Medigap Trap?
I knew the headline was pure click bait, but curiosity won. I wanted to see what this so-called “medigap trap” meant. Seniors already face an overwhelming amount of confusing Medicare information, and I suspected the article was designed to take advantage of that. After reading it, the explanation turned out to be simple.
When someone first turns 65 or first enrolls in Part B, they cannot be declined for a Medicare Supplement (Medigap) plan. They can choose any plan with any company—except Plan F for newer Medicare beneficiaries—and they can keep that plan as long as they pay the premium. These plans are guaranteed renewable, meaning your health cannot cause the company to drop you.
Many seniors, however, choose a Medicare Advantage plan when they turn 65 or when they first take Part B after retiring. That choice is perfectly fine, and many people enjoy their Advantage coverage. The challenge comes later: after a few years, some want to switch from an Advantage plan to a Medicare Supplement. At that point, they must qualify medically. If their health has declined, the insurance company may deny the application.
This is the heart of the “trap.”
A senior who chose an Advantage plan while healthy may later experience a major health event or receive a new diagnosis. When they try to move to a Medigap plan, they may be declined and forced to stay on the Advantage plan. They still have coverage, but they may face higher expenses and more frustration with networks and authorizations.
The key takeaway is simple and important:
You can always move from a Medigap plan to an Advantage plan, but you cannot always move from an Advantage plan back to a Medigap plan.
If you have questions about your options, our agents are happy to help. You can reach us at 800-750-2407.
God Bless!
