OSHIIP can help Ohioans understand plan choices 

 COLUMBUS — Ohio Department of Insurance Director Mary Jo Hudson is reminding Ohioans soon approaching or currently on Medicare that recent law changes to “modernize” Medicare supplemental insurance became effective June 1, 2010. The changes include the adjustment of some of the plan benefits, the addition of new plans and a reduction of choices from 14 to 11.

Also referred to as Medigap and MedSup, the coverage is sold by private insurance companies to help Medicare beneficiaries pay the coinsurance, copayments, or deductible amounts not covered by Original Medicare. The policies are “standardized” and the plans are sold as the same identical letters by each company. Monthly premiums vary from plan to plan and from company to company. Generally, you must be 65 or older when you buy a Medigap policy and have Medicare Part A (hospital insurance) and Part B (medical insurance).

“The intent of the Medigap modernization was to eliminate outdated and underutilized benefits and create more cost-effective premiums for policyholders,” Director Hudson said. “I urge anyone with questions about their Medigap coverage and plan options to call the Department’s Ohio Senior Health Insurance Information Program (OSHIIP) toll-free hotline at 1-800-686-1578.”

The Department is also advising Ohioans to watch for unethical conduct by sales representatives marketing Medigap plans. It’s illegal for an agent to pressure you into buying a Medigap policy, or lie to or mislead you to switch from one company or policy to another. Report any such behavior by calling the Department’s fraud hotline at .

Medigap Changes:

• Plans No Longer for Sale – Plans E, H, I, and J will no longer be sold after May 31, 2010. But, if you already have or you buy Plan E, H, I, or J before June 1, 2010, you can keep that plan.
• Requirements – Insurance companies selling Medigap policies are required to make Plan A available. If they offer any other Medigap plan, they must also offer either Medigap Plan C or Plan F.
• New Plans Offered – Plans M and N are new choices. In addition, benefits for Plans A, B, C, D, F, and G will change.
• Plans D and G – Plans D and G effective on or after June 1, 2010 have different benefits than D or G Plans bought before June 1, 2010.
• Basic Benefits – Hospice Part A coinsurance (outpatient prescription drug and inpatient respite care coinsurance) will be covered.
• Part B Coinsurance – Plans K, L, and N will require you to pay a portion of Part B coinsurance or copayments, which may result in lower premiums for these plans. All other Medigap policies pay them at 100%.

Consumer Tips:

• Call OSHIIP at 1-800-686-1578 with questions about the new Medigap plans and for help determining the plan best suited for your needs.
• The Centers for Medicare and Medicaid Services (CMS) have mailed letters about the changes to people with Medicare. 
• Those already enrolled in a plan that changed on June 1^st are permitted to stay with their current coverage. Premiums may increase in the future.
• Some situations may require you to wait six-months until pre-existing medical conditions are covered.
• To find and review the credentials of a licensed insurance agent, visit the agent locator tool on the Department’s website at .
• Shop carefully. Compare available Medigap policies to see which one meets your needs.
• If you decide to change your plan or the monthly premium no longer fits you budget, you can apply for a new plan at anytime. You may be asked health questions to determine whether the new company will offer you coverage.  Do not cancel your current coverage before your new coverage is in place.  Then give your current insurance company a 30-day notice of your intent to cancel your policy. Be mindful that a waiting period for a pre-existing condition may apply with your new coverage.
• It’s important to ask how the company prices it policies. Generally, companies will use one of three pricing approaches, (1) the community-rated (the same monthly premium is charged to everyone), (2) issue-age-rated (the premium is based on the age you are when you buy the policy), or (3) attained-age-rated (the premiums is based on your current age, thereby increasing as you age).