AUTO ENROLLMENT IN PDP

Feb 25, 2019

  1. margostl
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    margostl Expert

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    Yes calling Medicare is the next step.I had checked in with her 3days before she alerted me to SS PDP plan. The call was for her annual review. She thought I did it when she received the bill.I lost one client then regained him due to a crooked broker confusing him.He called in to Medicare with a question, was then transfered to a broker who enrolled him in another plan.I caught it then renrolled him.The crook enrolled him again.This time he cancelled thru Medicare.I couldn't renroll him until AEP since his IEP had expired.I could not get answers from Medicare or the carrier on who the crooked broker was.Talk about a wall of deception.
    I'm jaded and alert after this.with any Medicare incidents
     
  2. Chazm
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    Chazm Guru

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    I highly doubt this person called into Medicare. Seniors think Medicare.com is Medicare. I get people who call me weekly asking if I’m the Medicare office.
     
    Chazm, Feb 26, 2019
    #12
  3. margostl
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    margostl Expert

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    I missed that Somarco mentioned Medicare.com as well.Bottom line it's a deceptive way to do business.I guess the risk of chargebacks is not a deterrent since most of them slip through.
     
  4. DS4
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    DS4 Guru

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    Sounds like the client was auto enrolled because of Medicaid eligibility?
     
    DS4, Feb 26, 2019
    #14
  5. margostl
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    margostl Expert

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    No she's not eligible she's a retired Teacher that has a medsupp.The board in Georgia retires their workers into a MA plan which most come out of.She was a T65. I have replaced many from referrals.
     
  6. WCMason
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    WCMason Guru

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    And that may solve the mystery. If the teacher retirement plan termed the medical but not the drug plan, and they can be separate in a retiree MA plan, the retiree PDP with SilverScript has to be cancelled, and any attempt to get her an individual PDP or MA plan will be blocked by the retiree PDP.
     
    WCMason, Feb 26, 2019
    #16
  7. vic120
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    vic120 Guru

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    Could possibly be something from retirement. I had one retirement plan in NY I had switched a few from referral source They had MA but when they opted out the company put them into drug plans or the drug plan from MA was not canceled (not sure which it was couple years ago)

    They had to fill a second form to disenroll from drug plan As the new drug plans were not approved till we fixed that
     
    vic120, Feb 26, 2019
    #17
  8. somarco
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    somarco GA Medicare Expert

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    Most GA public school teachers are covered under a self funded group health plan (SHBP) as long as they are under 65. BX is the current TPA for most of the options. They like to seamlessly enroll retirees into their MAPD plan. BX does not offer anything other than two MAPD plans to SHBP retirees. A "standard" plan and a "premier" plan. Those are the options.

    Retiring teaches get a lot of paperwork from BX including an opt-out form . . . which most never notice or have no clue what it is.

    The teachers unions push the retiree MAPD plans hard, telling teachers if they opt out they can never come back.

    I have never seen anything in writing in that regard but that doesn't stop the chatter.
     
    somarco, Feb 26, 2019
    #18
  9. alphawave2k
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    alphawave2k Super Genius

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    The SHBP in GA is crooked, and possibly the same as other states. There I said it....they extracted $1800+ from us b/c as my wife retired and got into the MAPD plan. I on the other hand, failed to let them know before my birthday month that I had my Medicare card. They "seamlessly" auto-enrolled me for the under 65 SHBP medical insurance. And yes, they threatened that if we didn't pay it, or opted out of their wonderful plan she would not be able to ever join in.
    They actually billed us through March, which would have been another whopping $800+ for a crappy HDHP. I tried to fight it, but I got nowhere with it...the state agency and whoever are all complicit in this type of activity. I was dealing with an outfit called Wage Works, whoever these mobsters are....it did remind me of mafia-type tactics.
    Those plans on the surface seem to be better, b/c they have a lower MOOP. The coverage is less than desirable....I could supply a list of what is not covered with their plan, whereas regular MAPD plans do. Being an agent in this field means fighting all the bureaucracy, companies and their illegal practices that most of us would be put into stripe outfits for doing.
     
  10. somarco
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    somarco GA Medicare Expert

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    SHBP is a self funded plan subject to ERISA, not state rules. The overseer for SHBP is the GA Dept of Community Health. They pick the TPA, award carrier contracts and "negotiate" plans and rates on behalf of SHBP.

    PAGE and GAE are, in my opinion, in bed with the folks that run SHBP
     
    somarco, Feb 27, 2019
    #20
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