Aged parent moved out of state. Now what?

[junkman]

A group client wrote me that "he moved his 85 yr old mother from AL to TN". She's currently in NHC's assisted living facility. She was enrolled in Blue Cross Blue Shield of AL Plan C Plus which has an AL network only. It looks like it is a Plan C with a network. Is this correct?

What I've gleaned so far is that she came up here for her son to help her and has decided to stay because of health issues. It also sounds like she would have a SEP because she moved out of network. When does the SEP begin? How long does she have to enroll? What can she apply for without underwriting?

What do we need to know in order to make sure that the answer is correct?

 

[BADTROUT]

Since you are licensed in TN (assuming since that's your state listed) You may consider a BOR of that policy so you can discuss the ins and outs directly with the carrier in the meantime (for the logistics conversation, not for the commission). I would also read up on the SEP information on Medicare.gov where they very specifically address this very situation. Special circumstances (Special Enrollment Periods) | Medicare.gov

Hope this helps...

 

[TN_agent]

Junkman, Is the Plan C a "Select" medigap policy? (you said it was a "Plus", not sure if that is just BCBS AL terminology for their Select plan?, I don't sell in AL). If so page 22 in guide to Medigap would suggest a GI for a, A,B,C,F,K or L in TN within 60 days plus/minus loss of Select coverage due to moving out of service area.

 

[somarco]

Junkman, Is the Plan C a "Select" medigap policy? (you said it was a "Plus", not sure if that is just BCBS AL terminology for their Select plan?, .

Pretty sure that is a Select plan. I encountered that a couple of yrs ago. Person moved to GA with a stupid BX Select (or whatever they called it). No SEP. Cannot qualify medically. Only option was MA during AEP.

Select plans are total BS.

 

[junkman]

Best information I can find is it is a MedSup C select which means no out of network benefits. C Plus Medicare Select Plans | Blue Cross and Blue Shield of Alabama

We'll proceed carefully but expect she is in a SEP. My understanding from the link above is that she's eligible for an F which actually has a lower premium than a C. The agent must have been writing for the commission and not the client.

She doesn't have benefits now since everything is out of network and has options because of AEP.

edit: There is a plan summary on line and she either has B or F. I'll be able to figure it out once I know what the premium is. This is another good reason why we should advise against restrictions when possible. The agent could have sold a G or even regular F and we wouldn't have to jump through hoops.

 

[Larry Swank]

That was a good thing that was done.

 

[junkman]

I wrote her a F under guaranteed issue. Not much compensation but they're friends and what goes around.....

 

[TwoCents]

I wrote her a F under guaranteed issue. Not much compensation but they're friends and what goes around.....

And her Part D coverage?

 

[junkman]

Yes. Part D also.