What’s this about Medi Gap Plan F going away?

Medicare Access and CHIP Reauthorization Act of 2015 (MACRA),
(H.R. 2, Pub.L. 114–10)
commonly called the Permanent Doc Fix,

establishes a new way to pay doctors who treat Medicare patients, revising the Balanced Budget Act of 1997. The reform is the largest in scale on the American health care system since the Affordable Care Act in 2010. It fixes the way Medicare doctors are reimbursed, fills in a funding gap and extends a popular children’s insurance program, CHIP.[1]

There MACRA related regulations also address incentives for use of health IT by physicians. Wikipedia

Medi-gap Plans C and F

will no longer be available  to newly eligible Medicare beneficiaries beginning in 2020.  This is because CMS-Medicare decided they want those on Medicare to have more skin in the game, thus they no longer allow the Part B Deductible to be covered.   Those who purchase Plan F, Innovative F, High F or F Extra can keep their plan!

For new enrollees, Plan G has same comprehensive benefits as Medicare Supplement Plan F, but Plan G does not cover the Part B deductible amount. Members are responsible to pay the Part B deductible. Blue Shield Email dated 9.20.2017 *    Choosing a Medi Gap Policy # 02110 *  CA Health Advocates  *   AAFP.org  *  CMS.gov  *  CMS  FAQ’s  *  AHCA of 2017 §102 would add $422,000,000 for 2017  *  Small practices to be exempt?  Modern Health Care 6.20.2017

Medi Gap A - N Chart
Rev. 7.2021
Click link or image to enlarge

Plan A - N chart a - n chart

 

NAIC Draft Chart for 2020

Resources & Links

AAFP 

CMS.gov

CA Health Care Advocates

NAIC – National Assoc of Insurance Commissioners – Guidance for MACRA  *   FAQ’s *

Section 401 of MACRA –  Sec. 1882. [42 U.S.C. 1395ss] (z)  prohibits the sale of Medigap policies that cover Part B deductibles to “newly eligible” Medicare beneficiaries defined as those individuals who:

(a) have attained age 65 on or after January 1, 2020; or

(b) first become eligible for Medicare due to age, disability or end-stage renal disease, on or after January 1, 2020. NAIC * SSA.gov  *

4 comments on “No more plan F? Only G? MACRA

  1. 35 comments on “Plan F Extra FAQ’s non conical”

    1. Anonymous says:

      Blue Shield Extra F has vision and dental.

      What does it NOT have that Anthem Blue Cross F has

      There must be difference in premiums or something?

      • Take a look at the chart above. The Federal Government sets the standards for what the 10 Medi Gap plans cover. See publication 02110 – Choosing a Medi Gap Policy for more detail.

        Thus, F Extra has to have everything that F has.

        You can get instant premium quotes & comparisons by clicking here.

        If you want to stay with Blue Cross Medi Gap they will probably have a plan G Extra in March.

        The point of Blue Shield Extra, is that they are having a special promotion and offering it to anyone who has a Medi Gap plan NOW, with any company.

        Normally, one must wait till their birthday to change to an equal or lesser plan. In 2020 Innovative and Extra doesn’t count as better.

        So, you could wait till your birthday and stay with Blue Cross.

        • Underwriting Holiday for Medicare Supplement Plans

          We’re kicking off the holiday season with a holiday of our own. We’re happy to announce that for a limited time, current Medicare Supplement members from other carriers and from Blue Shield of California can enroll in Blue Shield’s Medicare Supplement Plan F Extra and Plan G Extra without underwriting approval.

          Here are the details to get started today:

          • Plans eligible for the underwriting holiday are Medicare Supplment Plan F Extra and Medicare Supplement Plan G Extra, and for effective dates of 1/1/2020 through 5/1/2020.
          • The enrollment period starts December 1, 2019 at 12 a.m. and ends February 15, 2020, at 11:59 p.m. Applications for these plans must be received during this time to be eligible Source ** Insure Me Kevin.com **Confidential FAQ’s

    2. Anonymous says:

      Why plan F cost more than F extra please?

      • Click here to get Medi Gap Quotes.

        For 2020 F won’t be sold to new customers at all, right? See our page on that… F extra was low priced to have a “fire sale.” To get as many people into F before sales were mandated to be closed by the Federal Government.

        See also Social Determinants of Health below

    3. Anonymous says:

      I am new to Blue Shield Plan F Extra & am unable to locate information regarding optometrists and benefits under the plan.

      Where is the information listed?

    4. Anonymous says:

      I just turned 85. My premium for Hi-F changed in October to $133 from $126.

      Do you have any info on significant premium jumps for my continuing on Hi-F?

      Do you have any guess on whether Hi-F will continue to be available to me?

      In my experience with Hi-F there have been two years where I received a rebate in excess of $100 🙂

      So I hope I can stay with Hi-F.

      • The October 2019 edition of Cal Broker Magazine has that, pages 8 & 9. The magazine states that the Insurance Companies are still mandated to offer the coverage in the future for those who reached 65 by 12.31.2019 or qualified through SSDI.

        See the rate chart above, dated 10.2018. It shows the premium changing by age from $126 to $133. The advantage here for you is that at 85 there are no more increases due to age.

        I was recently told at a Blue Shield Agent meeting that F & Hi F would be offered – continued – grandfathered in the future for those that have it. Hi F won’t be available to new people, but you can keep it.

        If the group of those you have high f and f have too many claims, than instead of rebates, there could be rate increases. It’s a function of Medical Loss Ratio. Info on 2017 Rebates

      • Anonymous says:

        Would you please clarify the changes I got on my Hi F plan for 2020? Attached

        What is the premium change?

        What is the deductible change?

        • Here’s Medicare.Gov on the cost sharing changes for 2020

          Does that “beg” the question, I paid so much into Medicare, why do they keep raising the costs?

          Here’s the latest rate sheet we have dated 4.2019

          If you look at the rate chart above, age 65 – $61, 67 – $64 and 69 – $71. Does your premium match that? We haven’t seen an update in the broker portal for your premium, nor been advised of any premium changes. We will post when we do.

          Part B Doctor visits deductible increases from $185 to $198
          Part A Hospital from $1,364 to $1,408

          The deductible where Hi F starts paying goes from $2,300 to $2,340. Sure it’s a High Deducible when so many people want FREE everything, but look at the rate chart and you’re saving $1,200 or more per year. At higher ages around $3,500/year. More than you would get on claims!

    5. Anonymous says:

      Any downside to all these extra benefits?

  2. MACRA prohibits the sale of Medigap Plans C and F beginning in 2020, but only to newly eligible Medicare beneficiaries. Only people who become 65 in 2020 or later, or anyone who becomes eligible for Medicare in 2020 or later because of disability or ESRD, can’t buy it. An individual who becomes eligible for Medicare before 2020, continues to work and delays enrollment in Part B, may buy Medigap Plan C or F if they leave that employment and enroll in Part B in 2020 or later. CAHealthCareAdvocates *

  3. Do I have to actually buy plan F now to be grandfathered in

    or if I’m 65 now but I have a group plan

    when I no longer am working will I still be able to buy plan f?

    • MACRA prohibits the sale of Medigap Plans C and F beginning in 2020, but only to newly eligible Medicare beneficiaries. Only people who become 65 in 2020 or later, or anyone who becomes eligible for Medicare in 2020 or later because of disability or ESRD, can’t buy it. An individual who becomes eligible for Medicare before 2020, continues to work and delays enrollment in Part B, may buy Medigap Plan C or F if they leave that employment and enroll in Part B in 2020 or later. CAHealthCareAdvocates *

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