When I first enrolled in Medicare in 2019, I picked a supplement plan F. In 2021 I was approached by a telemarketer and he talked me into Plan K, which cost less than Plan F since I was in good health. I was hospitalized in November 2022 due to diabetic issues when I passed out in the doctor’s office. Now I am a serious diabetic causing me to have kidney issues needing dialysis to survive.
Since I have Plan K, I must pay the deductible plus 50% of the cost until I meet the Medicare supplement’s maximum out-of-pocket which is almost $7,000! I tried to go back to Plan F, but the agent said I couldn’t because of the dialysis.
I thought with Medicare, pre-existing conditions did not count. Can you help me to understand this? Your assistance would be appreciated.
Anthony, Las Vegas, NV
A healthcare crisis can happen when you least expect it! While everyone wants to save a few dollars, they don’t realize that they must answer health underwriting questions to qualify for a new Medicare supplement!
Anthony, you went from the top-of-the-line Medicare Plan F supplement, where you had zero out-of-pocket costs and all Medicare-covered expenses would be covered 100% to a Plan K that does have an out-of-pocket, which is $6,940 for covered Medicare expenses for 2023.
Because you have end-stage renal disease, which requires dialysis, you cannot qualify for a new Medicare Supplement since you cannot pass the health underwriting.
Your options are to either stay on your Plan K or go with a Medicare Advantage HMO or PPO plan. But, if you’re switching to an Advantage plan, you will have to wait until the Medicare Annual Enrollment Period, which is October 15-December 7.
Toni Says: I suggest you talk with your healthcare providers about which Medicare Advantage Plan meets their qualifications!
There are 2 chapters in the Medicare Survival Guide Advanced Edition that explain the difference between Medicare Supplements and Part C Advantage Plans. In Chapter 6, I explain what Medicare Part C plans are and the different types to choose from: HMO, PPO, and PFFS. In Chapter 8, I discuss Medicare Supplements, also known as Medigap policies.
With a Medicare Supplement, the most comprehensive plans that cover the most expenses are plans F, G, and N.
Take time to discover which Medicare option is right for you. For more information, email firstname.lastname@example.org or call 832-519-8664.
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Originally published April 05, 2023
Bob Carlson, America's leading retirement expert, reveals the big secret the IRS won't tell you.