Medicare Answers: Med Supp Health Questions and Part D Penalties

  • Originally published October 15, 2013 , last updated December 23, 2014
  • Medicare
Medicare Answers: Med Supp Health Questions and Part D Penalties

This week’s Medicare Answers deals with two questions. The first involves Medicare Supplement coverage after a hospital stay and the other deals with prescription drug coverage penalties. If you have a Medicare question you’d like answered, email AskRoger@SeniorMarketSales.com.

Emmett asks:

I am 76 years old. If I stay in an advantage plan and go into a hospital in 2014 and then in 2015 I decide to go to a supplement plan, can the plan ask me health questions such as; have I been in a hospital or do I smoke, etc. and then refuse me coverage?

Thanks,

Emmett

This particular question came in from a consumer. Emmett, the fact that you were in the hospital would not affect your ability to qualify for Medicare Supplement coverage, but the reason you were admitted might. Also, the circumstances of etc. would affect your insurability. If in fact, your pre-existing conditions would allow you to return to a Medicare Supplement, the company would charge you a tobacco user rate. If you are in your Trial Right period, meaning you are within 12 months of taking a Medicare Advantage for the first time, you would be able to return to your Medicare Supplement that you had previously.

Tom asks:

I have a client who has just turned 65 and has decided to purchase a Medigap Plan F and not to purchase a Part D. I have told him that if he enrolls in a Part D plan in the future, the LEP will be added to his monthly Part D premium for as long as he has a Medicare Part D plan.

What if this person keeps his Plan F for 5 years and then decides to enroll in an MA-PD. Will he completely avoid the LEP since he now has prescription drug coverage as part of his MA-PD?

Thanks for your help on this one.

Tom,

The Part D penalty applies whether you enroll in a stand-alone PDP or an MA-PD. Tell your plan about any drug coverage you had if they ask about it. When you join a Medicare drug plan, the plan will send you a letter if it believes you went 63 or more days in a row without other creditable prescription drug coverage. The letter will include a form asking about any drug coverage you had. Complete the form and return it to your drug plan by the deadline in the letter. If you don't tell the plan about your creditable drug coverage, you may have to pay a penalty.