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Old 05-26-2018, 12:43 PM   #1
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medicare / medigap coverage - can i be denied?

folks,

i'll soon begin medicare coverage and have been holding off on a surgical procedure until i had medicare / medigap coverage. (i have been a VA patient for ~5 years but chose not to have their preferred procedure.)

a friend just mentioned that the previous existing condition for which i have recently seen a non-VA physician may be excluded from coverage for a period of time. does this ring true for those of you with specific knowledge? i tend to color within the lines so all reasonable workaround / options are appreciated.

thx in advance.
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Old 05-26-2018, 02:37 PM   #2
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folks,

i'll soon begin medicare coverage and have been holding off on a surgical procedure until i had medicare / medigap coverage. (i have been a VA patient for ~5 years but chose not to have their preferred procedure.)

a friend just mentioned that the previous existing condition for which i have recently seen a non-VA physician may be excluded from coverage for a period of time. does this ring true for those of you with specific knowledge? i tend to color within the lines so all reasonable workaround / options are appreciated.

thx in advance.
Go the FAQ section of Medicare.gov. It's all covered there. It may or may not be covered depending on when you apply.
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Old 05-26-2018, 03:06 PM   #3
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Go the FAQ section of Medicare.gov. It's all covered there. It may or may not be covered depending on when you apply.
Thanks very much, I did that.

It was unclear to me after reading, which is why I came here, hoping to find someone with specific experience similar to mine.

Thanks again.
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Old 05-26-2018, 04:29 PM   #4
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Where are you located and what is your part B date on your Medicare card. Please don’t provide any other information.
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Old 05-26-2018, 10:37 PM   #5
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Where are you located and what is your part B date on your Medicare card. Please don’t provide any other information.

CA

june
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Old 05-27-2018, 09:49 AM   #6
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Coverage

If you can wait till they have the open enrollment your supplement goes into effect as soon as you get. I have Mutual of Omaha it went into effect as soon as I paid it, and they can't ask about any pre exzisting conditions. Good Luck on it.
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Old 05-27-2018, 10:38 AM   #7
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If you can wait till they have the open enrollment your supplement goes into effect as soon as you get. I have Mutual of Omaha it went into effect as soon as I paid it, and they can't ask about any pre exzisting conditions. Good Luck on it.

gotcha, thx very much ... that’s what i’ll need to do if i am ineligible under current rules ... i’d prefer to have it sooner than later, though.

thx again, much appreciated.
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Old 05-27-2018, 10:54 AM   #8
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medicare / medigap coverage - can i be denied?

Suplimemts to my reading and understanding are not rated and you must be taken at the normal rate. While the rate varies from location and companies , the coverage for like lettered plans are identical . If you wait over a certain time from When you are first eligible ( 65?) or select none or some other managed care plan you can be rated at the later time , meaning your condition can be evaluated and the premium adjusted for your condition / denied , even at open enrollment
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Old 05-28-2018, 07:22 AM   #9
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Suplimemts to my reading and understanding are not rated and you must be taken at the normal rate. While the rate varies from location and companies , the coverage for like lettered plans are identical . If you wait over a certain time from When you are first eligible ( 65?) or select none or some other managed care plan you can be rated at the later time , meaning your condition can be evaluated and the premium adjusted for your condition / denied , even at open enrollment
understand, thx very much.
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Old 05-28-2018, 07:41 AM   #10
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This is a recent change.. When I went on Medicare and got my Medi-gap coverage via my Retirement pre-existing conditions did not matter. They were not allowed to exclude.

Thus. I can not tell you the CURRENT rules. I do know changes have been made.
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Old 05-29-2018, 07:56 PM   #11
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I took SS and Medicare last year in the month of my 65th birthday to get away from Obamacare. I take injections for Wet Macular Degeneration in one of my eyes that’s quite expensive. I have various other less serious issues. My open enrollment period was 90 days prior and no issues at all. I ended up with subpart G and a Mutual of Omaha supplement. Good luck on your situation.
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Old 05-30-2018, 09:54 AM   #12
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thx for the feedback, folks, here is an update to relate my discovery process & resolution to bring my participation in this thread to a close.

after reading various sites (SS, Medicare & OldeGuy-populated interwebz threads) the answer to my initial wasn't 100% clear to me. and yep, i get what you may be thinking: "it says on *that* link that your pre-existing conditions are / are not covered ... it says that right there -- what's the problem?". as you might expect, many links referred to in **many** threads / sources are outdated and since we're talking my health / financial risk i wanted to be correct in my decision. (for me a major hitch in relying on a particular site / resource was that on my new-to-me medicare card it says my plan A and plan B are effective on x date but when i log into my medicare site it says i've got plan A but not plan B.

in the end i called aarp's / united health care medicare insurance plan program, rinsed through the details with them - there are no previous condition restrictions - and purchased a f coverage plan to cover excess costs in my upcoming procedure(s). (i will continue to use the VA pharmacy for prescriptions.)

while on the phone with UHC i asked about my plan B coverage - in force or not, how do i pay for it? she said if my new card said it was effective x date, it was effective then and she believed SS would deduct that amount from my monthly SS ... but that i should contact SS to confirm. when i called SS the phone system informed me that my wait time was "1 hr, 37 mins" and i bailed.

sigh.

that's my answer so far and i'm sticking with it until informed otherwise ;-)

as always, YMMV and the feedback i'm providing is worth **exactly** what you've paid for it.

thx to those who provided input, very much appreciated.
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