Oregon Medicare Supplement

The New Medicare Supplement Guaranteed Issue Birthday Rule which went into effect January 1, 2013, now gives Medicare beneficiaries living in Oregon a yearly opportunity to compare Medicare Supplement (also known as “Medigap”) Plan prices and switch insurance companies if they find a more affordable plan.

What plans can I change to under the new Medicare supplement guaranteed issue birthday rule?

There are certain rules that apply, however.  The Medicare beneficiary must keep the same plan type or choose one with lesser benefits. For example, if a Medicare beneficiary has a Plan F then he or she can switch to any Medicare Supplement Plan A – N, except for an Innovative Plan F.  The Medicare beneficiary cannot switch to a Medicare Supplement Innovative Plan F because it offers more benefits than any other plan and the rule is they can keep the same plan type or choose one with lesser benefits.  This new yearly opportunity for Oregon Medicare beneficiaries is entitled the Medicare Supplement Guaranteed Issue Birthday Rule.  This new enrollment period applies only to Medicare Supplement plans and has no affect on original Medicare or other Medicare insurance, such as Medicare Advantage Plans or Prescription Drug Plans. 

What does the Medicare Supplement Guaranteed Issue Birthday Rule Mean?

The new Oregon Medicare Supplement Guaranteed Issue Birthday Rule means that every year a Medicare beneficiary will have the opportunity to shop and compare Medicare Supplement plans among the numerous insurance companies and purchase a plan with guaranteed issue rights.  These guaranteed issue rights means the Medicare beneficiary does not have to go through underwriting, or qualify for acceptance in the plan.  Therefore, preexisting conditions or age are not considered because the policy is guaranteed issue. The Medicare beneficiary can still shop and compare rates and Medicare Supplement Plans at any time and change plans at any time; however, outside of a guaranteed issue or special enrollment period, he or she will have to go through underwriting.

Why Was the New Oregon Medicare Supplement Guaranteed Issue Birthday Rule Created?

This new Medicare Supplement Guaranteed Issue Birthday Rule was created in response to frequent consumer complaints of being locked into plans with large annual increases and were not able to switch plans or companies due to not being able to pass underwriting due to current or preexisting conditions. 

How Does the New Oregon Medicare Supplement Guaranteed Issue Birthday Rule work?

The following explains how the Medicare Supplement Guaranteed Issue Birthday Rule works: 

  • The Medicare beneficiary’s opportunity to compare prices and change Medicare Supplement plans begins on his or her birthday and ends 30 days later.
  • The change is guaranteed, regardless of your health. New coverage begins on the first of the month following the application date (so a January 23rd application date results in a February 1st effective date).
  • This rule does not apply to Medicare supplement policies issued before January 1, 1990.
  • People with an employer-sponsored standardized Medicare Supplement policy can use the time around their birthday to switch to a non-employer sponsored supplement as long as the new plan does not have additional benefits. Keep in mind that if you leave your employer sponsored plan you may not be able to go back if the employer plan rules do not allow it.
  • Medicare SELECT Supplement plans are considered equal to the same plan type it is modifying.

The following chart illustrates the type of changes you can make as a result of the New Oregon Medicare Supplement Guaranteed Issue Birthday Rule:

 If you have a:

I can replace it with a:

Medicare Supplement Plan A

Medicare Supplement Plan A

Medicare Supplement Plan B

Medicare Supplement Plan A, B

Medicare Supplement Plan C

Medicare Supplement Plan A, B, C, D, K, L, M or N

Medicare Supplement Plan D

Medicare Supplement Plan A, B, D, K, L, M or N

Medicare Supplement Plan E

Medicare Supplement Plan A, B, D, K, L, M or N

Medicare Supplement Plan F (not a high-deductible plan F)

Any Medicare Supplement Plan (except for Innovative plan F)

Medicare Supplement High Deductible Plan F

Medicare Supplement High Deductible Plan F

Medicare Supplement Plan G

Medicare Supplement Plan A, B, D, G, K, L, M or N

Medicare Supplement Plan H

Medicare Supplement Plan A, B, D, K, L, M or N

Medicare Supplement Plan I

Medicare Supplement Plan A, B, D, G, K, L, M or N

Medicare Supplement Plan J

Any 2010 Medicare Supplement Plan

Medicare Supplement High Deductible Plan J

Medicare Supplement High Deductible Plan F

Medicare Supplement Plan K

Medicare Supplement Plan K

Medicare Supplement Plan L

Medicare Supplement Plan K or L

Medicare Supplement Plan M

Medicare Supplement Plan M or N

Medicare Supplement Plan N

Medicare Supplement Plan N

Why would I want to change my Medicare supplement to a different insurance company?

The simple answer is, to save money on your premium.  Medicare supplements are required by Medicare to be standardized.  This means that every Medicare supplement Plan F must have the same basic benefits regardless of which insurance company offers it.  Cost is usually the only difference between Medicare supplements of the same letter offered by different insurance companies. The new Oregon Medicare Supplement Guaranteed Issue Birthday Rule is a great opportunity for Medicare beneficiaries to shop and compare and change plans to an insurance company offer the same Medicare Supplement Plan, or a Medicare Supplement Plan with lesser benefits, and get a more affordable monthly premium.  Contact Medicare Pathways to review your options and assist you in determining which plans you are eligible to change to, as well as find you a lower monthly premium even if you are looking to stay with the same plan.  A Medicare Pathways Benefit Specialist will not only help you find a more affordable premium, but will assist you in enrolling in the plan.  You can call 1-966-466-9118 to speak with a Benefit Specialist, or you can Request a Quote, complete a small, simple form, and a Benefit Specialist will contact you.

 

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Medicare Pathways:  1-866-466-9118