Annual Disenrollment Question

[sman]

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.

I agree. I just wanted to throw out that they also consider Medicare Parts A & B creditable coverage as well (at least here in Georgia).

 

[vic120]

Medicare A/B is considered creditable coverage for any/all pre-x clauses on all types of plans.

This is not true

I had an issue because of this

The client ultimately had claims paid once he proved he had VA benefits
but the Medicare A & B alone did not count as credible coverage

Yes MA or any other including VA would be credible coverage

 

[sman]

This is not true

I had an issue because of this

The client ultimately had claims paid once he proved he had VA benefits
but the Medicare A & B alone did not count as credible coverage

Yes MA or any other including VA would be credible coverage

UHC (AARP branded Med Supps) certainly considers Medicare A & B as creditable coverage.

 

[vic120]

UHC (AARP branded Med Supps) certainly considers Medicare A & B as creditable coverage.

This was AARP specifically

when he called me as denied claim due to preex clause, I called UHC and there response was A & B does not count for credible coverage
It was not till we showed he had VA benefits that they went back and paid the claim.

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I did not think it was state specific because they told me this before I even got into details

Just based on my opening statement that I was calling in regard to client who was denied claim as pre ex and has been on Medicare for 10 years

answer was did he have a sup or MA previously

I said no but he is a VA member

The answer was VA is considered credible cov but A and B is not

 

[sman]

This was AARP specifically

when he called me as denied claim due to preex clause, I called UHC and there response was A & B does not count for credible coverage
It was not till we showed he had VA benefits that they went back and paid the claim.

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I did not think it was state specific because they told me this before I even got into details

Just based on my opening statement that I was calling in regard to client who was denied claim as pre ex and has been on Medicare for 10 years

answer was did he have a sup or MA previously

I said no but he is a VA member

The answer was VA is considered credible cov but A and B is not

In a few posts back, I copied and pasted the wording straight from the UHC (AARP) guidebook. It clearly states Medicare Parts A&B are considered creditable coverage.

 

[vic120]

Then I don't know why the would have declined this guys claims and told me it was due to lack of credible cov and the A & B does not count

This was 3 years ago maybe its changed

Maybe they assumed in there computer system I am located in NY
but they should see I send them buis in a dozen states

IDK but this guy was declined the claim because of lack of credible cov and has had Medicare A & B 10 years

I remember this because it was a nightmare to get him down to VA and get letter to satisfy the credible cov requirement for cov of pre ex

I also remember well because wife called me daily to moan about it

this was in my first year as well Ill never forget it

 

[G.Gordon]

This is not true

I had an issue because of this

The client ultimately had claims paid once he proved he had VA benefits
but the Medicare A & B alone did not count as credible coverage

Yes MA or any other including VA would be credible coverage

Is so!!....................

 

[sman]

Then I don't know why the would have declined this guys claims and told me it was due to lack of credible cov and the A & B does not count

This was 3 years ago maybe its changed

Maybe they assumed in there computer system I am located in NY
but they should see I send them buis in a dozen states

IDK but this guy was declined the claim because of lack of credible cov and has had Medicare A & B 10 years

I remember this because it was a nightmare to get him down to VA and get letter to satisfy the credible cov requirement for cov of pre ex

I also remember well because wife called me daily to moan about it

this was in my first year as well Ill never forget it

Ahh yes, a customer service person must always be correct. I'll stick with what I see in print directly from the company as opposed to what a customer service person tells me.

 

[vic120]

Even still they would not pay claims till they got written documentation from VA that did have VA benefits

the bills kept coming the wife kept calling till he got letter and UHC process another 3 days after they got it

They would not pay pre ex till this was completed regardless of who answered the phone

He was sick and to get him down to VA the whole thing took almost a month


He was 75 and has been on Medicare a &B since 65 years old

Again this was 3 years ago so it may have changed

I pulled up his app it was actually a NY Supp I don't know if state makes a difference

I've never had anyone have issues with pre ex

But this one was a real headache

I am certainly not making it up

 

[openmindedone]

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?

MAPD does not wave the waiting period for pre-existing conditions.
I verified this last year for a guy with cancer going from MAPD to AARP supplement.

Although they could have denied claims for his cancer treatment during the first 3 months, the good news is they never actually denied any claims.