Podcast
Questions and Answers
What is the duration of the Medicare Supplement Open Enrollment Period?
What is the duration of the Medicare Supplement Open Enrollment Period?
- 3 months
- 6 months (correct)
- 24 months
- 12 months
What is the rule regarding pre-existing health conditions during the Guaranteed Issue rights period?
What is the rule regarding pre-existing health conditions during the Guaranteed Issue rights period?
- Companies can charge more for a policy due to past health problems
- Companies can apply a pre-existing condition waiting period
- Companies must cover all pre-existing health conditions (correct)
- Companies can refuse to sell certain policies
What is the exception to the rule of covering all pre-existing health conditions during Guaranteed Issue?
What is the exception to the rule of covering all pre-existing health conditions during Guaranteed Issue?
- If the applicant has a chronic illness
- If the applicant has a pre-existing condition
- If the applicant is over 70 years old
- If there was a break in coverage for more than 63 days (correct)
What type of policies can companies refuse to sell during the Medicare Supplement Open Enrollment Period?
What type of policies can companies refuse to sell during the Medicare Supplement Open Enrollment Period?
How many circumstances under federal law give a beneficiary the right to buy a policy?
How many circumstances under federal law give a beneficiary the right to buy a policy?
What is the purpose of the 'State-Specific GI Rights' tab in the Medicare Supplement Master Reference Guide?
What is the purpose of the 'State-Specific GI Rights' tab in the Medicare Supplement Master Reference Guide?
What is the primary difference between federal GI rights and state-specific GI rights?
What is the primary difference between federal GI rights and state-specific GI rights?
When can a Humana contracted agent engage in preliminary underwriting discussions?
When can a Humana contracted agent engage in preliminary underwriting discussions?
What is required to be answered by the applicant before submitting the application?
What is required to be answered by the applicant before submitting the application?
What is the purpose of the Medicare Supplement Agent Field Guide?
What is the purpose of the Medicare Supplement Agent Field Guide?
What happens to an application taken outside of an applicant’s Medicare Supplement Open Enrollment Period or Guaranteed Issue rights in states where medical questions are allowed?
What happens to an application taken outside of an applicant’s Medicare Supplement Open Enrollment Period or Guaranteed Issue rights in states where medical questions are allowed?
Which condition would disqualify an application from being submitted if indicated by the applicant?
Which condition would disqualify an application from being submitted if indicated by the applicant?
What step follows if an application passes the real-time underwriting process?
What step follows if an application passes the real-time underwriting process?
What action is taken if an application requires further review after real-time underwriting?
What action is taken if an application requires further review after real-time underwriting?
What must an applicant do if they have suffered from one or more conditions listed on the Medicare Supplement?
What must an applicant do if they have suffered from one or more conditions listed on the Medicare Supplement?
What is a required action for applications taken outside of the Medicare Supplement Guaranteed Issue rights?
What is a required action for applications taken outside of the Medicare Supplement Guaranteed Issue rights?
What occurs if an application submitted electronically is denied during the underwriting process?
What occurs if an application submitted electronically is denied during the underwriting process?
What medication-related condition would prevent an application from being submitted?
What medication-related condition would prevent an application from being submitted?
What is the primary reason for the Medicare Supplement Open Enrollment Period?
What is the primary reason for the Medicare Supplement Open Enrollment Period?
What happens if an applicant is eligible for Medicare before January 1, 2020, but not yet enrolled?
What happens if an applicant is eligible for Medicare before January 1, 2020, but not yet enrolled?
What is the main difference between the Medicare Supplement Open Enrollment Period and Guaranteed Issue rights?
What is the main difference between the Medicare Supplement Open Enrollment Period and Guaranteed Issue rights?
What triggers Guaranteed Issue rights?
What triggers Guaranteed Issue rights?
What is the purpose of requiring proof of coverage to determine Guaranteed Issue?
What is the purpose of requiring proof of coverage to determine Guaranteed Issue?
What is the consequence of a break in coverage for more than 63 days during Guaranteed Issue?
What is the consequence of a break in coverage for more than 63 days during Guaranteed Issue?
What should be done before enrolling a client into a policy?
What should be done before enrolling a client into a policy?
What factor is crucial in deciding on a policy during the enrollment process?
What factor is crucial in deciding on a policy during the enrollment process?
What must an agent provide after the close of an enrollment?
What must an agent provide after the close of an enrollment?
What is emphasized as vital for ensuring meaningful conversations with prospects?
What is emphasized as vital for ensuring meaningful conversations with prospects?
What directly affects an agent's commission and residuals?
What directly affects an agent's commission and residuals?
Which resource is essential for agents handling Medicare Supplement plans?
Which resource is essential for agents handling Medicare Supplement plans?
Under what circumstances can an applicant's Medicare Supplement application bypass the need for further review by the Underwriting team?
Under what circumstances can an applicant's Medicare Supplement application bypass the need for further review by the Underwriting team?
What triggers the involvement of Humana’s Enrollment team during the application process?
What triggers the involvement of Humana’s Enrollment team during the application process?
What happens to applications that are denied after the real-time underwriting process?
What happens to applications that are denied after the real-time underwriting process?
Which of the following will NOT exclude an applicant from submitting their Medicare Supplement application?
Which of the following will NOT exclude an applicant from submitting their Medicare Supplement application?
Why might an application be sent to Humana's Underwriting team for evaluation?
Why might an application be sent to Humana's Underwriting team for evaluation?
In states where medical questions are allowed, what is true about applications taken outside of an applicant’s Open Enrollment Period or Guaranteed Issue rights?
In states where medical questions are allowed, what is true about applications taken outside of an applicant’s Open Enrollment Period or Guaranteed Issue rights?
How quickly do agents typically receive a response to their application submission if it goes through the real-time UW process?
How quickly do agents typically receive a response to their application submission if it goes through the real-time UW process?
Which part of the application process involves sending the application to Humana's Enrollment team for validation?
Which part of the application process involves sending the application to Humana's Enrollment team for validation?
What is the primary purpose of Medigap plans?
What is the primary purpose of Medigap plans?
What is the minimum coverage required for all Medigap plans?
What is the minimum coverage required for all Medigap plans?
During which period can Medicare beneficiaries enroll in a Medigap plan without being subject to medical underwriting?
During which period can Medicare beneficiaries enroll in a Medigap plan without being subject to medical underwriting?
What is a requirement for enrolling in a Medigap plan?
What is a requirement for enrolling in a Medigap plan?
What is the consequence of not enrolling in a Medigap plan during the initial enrollment period?
What is the consequence of not enrolling in a Medigap plan during the initial enrollment period?
What is the purpose of the guaranteed issue period?
What is the purpose of the guaranteed issue period?
What is the difference between the initial enrollment period and the guaranteed issue period?
What is the difference between the initial enrollment period and the guaranteed issue period?
What is the main difference between Medigap plans and Medicare Advantage plans?
What is the main difference between Medigap plans and Medicare Advantage plans?
What is a factor that affects Medigap premiums?
What is a factor that affects Medigap premiums?
Which of the following is a basic benefit of Medigap plans?
Which of the following is a basic benefit of Medigap plans?
What can cause Medigap premiums to increase over time?
What can cause Medigap premiums to increase over time?
What is a benefit that may be offered by some Medigap plans, depending on the type of policy?
What is a benefit that may be offered by some Medigap plans, depending on the type of policy?
What is a factor that may qualify certain groups for premium discounts in some states?
What is a factor that may qualify certain groups for premium discounts in some states?
Study Notes
Medigap Plans
- Medigap plans are private insurance policies that supplement Original Medicare (Part A and Part B) coverage, helping to pay for out-of-pocket expenses
- 10 standardized Medigap plans are available, labeled A, B, C, D, F, G, K, L, M, and N, each offering a different level of coverage
- All Medigap plans must cover certain benefits, including:
- Medicare Part A coinsurance and hospital costs
- Medicare Part B coinsurance and copays
- Blood transfusions (first 3 pints)
- Hospice care coinsurance and copays
- Skilled nursing facility care coinsurance
Enrollment
- Initial enrollment period for Medigap plans is typically within 6 months of turning 65 and enrolling in Medicare Part B
- Outside of the initial enrollment period, Medicare beneficiaries may enroll in a Medigap plan during certain times, including:
- Annual open enrollment period (Oct 15 - Dec 7)
- Special enrollment period (e.g., losing employer-sponsored coverage)
- Guaranteed issue period (e.g., moving to a new state)
- To enroll in a Medigap plan, Medicare beneficiaries must be:
- Enrolled in Medicare Part A and Part B
- Residing in the plan's service area
- Not enrolled in a Medicare Advantage plan
- Meeting any additional eligibility requirements set by the insurance company
Medicare Supplement Cost
Premiums
- Medigap policies have standardized plans, but premiums vary by insurance company and location.
- Premiums are influenced by age, location, and insurance company.
- Premiums increase over time due to inflation, age, or other factors.
- Some states offer premium discounts for certain groups, such as disabled beneficiaries under 65.
Coverages
- Medigap plans offer varying levels of coverage, including plans A, B, C, D, F, G, K, L, M, and N.
- Basic benefits of Medigap plans include Medicare Part A coinsurance, Medicare Part B coinsurance, and blood transfusions (first 3 pints).
- Additional benefits vary by plan, and may include Medicare Part A deductible, Medicare Part B deductible, excess charges, foreign travel emergency care, at-home recovery care, preventive care, and out-of-pocket limits.
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Description
Learn about the Medicare Supplement Open Enrollment Period, including when it starts, how long it lasts, and the rules insurance companies must follow during this period.
