I’m a Senior Citizen and I Think I’m Losing My Health Insurance Coverage. What Should I Do?

A lot of senior citizens lose their health insurance coverage when the company they’re working for stops offering them insurance, terminated them from their retiree plan or they have moved away to a different state. For many seniors, the unanticipated out-of-pocket expenses could prove to be a tremendous financial hardship. It's always wise to have health insurance.

What should you do next? There are multiple options available for you and your situation. It is very important to know your rights to ensure you make the most out of shifting to Medicare and getting a Medicare Supplemental Insurance Policy that you need. You might be able to qualify for a "Guaranteed Issue Medicare Supplement" which gives you the right to purchase a Medicare Supplemental Insurance plan. It is a good idea to talk to our expert health insurance specialists at (855) 230-0801 to further understand your options since there can be other reasons you may be losing coverage.

Losing Your Retirement Benefits or Health Insurance Plan

There are various reasons that cause a number of senior citizens to lose their health insurance coverage. It might be that the company they’re working for stops offering them insurance, terminated them from their retiree plan or they themselves have moved away to a different state that doesn’t offer the same insurance coverage. That could be quite devastating to find out all of a sudden.

Insurance coverage is important to ensure that you are able to get the medical care you need when you need it. The costs of medical services are rising drastically every year, thus it is quite crucial to have an adequate and comprehensive coverage that suits your needs. This said, it is actually possible to lose your Medicare coverage leaving you to pay your medical bills out of your own pocket.

If you are enrolled in Original Medicare, Part A (hospital insurance) and Part B (medical insurance), you can lose your coverage if you do not make your premium payments. When this happen you will be receiving a couple of warning notices in your mail. After your usual payment notice you’ll be receiving a Second Notice indicating a due date for you to pay your premiums. After your due date has elapsed, you will then be receiving a Delinquent Notice and will have until the 25th of the month after you received it to settle your accountability. If you still fail to make a payment, your Medicare coverage will be terminated and your will cease to receive benefits.

If you have limited income or resources you might have a hard time paying for a monthly Medicare premium or even afford one. Medicare has programs suited for enrollees with limited income and resources. One of these programs, the Medicare Savings Program, is designed to assist eligible Medicare beneficiaries with payment of their Medicare premiums and, in some instances, Part A and Part B co-payments and coinsurance. To learn more, you may contact your State Health Insurance Assistance Program (SHIP).

Another reason for losing your Medicare coverage will be if you lose your eligibility in receiving Medicare. This can happen in the event that you’re younger than 65 and availed a Medicare coverage due to a medical condition or a disability. You may lose your Medicare coverage in case you no longer have a medical disability that qualifies you to receive Medicare coverage.

When you’re on the risk or even on the cusp of losing your retirement benefits, you might find yourself at loss on what to do. If you want to know your options or looking to sign up with a new plan we can help you with that.

In a lot of cases, seniors looking for health insurance coverage after they retire is due to the fact that that they have lost their retirement benefits and are in dire need of one. This, however, can be difficult if you do not know exactly what you are looking for, or where to start.

If you or spouse worked and paid your Medicare taxes for less than 40 quarters you have to pay a monthly premium in order to avail your Medicare Part A (Hospital Insurance) since you wouldn’t be having a premium-free Part A. Once you become eligible in Medicare Part A and Part B, it is better to enroll than to face late enrollment penalty on top of your premiums. If you don’t sign up for to a health insurance even though you can afford one, you could be facing penalties called individual shared responsibility payment. This also means you wouldn’t be having any health insurance coverage.

When you failed to pay your monthly Medicare premiums even after receiving your all the notices, your Medicare healthcare insurance is terminated. You can re-enroll on the next Enrollment Period but you will have to face a penalty. Whatever amount for your premiums you haven’t paid before needs to be settled first before you can re-enroll. Additional information regarding this is available at www.medicare.gov/ or 1-800-MEDICARE.

If you lose your coverage due to quitting your job, losing your job, your company goes bankrupt, or your employer ceased on giving you retirement benefits Health Insurance Portability and Accountability Act (HIPAA), Consolidated Omnibus Budget Reconciliation Act (COBRA), and the Affordable Care Act (ACA) all provide ways to continue your coverage. Employee Retirement Income Security Act of 1974 or ERISA can help with the funds you already placed or paid for your insurance while you were working. For more information regarding this, you can contact Employee Benefits Security Administration at askebsa.dol.gov or toll-free number 1-866-444-3272.

You might also be qualified for a Guaranteed Issue Medicare Supplement depending on your situation. Having guaranteed-issue rights enables you to have a Medicare Supplement policy, also known as Medigap, without denying you coverage and charging you more even though you have pre-existing or current health conditions.

If you would like to learn more about the options that are available to you in regards to your situation please contact us at (855) 230-0801.

Losing Your Medicare Advantage Plan

Medicare Advantage plans are offered by private companies in alternative to original Medicare Part A & Part B. If you are enrolled in a Medicare Advantage plan or a Medicare Advantage Prescription Drug plan, you may lose your coverage if you fail to pay your plan’s premium or your Medicare Part B premium. As they are provided by private companies, they can set their own rules regarding late payment and non payment penalties.

You may lose your Medicare Advantage coverage if you move outside the plan’s service area like when you are transferring to another state and such. Medicare Advantage will send you a notice regarding the status of your eligibility following your move. You will then be qualified for a Special Election Period, which allows you to select a new Medicare Advantage plan or return to Original Medicare (Part A and Part B) coverage and possibly select a stand-alone Medicare Part D Prescription Drug Plan outside regular enrollment period due to your special circumstance.

If you’re enrolled under a Special Needs Plan from Medicare Advantage, there are several eligibility requirements that you must pass on top of the general requirement for a normal Medicare Advantage coverage plan eligibility. You stay enrolled in the Special Needs Plan as long as you continue to meet the special conditions for your eligibility, otherwise, you lose your Special Needs Plan. You will be given a Special Enrollment Period to avail a different Medicare Advantage Plan or return to the original Medicare.

A lot of people don’t actually know that a Medicare Advantage Plan isn’t a Medicare supplement but in fact a replacement of Medicare coverage itself. If you are losing your Medicare Advantage Plan and want a different health insurance policy or want to change back to original Medicare and then get a supplemental health policy for a full comprehensive coverage, we at National Insurance USA Group can definitely help you with that.

In case your coverage through Medicare Advantage Plan gets terminated at no fault of yours, you may warrant a guaranteed issue period to avail Medicare Supplement Policy (Medigap) without denying you coverage and charging you more even though you have pre-existing or current health conditions.

Losing Your Medicare Supplement Insurance

Your Medicare Supplement Insurance Policy is guaranteed renewable as long as you purchased one on and after 1992.

A Medicare Supplement Insurance policy, also known as Medigap, helps fill in the “gaps” left by original Medicare. This means that Medigap offers you a more comprehensive coverage than having original Medicare alone. Depending on your Medigap policy, if you add Medicare Part D (Prescription Drugs) to your supplement, then you’ll likely find yourself with a very comprehensive coverage.

There are only very few circumstances where you may find a cessation of your Medicare Supplement, Medigap, coverage. This include your failure to pay your plan’s monthly premiums, your untruthfulness in the statements you made in the Medigap policy application, or in the off-chance that insurance company becomes bankrupt or insolvent.

If you transfer to another state, you can likewise keep your Medigap policy though it is better to compare rates at your new location in order to get the best deal. There are times that another company might have the lowest price in your new state for your policy.

Be sure to remember to inform Social Security on your change of address since they are the ones handles Medicare enrollment. You can contact them through their website at www.ssa.gov or by calling 1-800-772-1213 (TTY users 1-800-325-0778) and speak to one of their representatives from Monday through Friday, from 7AM to 7PM. You can also visit the Social Security office nearest you.

Same goes if you receive your retirement or disability benefits from the Railroad Retirement Board (RRB), notify them either through their website or by calling 1-877-772-5772 (TTY users call 1-312-751-4701) Monday through Friday, 9AM to 3:30PM.

For more information regarding losing your Medicare Supplement Insurance policy coverage and your possible options you can call our toll free hotline (855) 230-0801.


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