Annual Disenrollment Question

insuranceconceptscindy

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I really should know the answer to this, and I'm pretty confident in my guess, but I want to know 100%-

I have had a few cases during ADP so far who are dropping MAPD to Supp and PDP. AARP has been their only option. (Wheelchair lady and 88 year old guy)

With AARP, do they allow the MAPD as creditable coverage so that they will not have a pre-ex issue?

I feel stupid asking this, but it just doesn't ever come up for me.

Anyone have any issues with AARP and pre-ex?
 
I really should know the answer to this, and I'm pretty confident in my guess, but I want to know 100%-

I have had a few cases during ADP so far who are dropping MAPD to Supp and PDP. AARP has been their only option. (Wheelchair lady and 88 year old guy)

With AARP, do they allow the MAPD as creditable coverage so that they will not have a pre-ex issue?

I feel stupid asking this, but it just doesn't ever come up for me.

Anyone have any issues with AARP and pre-ex?

Both Medicare and a MAPD are considered prior creditable coverage. So whether or not they had an MAPD is somewhat irrelevant since they've had Medicare Parts A & B.
 
Sman - you might be right and I have not had this come up either, but I am not sure that Medicare alone is creditable coverage. Medicare FFS + Med Supp would be, but I don't know about Medicare alone. I agree MA would count.
 
Going to a supp, outside of any GI or OE, is definitely subject to underwriting and Pre-ex.
My concern is if going from an MAPD to med sup will not be subject to pre-ex.
 
Sman - you might be right and I have not had this come up either, but I am not sure that Medicare alone is creditable coverage. Medicare FFS + Med Supp would be, but I don't know about Medicare alone. I agree MA would count.

Since the carrier in question is UHC (AARP branded Med Supp), this is straight from their guide book:

Some common examples of creditable coverage include: Employer group or individual health plan, Medicare Advantage plan and Medicaid. Medicare Parts A and B are creditable coverage.

I don't know about you, but that looks like they consider Medicare Parts A & B to be creditable coverage. If you still "don't know", you can always call the carrier to confirm.
 
Going to a supp, outside of any GI or OE, is definitely subject to underwriting and Pre-ex.
My concern is if going from an MAPD to med sup will not be subject to pre-ex.

If it's not GI or OE, it will have to be subject to pre-existing conditions for the sake of underwriting. I don't suppose she was in the MAPD less than a year? In my state BCBS Med Supps are GI. AARP might be your only option.
 
If it's not GI or OE, it will have to be subject to pre-existing conditions for the sake of underwriting. I don't suppose she was in the MAPD less than a year? In my state BCBS Med Supps are GI. AARP might be your only option.

I think some of us may be confusing the difference between underwriting and pre-ex. Some carriers will not pay for pre-ex for the first 3-6 months while covered on that particular Med Supp when the person had no prior coverage.

AARP has a pre-ex clause here in Georgia. While they will approve a person for a Med Supp they will not cover pre-ex conditions for 90 days (I believe that's the length of time - not where I can look right now) if there is no prior coverage. I assumed this is what the OP was questioning.
 
Since the carrier in question is UHC (AARP branded Med Supp), this is straight from their guide book:

Some common examples of creditable coverage include: Employer group or individual health plan, Medicare Advantage plan and Medicaid. Medicare Parts A and B are creditable coverage.

I don't know about you, but that looks like they consider Medicare Parts A & B to be creditable coverage. If you still "don't know", you can always call the carrier to confirm.

Thanks Sman - I was thinking about some NY regs that don't require a carrier to consider Parts A and B to be creditable outside of some limited situations.
 
I think some of us may be confusing the difference between underwriting and pre-ex. Some carriers will not pay for pre-ex for the first 3-6 months while covered on that particular Med Supp when the person had no prior coverage.

AARP has a pre-ex clause here in Georgia. While they will approve a person for a Med Supp they will not cover pre-ex conditions for 90 days (I believe that's the length of time - not where I can look right now) if there is no prior coverage. I assumed this is what the OP was questioning.


I reread the original post and I agree with you that that's the point in question. I don't see a problem though as they had prior coverage with the MA/MAPD.
 
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