Changing Medicare Supplement Plans
California Birthday Rule - lower your premium while keeping the same coverage.
Can I change Medicare Supplement Plans?
Yes, you can change Medicare Supplement Plan coverage. However, it depends when and what you’d like to change about your Medicare Supplement Plan. Are you looking to change from one insurance carrier to another while keeping the same coverage or plan letter (ie. Plan G to Plan G)? Or, are you looking to change the standardized coverage or plan letter you currently have to more or less coverage from your current plan (ie. more coverage- Plan N to Plan G or less coverage- Plan G to Plan N)? Maybe, you’re looking to change plans using the guaranteed-issue California Birthday Rule to lower your monthly premium? I highly recommend using this rule whenever making changes to your Medicare Supplement Plan. We can help you with any changes to your Medicare Supplement Plan coverage.
Depending on what you’re looking to accomplish by changing your Medicare Supplement Plan, there are ways to make changes to your coverage that provide you protection from the risk of losing coverage. These are called guaranteed-issue rights. The alternative way to make changes, which isn’t guaranteed-issue is through medical underwriting (health questions asked) where coverage can be denied based on your past medical history.
Under the California Birthday Rule, you can move from like Medicare Supplement Plan to like Medicare Supplement Plan (or a lower Medicare Supplement Plan) with guaranteed-issue. Thus, keeping the same coverage while lowering your monthly premium–just with a different insurance carrier. Changes outside this 60 day window may subject you to medical underwriting. Increasing your level of coverage (or plan letter) in a Medicare Supplement Plan may also require you to go through medical underwriting for approval. This is another reason why starting in the higher level of coverage when first applying with guaranteed-issue is recommended (Plan G). It’s easy to move you coverage to a lower plan level, if you so chose, at a later time.
These various scenarios will be discussed in detail later in the section. First, we must narrow down the reason you’re looking to move plans. We can then dictate if the change will be considered guaranteed-issue or subject to medical underwriting. Here are few examples of why clients may choose to move their Medicare Supplement Plan.
Changing insurance carriers to lower your monthly premium.
Why change insurance carriers? Well, before we get into the reasons as to why someone would be looking to change carriers to lower their monthly premium, let’s assume a few things so we can breakdown this scenario clearly. Let’s use Plan G in this hypothetical example.
The client is happy with their plan coverage, but their rates have had a large increase of 20-30% over the last 2 years. The client is looking to lower their monthly premium with another insurance company. They are do not want to change their coverage, or access to their Medicare physicians and providers. I’ve shown them in writing from a Medicare.gov source that they can switch insurance carriers with guaranteed-issue rights if they are within a 60 day window of their birthday in the state of California with current Medicare Supplement Plan coverage.
This is called the California Birthday Rule. This rule allow my clients to move with guaranteed-issue rights to any like plan with lower premiums within 60 days of their birthday without the risk of losing coverage. Contact my office to get your Medicare Supplement Plan rate lowered during your birthday month or the following 60 days!
Plan G to Plan G. Same coverage. Lower premiums
Let’s say the new Plan G quote shows my client they can save $30-40 per month. Again, the client wants to keep the same level of Medicare Supplement Plan coverage and is only looking to reduce the monthly premium for Plan G through another insurance carrier.
Keeping everything consistent with what we have stated above, the client is in essence, only changing the insurance carrier that would be offering the Plan G coverage. Remember, this Medicare Supplement Plan (regardless of insurance carrier) will follow Medicare (just changing the “trailer” or secondary coverage that follows Medicare as the primary payor– we are not changing Medicare or “the truck”). All Medicare Supplement Plans will all follow Medicare the same. The difference is which plan letter or level of coverage do you have and with which insurance carrier are you paying to insure your Medicare covered services?
Now, let's review the scenario.
Changing from Plan G with insurance company “ABC” to Plan G with insurance company “XYZ”. No change in benefits. No change in access to physicians or Medicare providers. We are only reducing the monthly premium for the client. (Swapping the “trailer behind the truck”).
Remember, the Plan G coverage is standardized across all carriers just as any Medicare Supplement Plan letter is for any insurance carrier. All Medicare Supplement Plans follow Medicare as the primary payor exactly the same. Again, this has no effect on any current medical procedures or planned procedures since its the secondary and the secondary never dictates what is covered or who you can see. Again, Medicare, as the primary insurance does this. We aren’t making any changes to your primary coverage!
Changing Medicare Supplement Plans has no effect on your Part D.
Changing Medicare Supplement Plans will never have an effect on clients stand-alone Medicare Prescription Drug Plan (Part D). Remember, you chose the “customized Medicare Plan path” and therefore, Part D is a separate piece of your coverage. This allows the client to customize their Medicare Supplement Plan surrounding their birthday as well as customize their Part D plan each year in separate windows. Part D changes each fall during AEP and Medicare Supplement Plan changes in the 60 day window from the clients birthday (obviously, this variable 60 day window will depend on the client’s birthday).
To illustrate the two windows, our clients review their Medicare Supplement Plan premiums a month prior to their birthday and the following 60 days after the birthday if they’d like to lower their rates. This gives us plenty of time to make a change if needed. All Medicare Supplement Plan clients review their separate stand-alone Part D Prescription Drug Plan during the AEP October 15-December 7th each year as this is widow is standardized for all Part D Plans.
“There can be big differences in the premiums that different insurance companies charge for exactly the same coverage”. This is direct quote from Medicare’s own “Choosing a Medigap Policy” (CMS).
With that said, why would you want to pay more for an insurance product if you had options to choose an insurance carrier with the lowest price and same coverage? (ie. Compare pricing of Plan G with 10+ insurance carriers within 60 days of your birthday. Run the quote and decide which one you want to go with. It really is that simple.
Most clients change Medicare Supplement Plan insurance carriers once every 2-3 years (not the plan letter) using the California Birthday Rule. Typically, our clients save $300-$500 a year in when they make the change. New insurer. Same coverage. Same access. Win-win-win! Do clients ever return to the same Medicare Supplement Plan insurance carrier they started with? Absolutely, but only when the rates for their age and in their ZIP code make sense to do so. If the premium is not lower, there is no reason to change carriers, right?! It’s all in the numbers.
(i.e Only changing the Medicare Supplement portion of this equation – Plan G to Plan G)
How do we change insurance companies, but keep the same coverage, i.e Plan G coverage?
This is surprisingly simple and easy as a Medicare Supplement Plan client in the state of California. As a current Medicare Supplement Plan client with Plan G, you have the California Birthday Rule to move to any other insurance companies Plan G within 60 days on your birthday with guaranteed-issue (no health questions asked).
You basically choose the new carrier, enroll, and the acceptance into the Plan G with the new insurance company is guaranteed. Obviously, we would shop rates to find the carrier that is going to offer you the lowest premium for your age in your ZIP code for the Plan G.
California Birthday Rule - Use your guaranteed-issue rights in CA.
Your Medicare stays exactly where it is– as the primary payor. Your new Plan G would again, act as the secondary insurance plan. The new Medicare Supplement Plan would continue to pick up any deductibles, co-insurance, copays as it did before. Any applicable deductibles paid in that calendar year would not restart. You simply pay a new insurer less money for the same coverage and continue enjoying your Medicare coverage throughout retirement. We will handle the paperwork and transition for the new companies Medicare Supplement Plan cards. Then, just present the new Medicare Supplement Plan card to same physicians and providers you see for medical care.
I recommend that you notify the front office of your physician or providers office of the change so they can get a new copy of the new Medicare Supplement Plan insurance card on file. Since they typically ask for your Medicare Supplement Plan card at each appointment, it will be business as usual at all your Medicare doctor/provider appointments.
Since the coverage is guaranteed-issue through the California Birthday Rule, we can simply fax in a cancellation for the older more expensive Medicare Supplement Plan to end on the last day of the specified month you’re moving plans. Knowing the newly issued plan will begin the 1st of the next specified month will make the transition a stress-free process.
When using the California Birthday Rule, the 60 day window allows you to choose the next month or the month after to start coverage– if you prefer having more of a buffer between the transition to the new Plan G (in this example). The month you choose coverage to start with the new insurance carrier makes no difference, but some clients want the new card in hand. If so, choose the new effective date the following month to have your new hard in hand before the 1st it becomes effective. By all means, we can wait for proof of guaranteed acceptance before faxing in the signed cancellation to the old insurance company. You tell us what you’re most comfortable with.
Change carriers within 60 days of birthday.
Lower your premium with the same coverage.
The new plan is guaranteed-issue.
Moving to a new Medicare Supplement with more coverage.
Why? Well, before we get into the reason why someone would be looking to change to a plan that provides more coverage than their current Medicare Supplement Plan, let’s assume a few things so we can breakdown this scenario clearly. Let’s use moving from Plan N to more coverage with Plan G in this hypothetical example.
Let’s also assume the client is satisfied with their access to physicians with a Medicare Supplement Plan. However, they are looking to upgrade their coverage from a Plan N to a Plan G to cover the physician office copays and the Part B excess charges that their current Plan N does not cover. This is merely a preference for the client to upgrade their coverage. The client knows they will pay more per month for the Plan G, but would rather pay a little more premium per month than have to pay the $20 copay for each office visit, physical therapy, and/or chiropractic appointments, etc.
If the client has current Plan N coverage with an insurance company and resides in California. Looking to upgrade coverage from Plan N to Plan G with the same insurance company or a new insurance company that is offering the Plan G at the best rate at their age, and in their ZIP code.
Most importantly, the client wants to keep all their current doctors as well as the same access to Medicare providers in their community, and nationwide.
We can now simplify exactly what we can help the client with:
Changing from Plan N with insurance company “abc” to Plan G with “any insurance company” that has the best rates for the new higher level of coverage. Upgrading coverage will increase their monthly premium slightly. No change with access to physicians or Medicare providers. Remember, the current Plan N coverage and new Plan G coverage is standardized across all carriers just as any Medicare Supplement Plan letter is for any insurance carrier. All Medicare Supplement Plans must follow Medicare as the primary payor exactly the same. This also has no effect on the stand-alone Medicare Prescription Drug Plan (Part D) that the client has for their drug coverage. It’s a separate, and again, this allows the client to customize their plan each year, if they choose to do so.
How do we upgrade from the current Plan N to the new Plan G?
This scenario can get a little tricky, but I’ll do my best to explain the basics of it on this site and if you want a more in depth breakdown, please contact my office to set a phone appointment to review your situation. To review, we are discussing a client requesting to upgrade their coverage from a Plan N to a Plan G in the hypothetical example.
For starters, the California Birthday Rule cannot be used to upgrade your coverage from a lower level plan to a higher level plan with guaranteed-issue rights. This is true with the same insurance carrier your current Plan N is through, or another insurance carrier offering the higher level of coverage Plan G offers. The California Birthday Rule is used from “like plan to like plan” or “Plan N to Plan N”, not higher, such as “Plan N to Plan G”.
Since we cannot use the California Birthday Rule in this scenario, the client will need to apply and qualify through medical underwriting with each carrier they are seeking to get Plan G through. The reason I say, “each carrier” is because the underwriting for each Medicare Supplement Plan is different for each insurance company. Even though the coverage they are offering is the same, the health questions are slightly different when applying without a guaranteed issue and answering each insurance companies underwriting health questions.
Ideally, we would shop the rates for your age and ZIP Code to find the best two to three carriers with competitive pricing and review the applications to see if you answer yes to any of their health questions. If you do answer, yes, it is likely you’ll be denied the coverage. Applying to upgrade from Plan N to a Plan G is theoretically the same as it would be for a client that is outside a guaranteed-issue period with no Medicare Supplement and/or is applying to see if they can qualify for coverage.
There is no annual enrollment period that is guaranteed for Medicare Supplement Plans like there is for individual plans with the Affordable Care Act (pre 65) as many people assume. Many clients are not presented all the facts when enrolling with other agents or insurance companies. They toss around the term “open” as if moving plans is something you can do each year. When it comes to Medicare Supplement Plans, you can be denied coverage without guaranteed-issue rights.
The short answer is you must apply and wait to see if they accept you. This is one of the reasons why I always recommend clients to start with the best Medicare Supplement Plan coverage (Plan G) and go through the best priced carrier at the time. We can always move the Plan G from carrier to carrier throughout the years to lower your premium with the California Birthday Rule. You cannot upgrade to a higher coverage level unless you qualify. It’s likely the reason you want to upgrade is because you are using your plan frequently, which is also likely the same reason you will not be accepted by the new plan– Catch 22!
Moving to a new Medicare Supplement plan with less coverage.
Keeping all things equal with the other scenarios. This hypothetical is assuming a client is seeking to move from a current Plan G to a new Plan N with the same insurer or a new insurance company offering Plan N (lower coverage/lower premiums).
Fortunately, this is as simple as it gets. If you have a current Plan G and are looking to lower you coverage and premium to a Plan N (which is better than cancelling the plan altogether). You can downgrade your coverage using the California Birthday Rule within 60 days of your birthday with guaranteed issue rights.
This applies to the same insurance carrier or a new carrier you’re looking to downgrade your coverage with. If your current Medicare Supplement Plan insurance company has the best rate for the lower coverage Plan N, then by all means downgrade internally with the same carrier. If not, shop new carriers.
Important: Before downgrading your Plan G status, I recommend shopping all Plan G rates. You may find that another insurance company is offering the same Plan G for $25-30 less than your current carrier for the Plan G coverage. You may want to consider this option before lowering your coverage since you’ll have to qualify to move back to Plan G in the future, which again is unlikely since the only reason someone wants to upgrade their plan is likely the same reason the upgrade wont be approved (ie. you’re using the plan frequently and incurring out of pocket costs (copays), which typically means pre-existing conditions disclosed on the new application will cause the upgrade to be denied).
