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Tom Schrette and Alan Cash

Tom Schrette and Alan Cash

J.L. Sousa

Dear Tom and Alan:

Uh oh. I hear Anthem is leaving California. Really! Actually, I read it in your column. I have an Anthem Medicare Supplement Plan F.

What do I do now?

Alarmed

Tom: Thanks for reading the column. There are two very important parts of the Anthem news:

1. It does not affect Anthem Blue Cross Medicare Supplement plans.

2. It does not affect Anthem large or small group products.

Those are all safe. Whether purchased direct or through the Covered California health insurance exchange, the individual under 65 plans are the ones leaving most of the state.

If bought through Covered California, the Exchange tells us the subscriber will be automatically “migrated” to the least expensive plan in the same tier, i.e., bronze, silver, gold or platinum, and the same type, i.e., HMO, PPO, EPO, etc.

The new plan would go into effect as of Jan. 1, 2018.

If they go by the tier, the least expensive would be the Blue Shield Silver PPO; if by the type, it would be the Health Net Silver EPO.

Here’s the refresher: PPO = Preferred Provider Organization; EPO = Exclusive Provider Organization; HMO = Health Maintenance Organization. Beginning Nov. 1, anyone can apply for anything and will be accepted for a Jan. 1, 2018 effective date.

Al: Now, back to our reader’s situation. She is in a very good place with her Medicare combined with a Plan F supplement:

1. Anthem Blue Cross will almost certainly not leave the Medicare market.

2. Her current plan covers the annual Part B deductible of $183, as well as the hospital deductible of $1,316.

3. She even has a foreign travel benefit not covered by Medicare.

4. If some other company offers Plan F at a better price, she can switch, guaranteed, each year during her birth month.

Tom: However, since all good things must come to an end, Plan F will not be available to new subscribers beginning Jan. 1, 2020.

Congress passed legislation saying Medigap plans will not be able to offer coverage of the Medicare Part B deductible (currently $183).

According to the website ElderLawAnswers:

“The reasoning behind making Medicare beneficiaries pay the deductible themselves is that it will cause them to think twice before going to a doctor and perhaps costing the Medicare system unnecessary money.”

Al: For most people, Medicare Part A (hospital) doesn’t cost anything, while Medicare Part B (doctors) does have a monthly premium. Right now the “standard” Part B premium is $134.

Many of those new to Medicare are not yet collecting Social Security benefits, so they receive a quarterly bill to cover Part B. Once they begin Social Security benefits, the average of $109 per month is automatically deducted.

But…not so fast! Those making too much money will pay more. For example, an individual earning above $214,000 will pay $428.60 instead of $134.

Submit questions at schrette@gmail.com or alancash@gmail.com.

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