Annual Disenrollment Question

[yogooglethis]

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.

Says that in the Fl.,Ga. and N.C. AARP/UHC handbook too but it goes on to say:

" however,individuals who buy medicare supplement are KEEPING not replacing , medicare parts A and B


So that's why the waiver of pre ex clause on replacement form wouldn't apply.

 

[G.Gordon]

The replacement form is not what this thread is about. That form is about replacing medigap or Medicare advantage.

The pre-x clause for claims from pre-x conditions will have to be paid if you had A/B more than six months before any Medigap enrollment.

 

[yogooglethis]

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.

MAPD ennrollment 100% does satisfy the pre ex limitation as long as they were enrolled in MAPD at least as long as pre ex waiting period on new policy.This is always # 2 or B part of the Additional Statements on the state required Replacement Form.I always read this clause to clients to ease their mind about replacing.I thought this was common knowledge


(B) State law provides that your replacement policy or certificate may not contain
new preexisting conditions, waiting periods, elimination periods or probationary
periods. The insurer will waive any time periods applicable to preexisting conditions,
waiting periods, elimination periods, or probationary periods in the new policy (or
coverage) for similar benefits to the extent such time was spent (depleted) under the
original policy.

----------

The replacement form is not what this thread is about. That form is not about replacing medigap or Medicare advantage.

The pre-x clause for claims from pre-x conditions will have to be paid if you had A/B more than six months before any Medigap enrollment.

Right on. Going from medicare A and B only to any med supp doesn't have anything to do with a replacement form because you are not replacing anything - only adding new coverage and state laws allow that these new policies can impose up to a 6 month waiting period if no creditable coverage is being REPLACED.

 

[openmindedone]

MAPD ennrollment 100% does satisfy the pre ex limitation as long as they were enrolled in MAPD at least as long as pre ex waiting period on new policy.This is always # 2 or B part of the Additional Statements on the state required Replacement Form.I always read this clause to clients to ease their mind about replacing.I thought this was common knowledge


(B) State law provides that your replacement policy or certificate may not contain
new preexisting conditions, waiting periods, elimination periods or probationary
periods. The insurer will waive any time periods applicable to preexisting conditions,
waiting periods, elimination periods, or probationary periods in the new policy (or
coverage) for similar benefits to the extent such time was spent (depleted) under the
original policy.

----------





Right on. Going from medicare A and B only to any med supp doesn't have anything to do with a replacement form because you are not replacing anything - only adding new coverage and state laws allow that these new policies can impose up to a 6 month waiting period if no creditable coverage is being REPLACED.

If you replace one Plan F with another, obviously, the new policy won't have any waiting periods for pre-existing conditions. In this case the new policy has the same benefits. In the replacement statement it says no waiting periods for "similar benefits", i.e. both policies having coverage for the Part A deductible.

Well, I think it's different when replacing an MAPD, which does not have the same benefits as the new supplement.

I don't mind admitting when I'm wrong, just not ready to do so yet. Tomorrow I'll check on it, to see for sure.

 

[yogooglethis]

If you replace one Plan F with another, obviously, the new policy won't have any waiting periods for pre-existing conditions. In this case the new policy has the same benefits. In the replacement statement it says no waiting periods for "similar benefits", i.e. both policies having coverage for the Part A deductible.

Well, I think it's different when replacing an MAPD, which does not have the same benefits as the new supplement.

I don't mind admitting when I'm wrong, just not ready to do so yet. Tomorrow I'll check on it, to see for sure.

No worries but this information is on most medicare supplement applications and on on every Medicare supplement outline of Coverage and Consumer Guide For Medicare supplement that the DOI requires agents to leave behind with policyholders.



The following is on page 6 of 7 of Fl. AARP/UHC med supp application right above signature field..The Replacement Form explains how this is satified as long as they are replacing creditable coverage i.e anther med supp,MA,EGHP etc


I understand the plan will not pay benefits for stays
beginning or medical expenses incurred during the
first 3 months of coverage if they are due to conditions
for which medical advice was given or treatment
recommended by or received from a physician within
3 months prior to the insurance effective date.










From 2015 Consumer Guide for Medigap:

Do I have to wait a certain length of time after I buy my first
Medigap policy before I can switch to a different Medigap policy?

No. If you’ve had your old Medigap policy for less than 6 months, the
Medigap insurance company may be able to make you wait up to 6 months
for coverage of a pre‑existing condition. However, if your old Medigap
policy had the same benefits, and you had it for 6 months or more, the new
insurance company can’t exclude your pre-existing condition. If you’ve had
your Medigap policy less than 6 months, the number of months you’ve had
your current Medigap policy must be subtracted from the time you must
wait before your new Medigap policy covers your pre‑existing condition.
If the new Medigap policy has a benefit that isn’t in your current Medigap
policy, you may still have to wait up to 6 months before that benefit will be
covered, regardless of how long you’ve had your current Medigap policy.
If you’ve had your current Medigap policy longer than 6 months and want
to replace it with a new one with the same benefits and the insurance
company agrees to issue the new policy, they can’t write pre-existing
conditions, waiting periods, elimination periods, or probationary periods
into the replacement policy.