I recently was asked why I do so many Medicare educational seminars all year round, but especially around the annual enrollment period (Oct. 15 — Dec. 7). The answer is simple — Medicare is confusing. Getting a handle on the ins and outs is just overwhelming for many of us.
If you think I’m exaggerating, let me give you an example.
In 2015 Congress passed the Medicare Access and CHIP Reauthorization Act (MACRA). As a result, anyone who is newly eligible for Medicare on or after Jan. 1, 2020, no longer will be able to purchase Medigap Plan C or F (including the Plan F high-deductible plan). They can’t choose Plan C or F because MACRA prevents individuals new to Medicare from purchasing Medigap plans that pay the Part B deductible ($185 in 2019). Those two plans pay the deductible.
Plans C and F are the “richest” of the Medigap plans. Both cover virtually 100 percent of your medical expenses. Congress didn’t like this aspect of those plans. They felt that people over-utilized the plan and went to the doctor for every little thing. So they figured if they made people pay some of their medical costs, they would curtail going to the doctor.
I’m not sure an annual deductible of $185 is enough of a deterrent, but the great minds in Washington D.C. do. So no more plan C and F enrollments after Jan. 1, 2020.
If you currently have C or F, you may keep it for as long as you want. You’ll see no changes to the plans and you can over-utilize to your heart’s content.
Looks pretty simple, right? If you’re new to Medicare after Jan. 1, 2020, you can purchase one of these Medigap Plans: A, B ,D, G, K, L, M or N. But after Jan. 1, 2020, no Plan C or F. Got it?
Well — you think you got it. Actually, both you and I didn’t get it. See, plans C and F went away — but not really.
Ever hear of the KISS rule? “Keep It Simple Stupid.” Washington apparently hasn’t.
They could have said that after Jan. 1 no one could begin C or F; that if you’re newly eligible, for whatever reason, you must choose one of the other eight Medigap plans. But they didn’t make it that simple.
MACRA says that if you were eligible for Medicare before Jan. 1, 2020, but did not enroll, you will be able to purchase Plan C or F once you’ve enrolled in Original Medicare (Parts A and B). As long as you are within your Medigap open enrollment period, or have a guaranteed issue right, you can purchase Plan C or F.
For example: Say you turned 65 in 2018 and are still working. You enroll in Medicare Part A and opt out of Part B because you’re still receiving health benefits from your employer. You plan on working until you turn 72. So in 2025 you enroll in Part B. You then have the right to purchase any of the Medigap plans, including Plans C and F — seven years after they eliminated those plans.
Why did they add this extra complication? I love Trader Joe’s. Whenever I’m in a town with one, I go and stock up on my favorite items. Last time I was there I couldn’t find something. I asked and they said they didn’t carry it anymore. I was bummed out, but I found something similar and bought that instead. Life can be that simple.
They could have said Plan C and F were out of stock after Jan. 1. But, alas, no. Congress had to add layers to complicate our lives even more.
Hence the Medicare seminars.
Next one is Sept. 24 in Bellaire. If you’d like the schedule, please email me or call and I’ll send it to you.
Be aware that the seminar at my office on Oct. 15 has limited seating — so contact me ASAP for that one.