare supplement plans, Medicare Advantage Plans, and Medicare Part D Plans, but there is much more to being an independent insurance agent who offers Medicare insurance.  It is about a long term relationship with my clients.  It is more than Medicare supplement plans.

Losing a Medicare Client

I recently lost a couple of clients.  They passed away suddenly.  I happened to have spoken with one of them a few days before her passing.  She had called about some photos she had seem on my personal Facebook page.  It is painful when a client dies because I get connect with my clients, especially over time.

More Than Apply for Medicare

The recent loss also reminded me of the nature of my relationship with my Medicare clients.  It is a relationship that is meant to last over time.  It is more than helping them apply for Medicare.  I tell my clients when I enroll them that this is a relationship until “Death do us part.”  I will be checking in on them every six months to make sure their plan is working well.  I check in especially during Open Enrollment Period when beneficiaries may make changes to their plans.  I want to make sure that clients have the best possible plan that fits their needs at the best possible price because we know three things for certain.  Medicare will change, the Medicare plans will change, and their needs will change.  I want to be on top of those changes for them.

If you want someone who will take care of your Medicare needs over the years, give us a call 402-614-3389.

Delay Medicare Enrollment

Many people work past 65.  They continue on with them employer group coverage.  They delay Medicare enrollment.  At 66+, they wonder what to do about Medicare.

How to Enroll after 65

Here is what to do.  Go to Medicare.gov.  Click on “Forms, Help, Resources” on the top right. Then click on “Medicare Forms” on the left middle.  You will see the enrollment forms in the middle of the page in PDF form.  There are two forms: one to enroll in Medicare Part B and a second for your employer to sign off on your coverage.  You fill out the enrollment in Part B.  Give the second form to your employer.  Your employer will verify that you have had health coverage as good as Medicare since you turned 65.  They will sign the form.  It is important for you to write in the date that you wish your Medicare Part B to start.  Give yourself enough time to find a Medicare plan and prescription drug plan.  (There are much shorter and restrictive time limits when you have delayed Medicare Part B enrollment.)  Drop the forms in the mail or hand deliver them to the local Social Security office.

Medicare Employer Enrollment Forms

Why do you want to involve your employer with your enrollment in Medicare Part B?  If you do not have your employer verify that you had health coverage from the time you could have enrolled in Medicare until the time you did take Part B, Medicare will assume you did not have creditable coverage and will asset a penalty.  The penalty is a 10% increase in Part B premium for every year you did not have coverage.  That can be significant over time and completely unnecessary.  Delay Medicare enrollment at your own risk.  Get the form.  Your employer is required to verify.  The human resource department will know exactly what to do.  It is a very simple matter.

At Omaha Insurance Solutions, we help clients who delay Medicare enrollment all the time.  We can get this done quickly and easily.  Give us a call 402-614-3389.  We can email you the forms, walk you through filling them out, and explain what to do.

A distressed prospective client told me that Medicare did not cover mental health treatment.  I stammered a bit because the subject had never come up before,  and I was surprised.  I said that it did.  She had read that it only covered a one time welcome visit to Medicare.  I then showed her in the Medicare & You Handbook on pages 40 and 59 where it detailed the coverage.  There is the welcome to Medicare screening, an annual screening, and complete medical coverage.  She was surprised and relieved there was Medicare mental health care.

Seniors Need Mental Health Care

Mental health is a serious problem in society, and it is growing among seniors.  The World Health Organization documents how important among seniors this issue is.   Depression is under reported, little recognized, and often an untreated illness; but Medicare mental health cares for beneficiaries with mental health concerns, like depression.  It probably does it better than most employer plans do.

Medicare Mental Health Part A

Medicare Part A deals with the hospital.  The same rules around hospital deductibles and co-insurance apply to psychiatric hospitals as to other hospitals.  There is, however, one difference.  Medicare only allows a lifetime amount of 190 days for  a stand alone psychiatric hospitals.

Medicare Mental Health Part B

Medicare Part B covers psychiatrists, counselors, treatment groups.  Again the same 20% co-insurance applies as to any other Part B doctor visit.  If you have a long standing relationship with a psychologists before Medicare, you may keep that relationship going after you go on Medicare if the medical professional takes assignment for Medicare.

Medicare Supplements will cover Medicare mental health issues and professionals the same as other fees in accordance with your particular Medicare supplement plan.  Medicare Advantage will have the same co-pays for psychiatrists and psychologists as for other specialists.

No need to be stressed or depressed about Medicare mental health.  You are covered.

Medicare Quote Honesty

People ask for Medicare quotes from insurance agents and companies, but people really don’t know what they are asking for or what they should be looking for.  It’s not your fault.  You only enroll in Medicare once in a lifetime, so its hard to be an expert.  Here are some tips when you are asking for a Medicare quote.

Medicare Part D Quote

medicare-part-dHow do you know that the agent is showing all the Medicare Part D plans?  Make sure she is showing you the Part D plans on the Medicare.gov website.  There will be a number indicating how many plans are available in your state.  When she proceeds to the page with the quote, all the plans will be listed in order of cost to you beginning with the least.  Make sure she enters ALL of your medications and they appear on the medication list.  That is how you know that you have a real Part D quote.

Medicare Part C Quote

Medicare QuoteHow do you know that the agent is showing all the Medicare Part C plans?  Again there will be a number on the Medicare.gov quoting mechanism indicating the total number of plans in your area.  When you proceed to the list, they will be listed in the order of the plan most favorable to you in terms of the medications listed.  It may or may not be the best plan when looking at the medical side.

Medicare Supplement Quote

How do you know that the agent is showing you all the Medicare supplements?  You see the usual companies, like United Health Care, Aetna, and Blue Cross.  What you should also see is a Medicare Quotenumber of lesser known companies.  Many of those companies will be the lower cost plans.  Some agents don’t include the lower price plans because they get paid less.  If you see a number of unfamiliar names, that is good. You are probably seeing a complete list of supplements

Call us at Omaha Insurance Solutions 402-614-3389 for a quote.  We will show you everything.  We are not concerned about selling you one company over another.  We are concerned about you getting what is best for you.

The Big Lie

The “Big Lie” is a phrase and idea that Adolph Hitler and then Joseph Goebbels promoted in their propaganda war.  They observed that if you told a lie about the opposition, made the lie an outrageous claim, and repeated the claim, people would believe it.  This technique existed before the Nazis and will continue on to the end of time.  Some politicians and sales people are particularly adept at this technique.  Center for Medicare & Medicaid Services (CMS) refer to phenomena such as this as Medicare scare tactics.  CMS dictates client and agent interaction and strongly discourages insurance agents and companies from engaging in Medicare scare tactics.

Medicare Scare Tactics

Medicare Scare TacticsSome insurance agents who offer Medicare supplements and plans use Medicare scare tactics to promote their themselves and their products.  They will make outrageously negative claims about opposing companies, products, or agents.  “That company had a 40% rate increase.”  “That company uses lower initial rates; then jacks them up when you are older.”  Some agents who only offer Medicare supplements will dump on Medicare Advantage plans.  “Those co-pays will bankrupt you.”  Some agents who offer Medicare Advantage plans exclusively will rip on Medicare supplements.  “Why waste your money on premiums when you hardly go to the doctor.”  I’ve seen agents falsely accuse another agent of illegal or unethical business practices.  “He is not even properly licensed” or “he got himself into trouble.”  The more outrageous the accusation, the more it is believed by some.

Counter with Facts

Medicare Scare TacticsFacts, however, are stubborn things.  To counter Medicare scare tactics, ask them to show you the facts from a reputable third party source.  I show my clients the insurance company’s history of rate increases.  I show clients BOTH supplement and advantage plans side by side.  They make the determination which is better for them.  All licensed insurance agents are listed on the insurance department website  by all states.  You can check them out and see if that person has any complaints.  When a person makes accusations, have them produce the evidence.

Scare Tactics are Flashing Signals

Medicare scare tactics, a.k.a., trash talk, is a signal.  It is like someone who gossips about a co-worker.  You know they will be gossiping about you when you walk away.  Agents who talk trash about other companies, agents, agencies, and products don’t really have something better to offer.  There is no need to talk someone or something down if you are offering something better.  Let the facts speak for themselves.  The process of selecting a Medicare solution should be an educational process, not propaganda.

If someone is trying to scare or rush you, they probably don’t want you to really see who they are or what they are offering.   Cut through the noise.  Brush aside the smoke.  Look for the facts.  “The Truth will set you free.”

A gentleman called me who was losing his group health coverage from a former employer. He was a retiree from a Fortune 100 company. You would recognize the name of the company immediately. As part of his retirement package, he had a very generous health plan for himself and his wife. He had been on it for decades, but the company could no longer afford to maintain it. They canceled the plan, so my client found himself cast out into the Medigap world at 92 not knowing what to do, and he didn’t realize that he would need a Medigap guarantee issue to be get a plan.

Medigap Guarantee Issue Solution

When you are a Medicare beneficiary and you loss group coverage, you have what is called a guarantee issue period. It is a very limited opportunity that has an exasperation date on it. It is an incredibly important guarantee for those who have pre-existing conditions.

What is Medigap Guarantee Issue?

What is guarantee issue for a Medigap policy? How does it work?  What should you do to make sure you don’t miss out?  Guarantee issue for a Medigap policy applies to a number of situations.  I will just speak to one—when you involuntarily lose your group health coverage while on Medicare Part A & B.  Guarantee issue means that an insurance company must offer you a Medigap plan—usually plans A, B, C, & F—without asking health questions.  They must sell it to you no matter your health condition.  For those with pre-existing conditions that would exclude them, this is a treasure.  (Each state may handle guarantee issue situations somewhat differently, but this is the general concept.)

Medigap Guarantee IssueHow Does Medigap Guarantee Issue Work?

How does guarantee issue work for a Medigap policy when you have involuntarily lost your group health coverage? The company that is ending group health coverage will usually give you sufficient time to find other coverage. You are able to purchase a supplement as early as 90 days ahead of time. After coverage has ended, you usually only have 63 days to find coverage without going through underwriting. If you miss that time frame and you have a serious health issue, you will not find a Medigap policy. You will only have Medicare.

What Should You Do to Get Your Medigap Guarantee Issue?

What should you do if you are losing your group plan that covers your Medicare deductibles and coinsurance? First get educated about Medicare. Second get a quote and start looking for a Medigap plan. Third see if you can pass underwriting so you are not restricted to the more expensive plans, but please don’t doddle. There is a clock ticking in terms of your guaranteed issue period.

To summarize, you have a special opportunity to get a Medigap plan when you lose your group plan. The special opportunity is that you do not have to answer health questions for a defined period and the insurance company has to sell you a plan. You need to be aware of the rules and follow them so you do not miss out. Still try underwriting so you have more options, but you have the guarantee provision to fall back on.  There are rules and time limits around guaranteed issues. Make sure you fully understand these rules and the ramifications. Call to find out the facts so you don’t miss out. 402-614-3389 OmahaInsuranceSolutions.com

I quoted a prospective client a Medicare supplement rate that was significantly less than the plan he was currently on. When I explained that he would have to go through Medicare supplement underwriting and answer some health questions because he was no longer in his Open Enrollment, he wasn’t happy. 

Why was he upset? Because he remembered how time-consuming and intrusive it was to apply for life insurance.  A nurse came to his home, weighed and measured him, took blood and urine, and asked a bunch of questions. Then, they got reports from the various doctors and a letter about a certain health issue. 

The client claimed there was no amount of money that could induce him to go through all  again. That’s understandable. However, when I said I could probably do the Medicare supplement underwriting in sixty seconds or less, his tone changed.

How can Medicare supplement underwriting be so simple, though? Let me explain.

Medicare Supplement Underwriting

medicare supplement underwriting questions

How is Medicare underwriting defined in Omaha? In short, it’s a simple process used by insurance companies to learn more about you and your health. There’s no need for medical exams or doctor’s visits – all you’re doing is answering a basic set of health questions. 

What are the Health Questions for Medicare or Medigap Supplement Underwriting?

The questions can be grouped broadly into four categories:

  • Knock-out questions 
  • Height and weight
  • Current health issues
  • Smoking status

If you answer “yes” to certain knock-out questions, then you can’t get Medigap or a Medicare Supplement – here’s how it works.

Medigap Underwriting Questions: What Are Knock Out Questions?

They are questions relating to serious medical conditions. If you have this serious medical condition, you are ineligible for a Medicare supplement or “knocked out” of consideration.

Medicare Supplement Underwriting

To clarify, you can’t be denied Medicare, but a private insurance company can deny coverage for a supplement outside of your Open Enrollment Period.

What are some examples of knock out questions? They vary, but they include:

  • Are you currently confined to a wheelchair, nursing facility, or hospital bed? 
  • Do you currently receive assistance bathing, transferring, toileting, eating, dressing or need the assistance of a walker? 
  • In the last two years, have you received treatment for cancer, leukemia, heart attack, congestive heart failure, multiple sclerosis, chronic kidney disease, diabetes with hypertension, stroke, etc.?

Why Does Medicare Ask Questions About Height and Weight?

The second category of questions has to do with height and weight. This is always a difficult question. If I asked my wife her weight, it would be very quiet and cold in the Grimmond household for a while. However,height and weight is an important determiner of future health, so it has an impact on price.

What Are Current Medical Issues?

Current issues cover existing medical conditions and related future treatment. For example, you may have a diagnosis for a future treatment, like a knee replacement or cataract surgery. 

For Medicare supplement underwriting purposes, you’ll probably need to address these medical issues before you can change supplements or the insurer simply won’t cover that procedure for the first six months. 

You may have had respiratory issues in the past that do not exclude you now, but if you are currently being treated for the issue, they could prevent you from getting the supplement for a time.

Why Am I Asked About Smoking Status?

There is plenty of medical evidence about the health risks associated with smoking, which also includes chewing. 

I met with a gentleman who described himself as a non-smoker, but when I pointed out he had a circle print on his back jeans pocket, he fessed up that he dipped occasionally. In medical underwriting, even occasional dipping means you’re still considered a tobacco user. 

Smoker/Non-smoker is the one health question that can be asked during Open Enrollment.

Medicare Supplement Underwriting is Easy

Why does this matter to you? Because your answers determine whether the insurance company accepts or denies you. It determines your health category and consequently your monthly premium.  Underwriting is not a difficult or a daunting task with a skilled insurance agent such as myself. It just takes a few minutes of your time, and you may be able to save yourself some money and maybe improve your coverage as well.   

Medicare Supplement Underwriting Omaha Insurance Solutions

The key thing to understand is that not all insurance companies have the same underwriting guidelines. Some may be laxer or more restrictive than others. They may be lenient on one condition or more severe on another. That is when an experienced agent can help you with getting the best outcome for your underwriting. He can guide you to the company that will be most favorable to your condition for the best possible price.  

Call OmahaInsuranceSolutions.com  402-614-3389  for help with your Medicare Supplement underwriting in Nebraska

What Our Clients Are Saying About Omaha Insurance Solutions

Steve S.

When it came time for me to enroll in Medicare, I had no idea what the process was or what types of coverage to expect. Christopher at Omaha Insurance Solutions took care of all of those questions and alleviated any anxiety with the process. His patience is outstanding and is outdone only by his knowledge of the products he represents. His services cost nothing, and he advocated for the best plan to fit my specific needs. I highly recommend Omaha Insurance Solutions when looking for answers to Medicare questions.

Paul K

The Medicare decision process was overwhelming for me. Chris and Angi did an exceptional job of laying out pros and cons for each option and patiently listened to my concerns and answered my questions. I never felt pressured to make a decision or steered in a direction that I was not 100% comfortable with. I trust Chris and would not hesitate to recommend Omaha Insurance Solutions to my family and friends.

Paul & Terri P.

Medicare can be confusing, but Chris did a great job of explaining all our options to us. He patiently answered all our questions and gave us knowledgeable advice. We are so appreciative of Chris and Angie’s guidance, and we highly recommend them to anyone needing help with Medicare insurance.