anyone with experience with this type of group

[vic120]

Has anyone have experience with the type of group where there is X amount of money available for med expenses and when it runs out it's done.

I have a prospect who says with her plan she expects to run through the money by march then she wants a plan, She would prefer Supp. She has Part B over 3 years, I don't remember If she is working and not going to stop when money is out or If she is retired now.

I don't know how this works and what exactly the possibilities are. I am guessing she cant purchase a plan now as then she should have 2 plans in place at the same time.

So after money runs out is it like retiring? I am guessing no GI. What about MA enrollment or PDP?

 

[Todd King]

It sounds like she is in a Medical Saving Account type of plan through her employer. If she is losing that coverage I would suppose it would be a GI situation just like any other group plan. If it is not a GI situation, maybe she can qualify for a Med Supp. Other than that, it's AEP and should be able to get a MAPD plan, not that I would suggest that one.

 

[vic120]

I don't know that she can pass the underwriting, Just don't know that it would qualify for GI. I am not sure this counts as losing group the same way it would if coverage was cancelled because it just runs out or money

I am also not sure if it counts to Buy Drug or MA coverage.

Also can she purchase a MA plan now if she has this in place, I think no but then will she be able to purchase when cash runs out?

 

[TwoCents]

I would be very careful with this one. Have you seen any documentation for the plan? It could be she has insurance with an HRA that doesn't quite meet her deductibles so in her mind when the money's out, she doesn't have coverage. Sounds like a clerical nightmare...when would you ever have open enrollment if everyone's plan can end at any time?

 

[vic120]

I would be very careful with this one. Have you seen any documentation for the plan? It could be she has insurance with an HRA that doesn't quite meet her deductibles so in her mind when the money's out, she doesn't have coverage. Sounds like a clerical nightmare...when would you ever have open enrollment if everyone's plan can end at any time?

I think you are right

 

[gregj]

I would be very careful with this one. Have you seen any documentation for the plan? It could be she has insurance with an HRA that doesn't quite meet her deductibles so in her mind when the money's out, she doesn't have coverage.

Yep - this