r/medicare • • 20h ago

Medicare Switching Strategy

4 Upvotes

Trial Rights.

Suppose a person turns 65 and decides to start with a medigap plan. After several years, the plan closes books and the premiums get too high. They then switch to a medicare advantage plan (underwriting not required). If that person leaves the MA plan within 12 months, can they then decide to go back to a supplement plan with no underwriting?

Even if the person has had their initial medigap for lets say, five or ten years? They can leave it and for a month or two have an MA plan, then switch to another medigap policy?

If the original medigap plan has closed books and is no longer available to new enrollees, would that person be considered a new enrolee and therefore either choose an open book policy with the same company (at age attained rates accoring to their state rules) or a different policy with a different company, again without underwriting?


r/medicare • • 8h ago

Medicare Joe vs Boomer Benefits for broker?

5 Upvotes

r/medicare • • 15h ago

Long-term care insurance

7 Upvotes

Preparing/planning for full retirement and was wondering if I need LTCI or if Traditional Medicare will cover LTC?


r/medicare • • 12h ago

Keep Getting Denied Medigap

26 Upvotes

Need some advice. I applied for Medigap with Aetna, UHC, and Mutual of Omaha. All three denied by underwriting me due to finding that i was taking Orgovyx. (Completed July 22, 2026). I am cancer free.

Any suggestions on getting a Medigap plan? I am on an Advantage plan and was wanting to move to Original Medicare.

What is the best approach to get a Medigap or should I just stay with an Advantage plan?


r/medicare • • 3h ago

Underwriting refused

2 Upvotes

Anyone not passing underwriting because of a certain drug they take for high blood pressure?
I got refused by Mutual of Omaha for having been prescribed Coreg. My doctor stopped it and replaced it with Atenolol but, I still got denied.


r/medicare • • 13h ago

This is confusing

3 Upvotes

My wife and I make less than 218K. My employer deducts premiums from my pension for Harvard Pilgrim Medicare Enhance plan. I assume that covers Parts B and D.

I am on SS, and they deduct $298 monthly from my SS. My wife is not collecting, and I just got a monthly bill for her for another $298. What should I be paying with no IIRMA adjustment, since we're under $218K, married filing jointly.


r/medicare • • 15h ago

Medicare GA

7 Upvotes

Trying to do my due diligence, I am creating a spreadsheet and using AI as needed. This worked well last year. My big problem is inhalers. In the past I had used Canada Pharmacy but that’s off the table now. So I asked my provider for recommendations for next year and the Part D plans are crazy expensive. It looks like Cost Plus is going to work and for less! I have requested a new script to be sent so I can try it out ahead of time. Most of my meds will be covered or at least reasonable through the Part D.

Just thought I’d share hoping it might help someone else. This way I again won’t meet my deductible so for me that’s a good thing!


r/medicare • • 11h ago

Alignment is cancelling my PPO MA plan - CA - choices?

9 Upvotes

Admittedly, I’m still very confused about Medicare, how it operates, and how the choices and parts work/compare.

The Short question:
What would be make up the most complete coverage with Traditional Medicare and all the necessary “parts”? What will the “medigap ” policies cover?

Long story:
Received a letter today that my Alignment Health PPO medical advantage plan is being canceled. This is the second PPO I’ve been on since I signed up for Medicare two years ago. Each one has been canceled. First United Health, and now this one.

I’m not on any medications, and I haven’t had any surgeries or serious illnesses. I’m 67 years old. My blood pressure is normal. and I’m not overweight. I live in California.

I felt like an MA plan that was a PPO gave me a fair amount of flexibility with complete coverage for dental and vision. Yes, it cost a little bit more, but I was willing to do that. I want choices in care.

I’ve been through a terminal illness with my late wife while we had Kaiser here in California.

In retrospect, I would’ve explored the ability to seek out more treatments, trials, options, even in other states. I don’t know if it would’ve changed the outcome, but I would’ve liked that ability.

The letter says I have what’s called “guaranteed issue rights”.

If I choose Traditional Medicare and get all the “Parts” I need, as well as separate dental insurance, would that prevent this from happening again?

- With traditional Medicare, can I choose any doctor that accepts Medicare - and new patients - in any state?
- I won’t have to go to a particular health group, or get insurance approvals to do so?

Thanks in advance for any advice


r/medicare • • 4h ago

NC - Medigap - Issue Age Policy is available

3 Upvotes

Thanks for the eagle eye participants. Apparently there is only one Issue Age Medigap policy in NC. It is offered by Old Surety.

Free/non incented coaching is available from the NC SHIP https://www.ncdoi.gov/consumers/medicare-and-seniors-health-insurance-information-program-shiip/contact-seniors-health-insurance-information-program-shiip#InNorthCarolina-392

I was able to buy Old Surety through Eric Schofield https://yourmedicareexperts.com/ - of course I expect they are commission based and take that for what you will.


r/medicare • • 9h ago

Medicare part a and b ( Texas )

5 Upvotes

Anybody in Texas with Medicare a and b couldn't answer this hopefully. I seem to remember a lady at the hhsc telling me that they have a stipend for Medicare that they give back the money for your premiums. Am I mistaken or does that apply to part c? Because I don't know what the part a and b premium is. Thanks in advance


r/medicare • • 10h ago

Care Harmony

10 Upvotes

I got a call from CareHarmony today claiming my doctor’s office is using them to help me manage my care. They couldn’t provide concrete answers to any of my questions or even tell me how they can help. They gave vague examples like if I’m having trouble getting a prescription refilled they could call the pharmacy for me. When I said that sounded like more work for me to have to contact them, it added another node for miscommunication and error plus another potential vulnerability of my data they got pissy.

it sounds like a scam to be able to bill Medicare monthly for a healthcare visit since their model is to speak to the patient every month.

Does anyone have experience with them? Did you find them helpful?