TONI KING: Medicare coverage and supplement plans

Dear Toni,

I am a 68-year-old exhausted and overwhelmed high school principal who retired from teaching when I turned 65. I am trying to understand the changes to my TRS-Care 3 plan. My wife turns 65 in January and enrolled in Medicare. I am concerned with the new changes which are happening to the TRS-Care plan since she is also included in Medicare.

I want to leave the TRS system because I only want Original Medicare with a Medicare Supplement Plan. I have a liver condition that requires a liver transplant soon.

Please explain what I need to do to get Medicare Supplement coverage for both me and my wife? I talked with an independent insurance agent who told me that I now must answer health questions and will not qualify for a Medicare Supplement because of my health conditions.

Thanks, Bob from Lubbock

Hello, Bob:

Every day at the Toni Says office, we help confused Americans understand what their proper Medicare options are, especially when there are a serious health issues such as yours.

You are applying for a Medicare Supplement will be a completely different experience than your wife's Medicare enrollment because she is new to Medicare.

Your wife is in her "Medigap Open Enrollment Period" which is explained in the Medicare & You Handbook. The handbook states, "The best time to buy a Medigap policy is during your Medigap Open Enrollment Period. This 6-month period begins on the first day of the month in which you're 65 or older and enrolled in Part B. During this period, an insurance company can't use medical underwriting."

Your wife will not have any problems enrolling and being accepted by an insurance company with any Medicare Supplement/Medigap plan.

Bob, your Medicare saving grace is a little different because you are leaving a group benefit plan, which TRS-Care 2 and 3 are, and have special rights available to you.

Your special right is that you were included in a group Medicare health plan and can receive a 63-day guaranteed issue period for applying for a Medicare Supplement/Medigap plan. Keep your company benefit termination letter to show the Medicare Supplement insurance company that you are in a guaranteed issue period. There are special Medicare Guarantee rules which you must abide by.

With guaranteed issue an insurance company must:

Sell you a Medigap/Medicare Supplement policy. "You have the right to buy Medigap/Medicare Supplement Plan A, B, C, F, K or L that's sold in your state by any insurance company, as stated in the 2017 choosing a Medigap Policy by Medicare.

Cover all your pre-existing health conditions.

Cannot charge you more for a Medigap/Medicare Supplement policy, regardless of past or present health problems, as stated in the 2017 Choosing a Medigap Policy by Medicare.

Both you and your wife can apply for a Medicare Supplement and qualify as long as you follow the rules. Your wife can apply during her Medicare Open enrollment period. Bob, you can apply during your Medicare Guarantee Open enrollment period and apply for certain Medicare Supplement plans.

Contact the Toni Says Medicare Call Center at 844-250-8664 or email Toni at info@tonisays.com regarding this information. Confused about Medicare and TRS Medicare webinars are now available online at www.tonisays.com for those who cannot attend a local workshop.

Final Confused about Medicare Workshops for 2017: Oct. 19, Copperfield Church, 6-8 p.m. 8350 Texas 6, Houston, TX 77095. RSVP:832-519-8664.