2008 MAPD Plan Still Deducting Premiums

Jan 6, 2009

  1. insurance0707
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    insurance0707 Guru

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    In all of our training and certifications it stated that you can only be enrolled in one Prescription drug plan at a time. If you enroll someone in a PDP plan that had a MAPD plan, it's going to automatically disenroll them from the MAPD plan. Of course, I'm getting calls from clients that the MAPD plan took out premiums from their accounts. I know you can send in a disenrollment form that would disenroll them from the MAPD but it's kind of nerve racking to do that because sometimes the PDP plans don't get issued or they get lost at the home office, then the client has nothing.

    Are any of you having this problem? What's the best way to get them disenrolled.
     
  2. Russ
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    Russ Guru

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    Heck...I've sent a few letters to one carrier to get someone dis-enrolled last year(2008 season)....it was Today's Options:skeptical:. It was nothing but aggravating to the person and me. I got them back on Medicare and a Medicare Supplement. Company was feeding this lady a line of BS. I don't trust the companies when it comes to dis-enrolling someone.
     
    Russ, Jan 6, 2009
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  3. walleyeb1
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    walleyeb1 Super Genius

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    As you stated this should disenroll them. But, it doesn't mean that the old company gets things done timely. I always advise clients to stop the auto bankdraft. If they don't the outcome is as you described. It will probably get straightened out but will take some phone calls and more headaches.
     
  4. insurance0707
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    insurance0707 Guru

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    I did send in a disenrollment form for one client. It took 2 months before they stopped deducting the premium. This was with a disenrollment form and a new PDP plan in place.
     
  5. Josh
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    Josh Retired Agent, Current List Broker

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    When someone enrolls in an MAPD (or MA for that matter) the plan sends that message to CMS who then process it and then kicks it back. The next time the old PDP get's an update it will tell them the member left their plan and then they have to process that internally. The lag time from when the app gets submitted to when the old plan cancels it from their end can be quite long. The best thing to do would be to have the member call the old plan (or call them with you) and have them disenroll that way. Another option would be to have them change the method of payment and then just have them not send in the check. The old plan should have received the disenroll notice before the second bill gets sent.
     
    Josh, Jan 6, 2009
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  6. Call4Insurance
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    Call4Insurance Guest

    I have a customer new to Medicare and signed for a Secure Horizons mapd. He changed his mind a month later and we called to have him dissenrolled so I could get him a med sup instead.
    The mapd co. never did the dissenrollment and he also had the med. sup. active and was paying for it.
    He then has surgery 3 months later only to have all ins. denied for claims pay because the hospital was not on the list for the mapd and wont file claims, the med sup wont pay since he has an mapd still in force.
    Can we come to the conclusion that medicare nor the advantage plan companies play by any set of rules? This is rediculous. He is now threatening to sue me for not representing things truthfully. Any advise on this one?
    ugh
     
  7. stormtracker
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    stormtracker Guru

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    What is your E&O deductible? :nah:
     
  8. AgentOrange
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    AgentOrange Super Genius

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    I would advise you to put everything in your moms name. Lock in is lock in, did you explain election periods and lock in ? There isnt a 30 day free look with mapds.
     
    Last edited: Jan 6, 2009
  9. jdeasy
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    No, but he said the client was new to Medicare. If this disenrollment was during the 7 month window, it was legal and should have been honored.
     
    jdeasy, Jan 6, 2009
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  10. AgentOrange
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    AgentOrange Super Genius

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    jdeasy, you know too many crazy election period rules. code sep-trial.
     
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