Senior Healthcare Direct

Medicare Supplement Insurance Underwriting

Medicare Supplement Insurance without Underwriting

medicare supplement insurance underwriting

Medicare Supplement insurance underwriting is NEVER required when you are first eligible and Apply for Medicare during your initial Open Enrollment Period (OEP). This is a 7-month period: 3 months before you turn 65, the month you turn 65, and 3 months after you turn 65. As a result, you can NEVER be disqualified for coverage based on your health condition during this period. In other words, you can have health conditions and your coverage will NOT be denied. Moreover, the plan can NEVER charge more if you have health issues during OEP. When you apply for Medicare during this period your acceptance into a Medigap Plan is guaranteed. According to Medicare.gov the best time to buy a Medigap policy is during your open enrollment period.

When is Medigap insurance underwriting required?

  • If the first time you enroll in Medicare Supplement Plan is AFTER your initial Open Enrollment Period, Medigap underwriting is required. In other words, you did NOT apply for Medicare during your initial OEP.
  • When you switch to a different Medigap Plan after your initial Open Enrollment Period, then underwriting is required.
  • Likewise, when you switch from Medicare Advantage Plan to Medigap Plan after your initial OEP, then underwriting is required.

Medigap State Birthday Rule

Medigap State Birthday Rule

In Oregon and California, Medicare beneficiaries can shop Medigap Plans within 30 days a birthday month with no underwriting. Specifically, you have a total of 61 days to enroll in Medigap Plan without underwriting: 30 days before your birthday, on day of birth, and 30 days after your birthday. In addition, applicants must have an existing Medigap policy in place. Senior Healthcare Direct can help you shop and save on Medicare Supplement Plans by calling 1-855-368-4717 or get you quote. When you find a plan you want, applying is fast and easy because there is no medical underwriting questions.

Likewise, in the state of Washington Medicare beneficiaries can shop Medigap

How To Switch Medigap Plans

Robert Bache, owner of Senior Healthcare Direct says, “Switching your Medigap plan has never been easier. It takes about 15 mintues and you can do it right over the phone.” Call 1-855-368-4717 to speak with a licenses agent and help you save money on your Medicare Supplement plan.

No physical or labwork is necessary to switch to Medigap plans. Answering health questions and an underwriting interview over the phone is all that is required to switch Medicare Supplement Plans. In the video below, Robert Bache shows application questions asked by Mutual of Omaha to qualify for their Medigap plans.

Underwriting Questions For Medigap Policies?

Anytime you apply for Medicare Supplement Plan (Medigap) outside your initial Open Enrollment Period (OEP), you will have to answer underwriting questions. Medigap policies are sold by private insurance companies. As a result, some of the underwriting questions insurance carriers ask will be different. However, many insurance companies ask similar questions. The following are the most common underwriting questions:

What is your height and weight?

The median (middle) American male height is 5 foot 10 inches and median weight is 198 pounds. The median American female height is 5 foot 4 inches and median weight is 170 pounds. If your weight is normal and you have no health conditions, then you will have no problem qualifying for health insurance. On the other hand, if you are underweight or overweight (obese), you can still qualify for health insurance coverage with increase in premium. However, if you are severely underweight or severely obese, then you will be denied by Medicare Supplement insurance underwriting. For height and weight guidelines, use the Body Mass Index chart below:

Body Mass Index chart

Acccording to Body Mass Index (BMI) chart above, the median American male and female has BMI of 29. Therefore, the middle value of all Americans bodies is overweight and almost obese. In fact, the Centers for Disease Control and Prevention (CDC) reports the percent of adults age 20 and over with overweight including obese is 71.6%. If your BMI is 19 to 24 (optimal), then you are normal weight and will pass Medicare Supplement insurance underwriting. In addition, you may qualify for health coverage with BMI of 17 to 18 (underweight) or BMI of 25 to 35 (overweight to middle obese) depending on other health conditions. However, you may not qualify for health coverage with a BMI over 35 when you have other health conditions. Any applicant with BMI of 40 or higher (severely obese) will not pass Medicare Supplement insurance underwriting.

Do you require assistance for activities of daily living?

Underwriting may ask you questions about activities of daily living including: eating, toileting, bathing, and dressing. In addition, underwriting will ask you questions about other instrumental activities of daily living. For example, underwriting may ask about activities such as shopping, meal preparation, housework, laundry, and taking medications. If you are unable to perform these daily living activities without assistance, then you will not be approved by Medicare Supplement insurance underwriting.

Do you have any of the following health conditions?

Anyone with a chronic, incurable health condition may be disqualified for health coverage. Medicare supplement applications have a long list of health condition questions including the following:

hypertension chronic health condition
High blood pressure, also called hypertension, is a chronic condition that if not properly managed can lead to heart disease and stroke.
  • Any cardio-pulmonary disorder requiring oxygen
  • Implantable cardiac defibrillator
  • Chronic Hepatitis B, C, D
  • Chronic Kidney/Renal Disease
  • Dementia and other cognitive disorders
  • Chronic Obstructive Pulmonary Disease (COPD)
  • Immune deficiency disorders like MS, AIDS, or Lupus
  • Nervous system conditions, such as Parkinson’s
  • Taking any medication that must be administered in a physician’s office

Coverage For Well-Controlled Diabetes and Hypertension

These chronic health conditions and other related conditions will disqualify you for health coverage. However, Medigap insurance company (Mutual of Omaha) may consider coverage for people with diabetes and hypertension who have well-controlled cases. For example, if your diabetes or hypertension had no changes in treatment or medications for at least two years, then your case is well-controlled. Moreover, your case is considered well controlled and insurable if you take no more than two medications (two for diabetes and two for hypertension). Furthermore, hypertension is considered stable if recent average blood pressure readings are 150/85 or lower. A well-controlled diabetes and hypertension case can be approved by Medicare Supplement insurance underwriting.

On the other hand, if you have diabetes (insulin dependent or treated with oral medication) and have one or more complicating conditions, you will not be eligible for coverage. For example, complications include:

  • Eye or vision problems
  • Numbness or tingling in the toes or feet
  • Circulation problems or pain in the legs

Do you take any of the following medications?

When you apply for Medigap coverage, you will be asked to list all the medications you have taken over the last two years. Moreover, the Medicare Supplement insurance company uses a underwriting system called Gen Re to look up all your prescription from pharmacies.

There is a very long list of medications which can disqualify your application. In general, these are drugs people take for chronic and incurable conditions. Some of these uninsurable medications include:

medicare supplement insurance underwriting
  • Alzheimer’s / Dementia drugs such as Cognex
  • Cancer drugs such as Lupron and Zoladex
  • Rheumatoid Arthritis drugs such as Methotrexate more than 25mg/wk
  • Opioid (narcotics) such as Fentanyl
  • Insulin more than 50 units per day for diabetes
  • Prednisone (corticosteroid) more than 10mg per day

Acute Health Conditions Will Pass Underwriting

Acute health conditions appear suddenly and often last a short time. For example, getting a cold or the flu may only last a few days. Furthermore, a broken bone, seasonal allergies, or urinary tract infection are acute conditions as well. On the other hand, osteoporosis a disease resulting in low bone density is a chronic condition. As a result, bones become more fragile over time and the risk of fracture is greatly increased. When applying with Mutual of Ohama to switch Medigap plans they ask, “Do you have Osteoporosis, and as a result, experienced a fracture?” Thus, if you had fractures from Osteoporosis, the you will be denied coverage.

In general, you can apply for Medicare Supplement insurance with an acute health condition and pass underwriting.

Finish Pending Surgeries and Treatments Before You Apply

Medicare Supplement insurance underwriting will deny coverage if an applicant has a pending surgery or treatment. For example, if you have an upcoming test / procedure / or labwork, it needs to be completed before you apply. In addition, physical therapy will need to be completed as well. Thus, you will need to complete the surgery and any follow-up visits or therapy before you apply.

Other Ways Underwriting Denies Coverage

Even after surgery is complete, some Medicare Supplement insurance underwriting may require a waiting period. For example, after major surgery such as knee replacement, the waiting period could be a year or two. Furthermore, underwriting can deny coverage if you are receiving home health care or have been hospitalized 2 or more times in the last 2 years. Likewise, coverage will also be denied if you are living in a nursing home. A commonly asked application question:

Are you currently hospitalized, confined to a bed, in a nursing facility or assisted living facility, receiving home health care or physical therapy?

By answering yes to the above question, underwriting will deny coverage. Another health condition people ask about is cancer. Most Medigap underwriting requires 2 years of cancer-free (in remission) before they approve coverage.

Underwriting may deny coverage based on mental health conditions. An application question may ask:

Do you now or in the last 2 years been treated for (including surgery) or advised by a medical professional to have treatment for major depression, bipolar disorder, schizophrenia, or a paranoid disorder?

Chronic mental disorders can cause Medicare Supplement insurance underwriting to deny coverage. However, seeing a therapist or taking a mild anti-depressant would pass underwriting.

How to Avoid Medicare Policy Delays

To avoid Medicare policy delays, it is important you give correct information. After speaking with a licensed agent at Senior Healthcare Direct, the policy is processed by our customer support team. To speed up the process our customer support team does a followup interview with the insurance underwriter. For example, you can avoid policy delays by giving the correct spelling of your last name as it appears on your Medicare card. In addition, more information may be required from your doctor to get your application approved. For an inside look at the underwriting process watch Robert Bache interview customer support team member Tammy Hess in the video below.

Read More: Medigap Mondays – Medicare Supplement Plans (Medigap)

Plan F Vs G

Medicare Plan F and G

Which is Better Medicare Plan F vs. Plan G?

In the video above, Robert Bache, owner of Senior Healthcare Direct, compares Medicare Plan F and Plan G. MedicareBob covers two important changes to Medicare in 2020. First, MACRA law is now in effect and you should have a new Medicare ID card. This law helps protect seniors from identity theft. It removes social security numbers and replaces them with a number that is unique to you. In the video, we show you the old Medicare card. Once you have your new Medicare card, you can destroy this old card. Get all 10 Things to know about your New Medicare card.

Your New Medicare Card

Second, MACRA law changed Medicare coverage for people newly eligible for Medicare in 2020. For example, if you are turning 65 or otherwise qualify for Medicare because of disability or terminal illness, then this MACRA law applies to you. However, if you had Medicare prior to 2020, then MACRA law change does not apply to you. For people newly eligible for Medicare in 2020, you will not be eligible for Plan F or Plan C. In other words, you can not get Plan F or Plan C. Therfore, the most comprehensive Medicare Plan you can get is Plan G.

Medicare Plan G vs. Plan F

So what’s the difference between Medicare Plan G vs Plan F? There are two big difference between Medicare Plan F and Plan G. First, Plan G has lower premiums than Plan F. Second, Plan G requires you to pay $198 Deductible in 2020. When you compare the lower premium benefit of Plan G, you can save $500 or more. In other words, Plan F will cost you $500 or more in premiums than Plan G.

Medicare Plan G Cost and Benefits

So what does Medicare plan G cost? In the video, MedicareBob says, “You pay a monthly premium usually between $80 to $120 per month.” In addition, you pay an annual deductible of only $198 once per year. Medicare Plan G pays the 20% coinsurance cost that original Medicare does not pay. For example, your doctor visit costs $400. Medicare Part B only covers 80%. You are responsible to pay 20% or $80. Your Medicare Plan G will pay this $80 doctor visit.

Is Medicare Plan G better than Plan F?

In the video, MedicareBob says, “You will want to go from Plan F to Plan G.” There are two big reasons to switch from Plan F to Plan G. The reasons you will want to switch is simple math. MedicareBob says, “When you look at Plan F compared to best Plan G, you will save $500 to $1500 in annual premium.” This is why Senior Healthcare Direct calls Plan G the “Greatest Value”. Plan G gets you the same comprehensive Medicare coverage of Plan F and saves you money with lower monthly premiums. The only difference is you pay one-time annual deductible of $198 in 2020 with Plan G.

When Can I Switch From Plan F to Plan G?

The good news is you can switch from Plan F to Plan G anytime. You do not have to wait until annual enrollment. You can call Senior Healthcare Direct today at 1-855-368-4717 or click the get your quote button.

medicare-supplement-plan-g-quote
Silver Sneakers Medicare Plans

Silver Sneakers Medicare Plans

What is Silver Sneakers?

medicare plans silver sneakers

Silver Sneakers is a health and fitness program for Medicare beneficiaries 65 years or older. Thus, if your a senior Medicare Plans may pay for Silver Sneakers. Members of Silver Sneakers have access to thousands of gyms, community centers, and other participating fitness location across the nation. As a member you can take classes designed for seniors of all fitness levels led by trained instructors. In addition, you have access to on-demand video library of classes and workouts. You can even download the SilverSneakers GO app to get your digital membership card and workouts. The app is free and available on IOS and Android devices. Most important, Silver Sneakers is a place for seniors to find a friendly, supportive community in person and online.

Why Join Silver Sneakers?

Silver Sneakers helps you stay strong in body, mind, and spirit. Regular physical activity keeps your heart, brain, bones, muscles, and joints healthy. For instance, if you have a chronic condition like arthritis, diabetes, or osteoporosis, safe exercise can help you feel better. In addition, staying social in the Silver Sneakers community is vital to your good health.

Silver Sneakers Program

The Silver Sneakers program includes a basic membership at any participating gym. Facilities and amenities vary by location, however, many Medicare Silver Sneaker gyms include the following:

  • Cardio equipment, including treadmills and ellipticals
  • Strength training equipment, such as weights and strength machines
  • Amenities, such as pools and walking tracks

Unlike other senior gym memberships, you can go to all fitness locations in the Silver Sneakers network. You can visit over 17,0000 Medicare Silver Sneaker locations across the United States.

Silver Sneaker program includes many types of exercise classes. You will find a variety of fun exercises classes designed for seniors of all fitness levels. Classes vary by location, but you will often find the following:

Silver Sneakers Program
  • Cardio and strength classes, which often include a chair for support
  • Water aerobics classesChair and standing yoga classes
  • Tai Chi, boot camp, and many other classes!

The instructors who lead Silver Sneaker classes are friendly and supportive. If you are new to a class, the instructor can help you learn how to do exercises safely. Furthermore, if you have limited mobility, instructors can adapt exercises for your needs.

Do you want to try something different from traditional gyms? You might like to try Silver Sneakers FLEX classes. The Silver Sneakers program offers more than 70 kinds of classes through its FLEX network. You can visit many different locations such as churches, community centers, or recreation centers. Some FLEX classes meet outdoors and many FLEX class sizes are smaller than gym classes.

Where to Find Silver Sneakers Locations and Classes?

You can find a Silver Sneakers locations and classes near you using the locator tool. You can go to any participating location or class you want in the Silver Sneakers network. For example, you can use weights in one location, go swimming at another location, and take a Silver Sneakers or FLEX class at a third location.

Medicare Plans with Silver Sneakers

You can find Silver Sneakers with Medicare Supplement Plans or Medicare Advantage Plans. However, you are less likely to find Silver Sneakers included in a Medicare Supplement Plans. A few of the Medicare insurance companies that may offer you Silver Sneakers Medigap Plans include:

  • AARP
  • Bankers Life aka Colonial Penn Life Insurance
  • Blue Cross Blue Shield

Depending on your location, Medicare plans with Silver Sneakers may be covered by Medicare Supplement Plan F or Plan G. However, more insurance companies offer Silver Sneakers with Medicare Advantage Plans including:

  • Aetna
  • Blue Cross Blue Shield
  • Humana
  • Mutual of Ohama
  • UnitedHealthcare
  • Well Care

You are more likely to find a Medicare Advantage Plan with Silver Sneakers than a Medicare Supplement Plan.

Silver sneakers enrollment

During Medicare Open Enrollment Period, you can switch to a Medicare Advantage Plan with Silver Sneakers between January 1 and March 31. To switch your Medicare Advantage Plan, you must be in a Medicare Advantage Plan now. Otherwise, you will need to wait until Annual Enrollment October 15 thru December 7. However, if you have Medicare Supplement Plan, you can shop a new Medigap Plan with Silver Sneakers anytime all year long. You can speak with a licensed agent about switching your Medicare Advantage Plan or Medicare Supplement Plan at Senior Healthcare Direct 1-855-368-4717. Otherwise, you can click the get quote button below.

medicare plans silver sneakers

Common Questions About silver sneakers

Does Medicare Cover Silver Sneakers?

Silver Sneakers is covered by many Medicare plans. For example, Silver Sneakers is covered by many Medicare Advantage Plans and Medicare Supplement Plans.

Does traditional Medicare cover Silver Sneakers?

Unfortunately, Original Medicare Part A and Part B does not offer or include Silver Sneakers.

Is Silver Sneakers available to anyone on Medicare?

To be eligible for Silver Sneakers you must be 65 years or older. Some people qualify for Medicare because of disability and are younger than 65.

Does Medicare Pay for Silver Sneakers?

If your Medicare Supplement Plan or Medicare Advantage Plan includes Silver Sneakers, then Medicare pays for Silver Sneakers.