Originally Posted by Bob368
I'm on social security disability and have been on high risk health insurance for 10 months. I also receive medicare A and B. I received a letter from my health insurance that my policy was going to be canceled because medicare provided a part D that covers medications, and that i needed to apply for it.
I think their just trying to get rid of me. I'll give you some insight:
My insurance premium per month is $670.00 and my medications are $3000.00 per month. My co-pays total for all meds are $90.00. So you can see way i think their just trying to cancel my policy for no legal reason.
My question is Can They Do This?
Please give me some information, opinions, answers!
Bob
This reply is a little late, sorry... I just saw it today. Please be careful of jumping at advice to join a Medicare Advantage Plan.... I am saying this and I sell them.
The other agent's reply that it is illegal for an insurance company to drop you is true. They can't... but they can try to get around the law either by convincing you to switch by some unsavory tactics such as the one you report, or by dropping the policy for that particular coverage even if it means everyone on that policy. They count the cost to the company... it's all in the math. Usually the latter tactic is used in cases where there are not many subscribers... Google "Ian's Law"...
Do the math. How much will you be at risk with the
MA plan? Check the Max Out of Pocket (MOOP) limit for hospital and medical expenses. If it is high, in your case over $8000, you may end up at risk more than with your current policy, (not including Rx). Look around for other
MAPD plans and examine the MOOP. It is more important than the monthly premium.
Make sure the
MA plan includes drugs... specifically an
MA-PD. With Medicare's Part D limits, which are in the
MA-PD plan, you will still pay $4550 out of pocket (True OOP which excludes the premiums) in drugs, (
not including hospital and medical) before you qualify for Catastrophic coverage which is 5% co-pay. So... An
MA plan will expose you to the MOOP + $4550 annually approximately. The Rx limit resets Jan 1 each year, so now is not a good time to enroll for 2009, assuming you qualify for an Special Enrollment Period (SEP). Enroll on or after Nov 15th, and get a Jan 1st effective date to minimize your expenses from switching coverage.
If the math works for you, just remember, if you voluntarily leave your current policy, you will most likely never get it back. And you obviously will not qualify for a Medicare Supplement unless you can get a Guaranteed Issue exception... and keep in mind some states do not provide Medicare Supplements for under 65. If your state allows Med Sups to under 65, this opportunity MIGHT be triggered if your current company terminates you and gives you a letter saying that their action qualifies you for a Special Election Period (GI). Given the choice with your comments, I would give them serious consideration. Pick a Med Sup plan that covers the benefits you think you will need the most, and also a Part D Prescription Drug plan (PDP). Med Sups have NO co-pays, but you pay a hefty monthly premium compared to
MA plans, but much less than your High Risk policy in most cases. Add the costs of both premiums... the Med Sup and the PDP.
There are NO medical requirements for a
MA or
MAPD plan other than you can't have ESRD. That is a good safety net, but think of it as a last resort until you do the math.
Above all, get a licensed and certified agent to do a thorough needs analysis for you. Produce your copy of your current health plan and have him tally the annual costs under that plan and compare it to anything else he recommends. Ask him if he is fluent with High Risk plans, (also called Impaired Risk). This will be helpful to evaluate your plan correctly. You, yourself, should study your policy very carefully. I know this is work, but it is extremely important that you know what you are giving up. Never leave a lifeboat for a floating stick. Remember: if you return to health after rehabilitation, if it is possible, you will lose your disability standing and therefore Medicare A & B and subsequently any
MA or Med Sup plan. This may be a moot point if your disability is permanent.
Can High Risk Insurance Co. Cancel Your Policy
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