Aug 06, 2015
By Rick Law, Medicaid crisis planner, Estate and Elder Law attorney at the Estate Planning Center at Law Elder Law. Senior Advocates in Western Chicagoland in Illinois.
Medicare supplement insurance fills the “gaps” between Medicare benefits and what a person must pay out-of-pocket for deductibles, coinsurance, and copayments. Medigap policies are sold by private insurance companies that are typically licensed and regulated by their state Department of Insurance.
These policies only pay for services that Medicare deems as medically necessary, and payments are generally based on the Medicare-approved charge. Some plans offer benefits that Medicare does not, such as emergency care while in a foreign country.
In Illinois, all policies sold after June 1, 2010, must offer hospice coverage; while preventive services and in-home recovery benefits are no longer sold.
Illinois requires Medigap companies to sell a person a policy—even if that person has health problems—provided that the person is at least 65 and applies within six months after enrolling in Medicare Part B, or is turning 65 and have been on Medicare due to disability previously.
During this open enrollment period, a company must allow a person to buy any of the Medigap plans it offers. A person can use the open enrollment rights more than once during this six-month period. Lawyers should investigate which policies are offered within their jurisdiction.
For example, people may change their minds about a policy they bought, cancel it, and buy any other Medigap policy within six months of enrolling in Medicare Part B. Although a company must sell a policy during the open enrollment period, it may require a waiting period of up to six months before covering any preexisting conditions unless a person has had other health coverage (“creditable coverage”) for at least six months on the day of applying.
Preexisting conditions are conditions for which a person received treatment or medical advice from a physician within the previous six months. An individual’s right to open enrollment is absolute beginning with enrollment for Medicare Part B, even if a person waits for several years after becoming 65 to enroll in Medicare Part B because of continued employment or other reasons.
Illinois residents under age 65 who receive Medicare because of disabilities have the same open enrollment rights as seniors. A person under 65 who qualifies for Medicare because of disabilities and who applies for a Medigap policy within six months after enrolling in Medicare Part B has a six-month open enrollment period beginning the day of enrollment in Medicare Part B.
Individuals can typically return their Illinois Medigap policy within 30 days after receiving it and get a full refund with no questions asked.
Too many families needlessly lose everything they have. Don’t let that be you. If you need help paying the overwhelming cost of long term care, give our office a call at 800-310-3100. Your first consultation is absolutely free. We’ll let you know what steps you need to take, right now, to protect yourself and your family. Call now, because when you’re out of money, you’re out of options!
Rick L. Law, Attorney, Estate Planner for Retirees.
Rick was named the #1 Illinois elder law estate planning attorney by Leading Lawyer Magazine. He has been quoted in the Wall Street Journal, AARP Magazine, TheStreet.com, and numerous newspapers and articles. Rick is the lead attorney for Law Elder Law, LLP, focusing in Estate Planning, Guardianship, and Nursing Home Solutions. His goal is to give retirees an informed edge when it comes to dealing with an uncertain future. Get flexible retirement strategies that work during good times and bad, plus information on how you can save your home and assets from being used to pay for long term care. Call 800-310-3100 for your free consultation now!
My wife and I had our first child three years ago. That’s when we decided to set up a trust, should anything happen to either of us. We reached out to Zach Hesselbaum to help us out. He was very thorough and professional throughout the whole process. Zach went above and beyond to make sure that we understood every detail of setting it up and he did an excellent job. We recently had our second child a few months ago. With the new baby, he helped us make the necessary revisions to the trust. Zach made this process great for us! I would definitely recommend using him for any of your estate planning needs!
Tom G., Naperville, IL