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Agent makes a plan benefit error on Med Adv App- can it be corrected?

Oct 6, 2018

  1. wehotex
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    wehotex Guru

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    I know an agent who completed an online app with an applicant, but neglected to key in the option to enroll into the Dual plan. Now, this member has been enrolled into a non-Dual plan and needs to be enrolled RETROACTIVELY back to the effective date of the app. I know that the mb may use an SEP to start the Dual plan for the 1st of next month, yet mb wants the retroactive date instead. My coworker says that the member could complain to the MA carrier and ultimately get the retroactive date, but that would result in an allegation to the writing agent- OUCH. Is there a solution?
     
    wehotex, Oct 6, 2018
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  2. josie
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    josie New Member

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    Probably not but they could contact the carrier themselves. It might depend on how long it has been effective. If it just became active within the last 30 days, there may be a slim chance. If it is a Dual plan, they should have medicaid anyway which would mean they are not paying for hardly anything as it is. It has to be sent to CMS for approval first anyway.
     
    josie, Dec 18, 2018
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