Can I Help This Guy?

[karaboo]

I am a newbie who's written some MAPD plans but, going forward, want to focus on Med Supps. Well, before I even got my feet wet with the Med Supps, an acquaintance has asked if I can help him find a cheaper way to get his Medicare coverage than his Blue Cross/Blue Shield Illinois supplement/PD that is costing him > $300/month.

He's in his early 70's and is diabetic (no insulin). Has 5 stents and had major back surgery (unsuccessful) about 3 years ago. He was advised (now a bit over 2 years ago) by his ortho that another surgery is needed and recommended. He refuses to have that recommended surgery. He does not take any meds related to pain or his back. His meds consist of metformin for diabetes and then several cardiovascular drugs.

I welcome anyone's insights. Thanks

 

[ShawnSIM]

Cigna will be launching their "enhanced underwriting" med supp in IL on 10-1. That may be a good option for him depending on exactly what he's looking for.

 

[goillini52]

I am a newbie who's written some MAPD plans but, going forward, want to focus on Med Supps. Well, before I even got my feet wet with the Med Supps, an acquaintance has asked if I can help him find a cheaper way to get his Medicare coverage than his Blue Cross/Blue Shield Illinois supplement/PD that is costing him > $300/month.

He's in his early 70's and is diabetic (no insulin). Has 5 stents and had major back surgery (unsuccessful) about 3 years ago. He was advised (now a bit over 2 years ago) by his ortho that another surgery is needed and recommended. He refuses to have that recommended surgery. He does not take any meds related to pain or his back. His meds consist of metformin for diabetes and then several cardiovascular drugs.

I welcome anyone's insights. Thanks

Nope, he's stuck. The companies that might take him with stents and diabetes won't take him because surgery's been recommended and not performed(that includes Cigna's substandard policy...it'll be more expensive than the BCBS). The companies that would take him with the recommended surgery that hasn't been performed won't take him because of the stents and diabetes. Nothing you can do for him until he has that surgery.

 

[ShawnSIM]

Nope, he's stuck. The companies that might take him with stents and diabetes won't take him because surgery's been recommended and not performed(that includes Cigna's substandard policy...it'll be more expensive than the BCBS). The companies that would take him with the recommended surgery that hasn't been performed won't take him because of the stents and diabetes. Nothing you can do for him until he has that surgery.

Damn, you're right since he has that recommended surgery

 

[yogooglethis]

I am a newbie who's written some MAPD plans but, going forward, want to focus on Med Supps. Well, before I even got my feet wet with the Med Supps, an acquaintance has asked if I can help him find a cheaper way to get his Medicare coverage than his Blue Cross/Blue Shield Illinois supplement/PD that is costing him > $300/month.

He's in his early 70's and is diabetic (no insulin). Has 5 stents and had major back surgery (unsuccessful) about 3 years ago. He was advised (now a bit over 2 years ago) by his ortho that another surgery is needed and recommended. He refuses to have that recommended surgery. He does not take any meds related to pain or his back. His meds consist of metformin for diabetes and then several cardiovascular drugs.

I welcome anyone's insights. Thanks

Most BCBS plans allow insured to switch down to plan N at their original entry age rate band with no underwriting.the savings can be significant if he has a plan b,c,d or f.you won't make any commissions for suggesting this but you might win some friends and influence people.

 

[j10]

A lot of times, I've seen the recommended surgery but not performed come with a "within the past two years" stipulation. Not familiar with Il but I've definitely seen that on some carriers' health questions.

 

[goillini52]

Most BCBS plans allow insured to switch down to plan N at their original entry age rate band with no underwriting.the savings can be significant if he has a plan b,c,d or f.you won't make any commissions for suggesting this but you might win some friends and influence people.

Yes, since BCBS is GI in Illinois, you just have to fill out a change of plan form to go up or down. Depending on where he lives upstate(Chicago area) or downstate...downstate at 73, Plan N would be $150 a month. That'd save him about $100 a month.

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A lot of times, I've seen the recommended surgery but not performed come with a "within the past two years" stipulation. Not familiar with Il but I've definitely seen that on some carriers' health questions.

Yes, Aetna's ok if more than 1 year...but they won't take diabetes and stents. Some are 2 years, some 5 years, some 10 years and some ever. The problem is that the ones that are ok on the time since advised to have surgery won't take the diabetes/stent combo.