Enrolling in Medicare

[Ms. Toad]

38. Yes, they do.

They can't diminish what is offered in a supplement plan, but they can put restrictions on insurance companies and providers, as long as they don't contradict federal law. Federal law allows rejection or price increases based on health at the time if late enrollment - It doesn't require them. It also allows, but doesn't require, non-participating providers to charge 15% above Medicare rates.

Illinois, for example, offers at least one MA plan which can be converted at a later date to a supplemental plan (guaranteed, no price increase). That is mandated by state law.

Some states permit rejection based on health - others prohibit it, and others govern whether (and how much) the insurer can increase prices for late enrollment.

The surcharge in some states changes the value of some of the plans, based on restrictions on non-participating providers. Medicare allows non-participating providers to charge 15% more than the Medicare rate. The best supplement plan covers that - but the second best doesn't (so if you go to a non-participating provider you may have to pay 15% on top of the 20% not covered by Medicare. Ohio prohibits this supplemental charge - so my father, who is unlikely to get treatment outside of Ohio doesn't need the best plan. Texas - allows it. I may week need treatment in Texas - one of the reasons I opted to pay a bit more for the top plan, rather than the one my father had.