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Changing From Medigap When It Gets Too Expensive

Medicare Mailbag

Question from Audrey, a Your Inside Cover reader, in New Haven, Connecticut:


I have Medigap, but I’m finding it difficult to afford the premium. What are my options to cover the 20% that Original Medicare doesn’t cover?

Audrey,

This is a great question, and it's unfortunately not unique to you. Many seniors are facing increasing Medigap premiums each year, especially since Medigap premiums are sometimes based on your age.

A few ideas come to mind based on your situation:

1. You can cancel your Medicare Supplement insurance plan anytime by letting your insurance company know you want to cancel.

- Be certain you want to cancel, though. Keep in mind that when you cancel your plan, you may not be able to get it back or switch to another Medicare Supplement plan without going through medical underwriting. When you go through underwriting, insurance companies can use your medical history and pre-existing conditions to deny you coverage or charge you more.

2. You may want to find out if you qualify for Medicaid, if your income and assets are low enough.

- Medicaid helps low-income people on Medicare with their Medicare premiums and cost-sharing requirements, and may also cover some benefits that are not covered by Medicare, such as dental services and long-term services and supports. To find out if you qualify, you can contact the Connecticut Medical Assistance Program.

- And if you don’t live in Connecticut, here’s the link to find the State Health Insurance Assistance Program (SHIP) in your state. SHIPs offer local, personalized counseling and assistance to people with Medicare and their families. You can also call 877-839-2675 to get the phone number for the SHIP in your state.

3. If you do not qualify for Medicaid and you want to stay in traditional Medicare, you could try to switch to a less expensive Medigap policy. Your options will vary based on your state, however, so it can be helpful to work with an agent you trust.

4. Another option could be to enroll in a Medicare Advantage plan. Medicare Advantage plans provide all benefits covered under Medicare Part A and Part B. A few details:

- Medicare Advantage plans typically have lower cost-sharing requirements than traditional Medicare.

- Medicare Advantage plans can charge a premium separate from your Part B premium, although these premiums tend to be much lower than Medigap plans. Some Medicare Advantage plans, though, charge zero-dollar premiums.

- Medicare Advantage plans also have limits on out-of-pocket spending, but they include physician networks. This means that you will pay more if you see a provider out-of-network or may not receive coverage for out-of-network care that is not an emergency.

If your situation is like Audrey’s, you can reach out to us and a member of our team will help you find the coverage that works best for you.

Thanks for reading,

Ari

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