Medicare - Supplemental Insurance

Question 1

What is the “Birthday Rule” with regard to Medicare supplements?

Answer 1

The Birthday Rule applies only in California and Oregon. It refers to a 60 day period around one’s birthday in which one can switch supplement policies without undergoing underwriting.

The rule provides an additional window outside of the Medicare Open Enrollment to change to a cheaper or better supplement without the need for underwriting.

Note that the Birthday Rule does not apply to Medicare Advantage policies.

Question 2

Why is medigap important for overseas travellers?

Answer 2

Medigap F pays for care overseas, whereas Traditional Medicare does not

Question 3

T or F

Medicare supplements generally cover the daily out of pocket charge for skilled nursing care under Part A for the 80 days after the first 20 days.

Answer 3

True.

So for those with supplemental policies, the first 100 days in a SNF are essentially free.

Question 4

Deductibles and co-pays for which of the following parts of Traditional Medicare are covered by a Type F supplement?

Part A

Part B

Part D

Answer 4

Medicare Parts A and B

Not D

Question 5

When can you enroll in a Medicare Supplement policy without underwriting?

Answer 5

1. If you enroll in Part B (and A) during your initial enrollment period at age 65, you have six months to enroll in a supplement policy without underwriting. (“Guaranteed Issue”). The six month period begins the on the first day of the first month that you are age 65 and are enrolled in Part B.
2. If you enroll in Medicare Advantage during your IEP, and then switch to Traditional Medicare within the first year.
3. If you enroll in Part B after 65 but during a SEP, then you have 6 months from the month you are first enrolled in Part B to enroll in Medigap. NOTE - Need to cross check this.