SK Associates

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Upon turning age 65 or qualifying for social security disability, part B will be automatically awarded unless the recipient opts out. This is a very important clause to understand, because if the individual has some other type of viable alternative insurance to Medicare, he/she should opt out until part B is needed. By doing this one will not only save the part B premium but also retain the right to open enrollment into a Medicare Supplement plan later on in time.

Another term which is often confused with open enrollment is guaranteed acceptance. While guaranteed acceptance is different from open enrollment, it has the same positive affect for an aspiring member in that it forces the insurance carrier to offer Medicare Supplement membership to the member regardless of health. There are numerous ways to attain guaranteed acceptance. We will touch on some the main ones here.
If you are on an employee sponsored health plan, whether you or your spouse is a current employee or retiree, if you are disenrolled for any reason, you qualify for guaranteed acceptance. If the employer discontinues their current plan and decides to pick up a lesser plan, this does not constitute guaranteed acceptance.
If a prospective member moves from one area to another, be it from another state or another part of the same state and the former insurance carrier does not offer coverage in the new area, the prospective member qualifies for guaranteed acceptance.

There are 10 traditional Medicare Supplement plans plus the advantage plans. The plans are differentiated alphabetically from A through G. There is also a high deductible version of F along with the brand new K and L plans. Both K and L are high deductible plans as well.Prior to the advent of the new prescription Medicare part D, there were also three plans with limited drug coverage, plans H, I and J. These plan are being phased out, yet are still grandfathered for those choosing to keep the old policies. We recommend that members with these older policies consider the prescription coverage through part D as a more affordable alternative to these plans.

Now let's evaluate the plans. Plan A is the only plan that does not cover the Medicare part A hospital deductible which is $952 per hospital admittance for 2006. This is one plan that is virtually worthless and should be done away with. Part B does not pay for days 21 through 100 of skilled nursing. For the year 2006 the skilled nursing deductible is $119 per day. While the average stay in skilled nursing is only 23 days, this benefit is quite inexpensive. Therefore it might be prudent to stay away from the plan B as well. The differentiation between plans C, D, E, F, & G are truly not as relevant. Plans C & F do pay the Medicare part B deductible, which is $124 for 2006. Generally we evaluate each situation for the best value.