Generally, you're able to sign up to a Medigap policy regardless of your health within six months of enrolling in Medicare Part B. If you don't sign up within this period, an insurer can deny your Medigap application based on your health condition.
However, I was browsing New York's Department of Financial Services website and I came across the following statement.
"New York State law and regulation require that any insurer writing Medigap insurance must accept a Medicare enrollee's application for coverage at any time throughout the year. Insurers may not deny the applicant a Medigap policy or make any premium rate distinctions because of health status, claims experience, medical condition or whether the applicant is receiving health care services."
Does this mean that New York residents can apply for any Medigap policy at any point in time without medical underwriting form the insurer?
Has anyone successfully signed up themselves or their parents to a Medigap plan beyond the initial six month period after Medicare Part B without a medical test or a denial based on health?
We have BCBSM Medigap C; a plastic card with group, enrollee ID, etc. info is issued. We show providers both the Medicare card and the Medigap card. If you don't provide the Medigap card, you'll be billed for what Medicare doesn't pay. Even if you do, there are some doctors and hospitals that forget to bill your Medigap insurance, so you have to monitor the Explanation of Benefit statements you get.
Medical providers bill the primary (Medicare) and Medigap directly. Medicare pays according to the formulae developed, and quarterly sends an EOB indicating the amount billed, amount Medicare allowed, provider, claim no., type of service and more.
BCBSM Medigap bills more frequently so I usually get the EOBs more quickly than the Medicare ones. They reflect what BCBSM pays, which is the 20% not covered by Medicare after it pays 80% of its approved amount.
I've never had to forward any bills directly to BCBSM for Medigap payment, but I have had to call providers and ask why THEY didn't bill BCBSM instead of sending us a bill. Sometimes they goof up and need a little bit of guidance.
Make sense?
It would not surprise me if NY law is similar if not the same given both are very "progressive" states.
Medigap policies are regulated by each individual state so maybe some states provide ratings. More important, no matter which company sells the Medigap policy all policies with letter F in your state are the same, all policies with letter G are the same, and so forth (and they all have to follow Federal guidelines for that type of policy). Only the prices differ. (Still if I were you I'd stick with a name you know.)
How are the claims and bills from the doctor handled? For instance, are they sent to Medicare first and then once Medicare figures out what you owe, they'll send you a bill to forward to the Medigap insurer?
I must have given you the wrong impression of Medigap billing. Really, all you do is present your Medicare and Medigap cards to providers. That's it. The coding and billing is handled by the provider.
It would become a little bit of work for you when one of the providers goofs up and doesn't bill Medigap, but that's really the only complication I've experienced.
There were a few incidences when Medicare was fraudulently billed, and that was extended to Medigap, so I wrote a letter to both advising them the charges were not legitimate. It's up to them to investigate from there.
Sorry if my answer was confusing.
BTW, I should mention that the Michigan BCBS is doubling its rates around the end of the year, and will be making changes in its coverage. Given the way they're addressing the issue (providing advance information, scheduling personal phone calls to answer questions, etc.), I suspect there will be some unwanted changes.