Skip to main content

Be in "the know" about Medicare

Facts about Medicare reform

It can be hard to tell what’s fact or fiction, particularly when it comes to complex subjects like Medicare. As a consumer, though, knowing the facts can go a long way in helping you get the most from your coverage.

The Medicare Access CHIP Reauthorization Act of 2015 (MACRA) External Site is no exception. As part of the law, people who are first eligible for Medicare after Jan. 1, 2020, are no longer able to enroll in a Medicare supplement plan that covers the costs of the Original Medicare Part B (medical coverage) deductible — no matter the carrier. Since the law has passed, there has been some confusion about what it means for Medicare supplement Plan F.

Let’s decipher fact from fiction:

Myth 1: In 2020, Plan F will go away.

Fact: Plan F availability depends on your Medicare eligibility date.

  • If you are currently enrolled in Plan F, you can keep your coverage. No action is required.
  • If you are first eligible for Medicare before Jan. 1, 2020, Plan F will be available.
  • If you are not first eligible for Medicare before Jan. 1, 2020, Plan F will not be available.

Myth 2: I became Medicare eligible when I was 42 years old due to a disability. Now when I reach age 65, Plan F won't be available.

Fact: If you were first eligible for Medicare due to a disability before Jan. 1, 2020, you have a second opportunity to choose any Medicare supplement plan — including Plan F — without answering health questions. You must apply no later than six months after the first of the month in which you turn 65. Enrollment outside this period will require you to answer health questions unless you qualify for some other guaranteed issue right.

Myth 3: In 2020 when Plan F goes away, I’ll be stuck on Plan F and rates will skyrocket.

Fact: If you are first eligible for Medicare before Jan. 1, 2020, Plan F will be available. So, if you are currently enrolled in Plan F, you can keep your coverage. Wellmark Blue Cross and Blue Shield has a history of stable Medicare supplement rates year after year and doesn’t anticipate rates for Plan F increasing due to MACRA. But, if you are thinking of moving to a different Wellmark MedicareBlue Supplement plan, know that you may have to answer health questions.

Myth 4: There is no difference between Medicare Supplement Plan F and Plan G.

Fact: Plan F covers the Medicare Part B deductible, while Plan G does not. This is one of the main elements of MACRA.

Myth 5: I have High Deductible Plan F, but effective Jan. 1, 2020, it won’t be available.

Fact: If you are currently enrolled in High Deductible Plan F, you can keep your coverage. Additionally, Wellmark members enrolled in High Deductible Plan F for 12 consecutive months will be allowed to move to Plan F during the Annual Enrollment Period (AEP) from Oct. 15–Dec. 7 for coverage to be effective Jan. 1. If you move from High Deductible Plan F to Plan F outside the AEP, you are required to answer health questions on the application.

The bottom line

MACRA does not affect Plan F for Wellmark members who are enrolled before 2020 or members who have group retiree benefits. The laws are always subject to change, so please visit External Site for the most up-to-date information.

A guaranteed issue right happens due to specific events, like situations that cause you to lose your current coverage. During this period, certain Medicare supplement plans are required by law to be offered to you, and you can’t be denied coverage on the basis of health history, age or other factors. To find out if you qualify for a guaranteed issue right, visit Medicare's website External Site.