|
A new, little publicized bill, Senate Bill 2043, was signed into law by Governor Wilson in September , 1996. The provisions of the bill became effective immediately. One of the most important provisions is a 30 day open enrollment period, commencing on each person's birthday, during which those who have a Medicare supplement policy apply to any company for a replacement supplement of equal or lesser benefits, and will be guaranteed issue regardless of their state of health. |
|
"The only plans that don't qualify for this guaranteed issue replacement are "Medicare Select". All plans offered by Blue Cross of California are "Medicare Select" plans, except their Standard Plan. However, you may apply to any other carrier during the annual open enrollment period for any Medicare supplement plan they offer. |
|
Some Medicare supplements issued for members of the American Association of Retired Persons (AARP) , have had large premium increases for the past two years. For example, their Plan "F" was priced at $96.75 a month for all ages in 1995 in the Los Angeles area. In 1996, it jumped to $138.35 , and in 1997 increased to $161.50. This is because the rates were the same for each person at any age over 65, and evidence of insurability was not required. Therefore, the younger of the 65 plus group often could find lower rates with another carrier who "age-rated" premiums, causing enrollment of a disproportionate number of older seniors." AARP Medicare supplements required no evidence of insurability, while other companies would not insure seniors with certain health histories, creating a selection against risk. So persons who may have been uninsurable for other companies enrolled in an AARP supplement. These factors resulted in an older and sicker group of insureds, with higher claim experience, and was further aggravated when large rate increases occur, and the younger and healthier members look elsewhere for coverage. Many AARP members are not aware that their Medicare supplement is not guaranteed renewable, and that they are insured under a group policy. According to AARP, this group policy will terminate on December 31, 1997. The terms of the certificate provide that if the group policy is terminated and not replaced by another group policy with the same type of coverage, the insured may convert it to an individual Medicare supplement policy issued by The Prudential. The conversion policy may not contain the same benefits and the premium may, for the first time, use age as a factor. There are three additional scenarios whereby a person over 65 may qualify for a Medicare supplement, even though they have health problems that would make them uninsurable for most insurance companies that offer Medicare supplements. These scenarios are: 1. When a person reaches his/her 65th birthday, they have a six month window of guaranteed insurability for any Medicare supplement they choose to purchase, and it can be effective on the 1st day of the month in which their birthday falls. 2. A person is also guaranteed a six month window of guaranteed insurability upon first enrolling in Part B of Medicare, providing they are 65 or older. Even if they wait until they are 70 or 80, they still have the guaranteed issue window after they first enroll in Part B. This often occurs when a person has a group medical plan through an employer and they do not initially enroll in Part B. 3. California Senate Bill 2043 also gives the same six month window of guaranteed issue when a person over 65 loses his employer sponsored group health insurance or an employer sponsored retiree health plan or a military retiree or Medicare eligible spouse. What coverage can be arranged for a senior who is not entitled to Part A or B of Medicare, either because they have not worked enough quarters to qualify for Medicare or have migrated to the USA within the last five years? In such a scenario, they may qualify for a "Medicare Bridge" policy offered by Lloyds of London, however, with no Medicare coverage, the premium is substantial. Seniors should also be aware that the most expensive of all care, long-term care, is not available from Medicare, except for a limited time and then only if it is skilled care. Almost all long-term care falls under the classification of "custodial care". Long-term care plans are available through many insurance companies and all do provide for such unskilled care as custodial care, personal care, residential care, adult day care and a variety of other levels and types of care in the home. In 1993, the state legislature passed Senate Bill 1943 which established new minimum standards for long-term care insurance policies. California now has the most liberal and beneficial long-term care plans in our nation. |