What Medicare A & B Pay, then what Medi Gap Pays

Does it make sense to pay the extra monthly premium when the only difference is the
annual  $283 for 2026 of the Part B Medical Insurance Deductible?

Here’s rules on changing from F to G for lower premiums.  Our Webpage

• Birthday Rule
• Underwriting Holiday rules waived if you want to transfer from one Medi Gap plan to another
• Health Questions if you don’t qualify for guaranteed issue
• You have a  Change in Medi Cal Benefits
• FAQs / Ask Us a Question

FAQ’s & Technical Details

Medi-gap Plans C and F

Medi-gap Plans C and F will no longer be available  to newly eligible Medicare beneficiaries beginning in January 2020.This is because CMS-Medicare decided they want those on Medicare to have more at stake when using benefits, so the Part B Deductible is no longer covered.   Those who have previously purchase or were able to purchase Plan F, Innovative F, High F or F Extra, prior to January 1, 2020  can keep (Grandfathered)  or enroll in the older plans!

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. Medicare now requires new people 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}

Here’s rules on changing from F to G for lower premiums.

• Birthday Rule
• Underwriting Holiday rules waived if you want to transfer from one Medi Gap plan to another
• Health Questions if you don’t qualify for guaranteed issue
• You have a  Change in Medi Cal Benefits

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

• MACRA 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

Resources & Links

• CMS.gov MACRA
• CA Health Care Advocates 2020 Changes
• 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  *