Meet Terry. Terry has end-stage renal disease and is enrolled in Medicare. A couple of years ago, Terry switched his Medicare Supplement after talking with a telemarketer. Now, he’s quite literally paying the price!
When I first got Medicare, I picked a Medicare supplement, “Plan F.” In 2019, I was approached by a telemarketing phone call. He talked me into Medicare Supplement Plan K to save some money since I was in good health and could answer the health questions.Advertisement.
I was hospitalized in March 2020 due to low sugar after passing out at home. I had no idea that I was an insulin-dependent diabetic. My kidneys stopped working properly, causing me to need dialysis. I have end-stage renal disease.
With Plan K, I must pay 50% of the Medicare Part A hospital deductible and the Medicare Part B cost is astronomical. I now pay the Part B deductible, plus a 50% copay for all Part B services. I had to pay over $5,000 in 2020 and even more for 2021.
I tried to change this Medicare Supplement during Medicare Annual Enrollment last fall, but the agent said I can’t because I’m having dialysis. I thought with Medicare, pre-existing conditions did not count. Can you help me to understand this?
Wow, Terry – what a great question!
Americans that do not have health problems need to realize that a health crisis can happen in a split second. Everyone wants to save a few dollars, but most don’t realize how intense it is to be medically underwritten with any type of insurance plan – especially a Medicare Supplement.
Terry, you went from a Medicare supplement, Plan F, where you would pay zero out-of-pocket and all Medicare expenses would be covered 100%, to Plan K, which does pick up Medicare expenses but has a tremendous out-of-pocket cost and keeps rising every year.
Since you now have end-stage renal disease (ESRD) which requires kidney dialysis, you cannot qualify for a Medicare Supplement However, starting in 2021, most Medicare Advantage plans began accepting those with ESRD.
With a Medicare Supplement, the most comprehensive plans that cover more of your Medicare expenses are Plans F and G. Now, remember that Medicare Supplement Plan F is not available for those who turned 65 beginning January 1, 2020. But, Medicare Supplement Plan F is still open to those whose Medicare Part A began prior to January 1, 2020. To change their Medicare supplement, they may have to answer underwriting questions.
Medicare Supplement Plan F picks up most of your Medicare-approved amounts with zero out of your pocket. Plan G is similar to Plan F, except it does not include the Part B deductible which is $203 once a year.
America should be aware of “friendly” telemarketers that call to try and change one’s Medicare plan options. Please be careful giving out personal information to strangers over the phone. Medicare telemarketers are lurking around like a “lion” waiting for the right person to attack to help change their Medicare decision when they only need proper Medicare information to help them make the right decision.
Originally published August 25, 2022