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Losing individual insurance coverage
May 30, 2012

I am losing my BCBS of FL coverage paid by FL Aids Insurance Continuation Program as of 6/30/2012 because I have Medicare A, B & D. I called several Medigap providers and was told I cannot purchase their plans because of my HIV/AIDS pre-existing condition. I have not had a greater than 62 day lapse in coverage --how can they get away with this? Ryan White in Area 12 of FL will no longer pay co-pays under $9 per medication as of May 1, 2012. My co-pays are $100 with extra-help. They will now only cover my mental health provider co-pays and cover me under ADAP during the donut hole which I fill in one month. Living on SSDI, these expenses will make me avoid healthcare and cause me to choose between groceries or medication co-pays. What is going on with Ryan White funding cutbacks? Is this on a national level or is this something local to my service area?

Response from Mr. Chambers

Every state is having to deal with reduced funding and each state tries to accommodate it differently, and, unfortunately someone always suffers when funds are cut (assuming you're in the 99% with most of us).

Moving from individual health coverage to a Medigap plan (Medicare Supplement) does not come under the Portability portion of HIPAA. Florida does provide a six month guarantee issue period that requires Medigap plans to accept anyone, regardless of medical condition, as long as they apply within the first six months they are covered under Parts A and B of Medicare.

At open enrollment at the end of this year, you may want to see if any Medicare Advantage HMOs or PPOs of sufficient quality are available in Florida. You can find that information at www.medicare.gov. If you find one of those that fits your needs, you won't have a need for a Medigap plan, and you can enroll in it during the 2012 Open Enrollment period for a January, 2013 effective date.

Good luck, Jacques

www.medicare.gov



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