Clarification on Med sup trial right

[DonP]

This business is a never ending learning curve . On trial right 2 if you leave a med sup ever ( Your parts A and B must be the same date ) you have 12 months to return to the same med sup . But here's what i never knew . Let's say you sign up for mapd Jan 1st 2025. Ok that within 12 month trial period means i must return to that same med sup by Jan 1st 2026( within 12 months). I just read that's not true . I must sign up by nov 30th 2025 for a dec 1 2025 start date . Jan 2026 is not "within 12 months " . Is that true ? If its true i didn't know that .

 

[goillini52]

This business is a never ending learning curve . On trial right 2 if you leave a med sup ever ( Your parts A and B must be the same date ) you have 12 months to return to the same med sup . But here's what i never knew . Let's say you sign up for mapd Jan 1st 2025. Ok that within 12 month trial period means i must return to that same med sup by Jan 1st 2026( within 12 months). I just read that's not true . I must sign up by nov 30th 2025 for a dec 1 2025 start date . Jan 2026 is not "within 12 months " . Is that true ? If its true i didn't know that .

That's not the way I understand it.

From Ritter's site:


"2. Med Supp Clients Who Switched to MA (or Medicare SELECT) for the First Time Less Than 12 Months Ago[/H3]
What if your client joined a Medicare Supplement plan when they became eligible for Medicare, then decided to try out a Medicare Advantage Prescription Drug plan? If they'd like to return to their previous plan (and Original Medicare), they can do so if their Medicare Advantage effective date is less than 12 months ago.

Example: Bob decided to leave his Medicare Supplement, prescription drug plan, and Original Medicare for a Medicare Advantage Prescription Drug plan during the Annual Enrollment Period. His new coverage has an effective date of January 1. His trial period will end on December 31 of the following year.

In this case, your client will only have the right to rejoin the Medicare Supplement plan they had before the switch. If their previous Medicare Supplement plan is no longer offered (i.e., the insurance company no longer sells it), they may buy a guaranteed issue plan sold by a different company in their state. They must apply for Medicare Supplement coverage no earlier than 60 calendar days before the date their Medicare Advantage coverage will end and no later than 63 days after that date. They can also pick up a stand-alone prescription drug plan."

 

[DonP]

That's not the way I understand it.

From Ritter's site:


"2. Med Supp Clients Who Switched to MA (or Medicare SELECT) for the First Time Less Than 12 Months Ago[/H3]
What if your client joined a Medicare Supplement plan when they became eligible for Medicare, then decided to try out a Medicare Advantage Prescription Drug plan? If they'd like to return to their previous plan (and Original Medicare), they can do so if their Medicare Advantage effective date is less than 12 months ago.


In this case, your client will only have the right to rejoin the Medicare Supplement plan they had before the switch. If their previous Medicare Supplement plan is no longer offered (i.e., the insurance company no longer sells it), they may buy a guaranteed issue plan sold by a different company in their state. They must apply for Medicare Supplement coverage no earlier than 60 calendar days before the date their Medicare Advantage coverage will end and no later than 63 days after that date. They can also pick up a stand-alone prescription drug plan."

Ok so that's saying that if you join a mapd Jan 1st 2025 you have 63 days after you term the mapd by dec 31st 2025 to get a new med sup GI? So that's saying you have until march 1st effective date to get a GI med sup?

 

[rmhaire]

This business is a never ending learning curve . On trial right 2 if you leave a med sup ever ( Your parts A and B must be the same date ) you have 12 months to return to the same med sup . But here's what i never knew . Let's say you sign up for mapd Jan 1st 2025. Ok that within 12 month trial period means i must return to that same med sup by Jan 1st 2026( within 12 months). I just read that's not true . I must sign up by nov 30th 2025 for a dec 1 2025 start date . Jan 2026 is not "within 12 months " . Is that true ? If its true i didn't know that .

Not true.

There are two trial rights but both are a full 12 months.

The 1st trial right is for someone who starts out with a MAPD and decides that they want to move to a supplement. These people can go with any Medicare supplement they want without insurability.

The 2nd trial right is for someone who starts out with a supplement, moves to an MAPD and then decides to go back to a supplement. Again a full 12 months but the difference is that they can only go back to their original supplement. (Unless no longer offered, then it's GI)

Also, with both trial rights, they can't apply for the supplement no more than 60 days before their MAPD ends. That's probably where they are coming up with this Nov, Dec stuff.

 

[DonP]

Not true.

There are two trial rights but both are a full 12 months.

The 1st trial right is for someone who starts out with a MAPD and decides that they want to move to a supplement. These people can go with any Medicare supplement they want without insurability.

The 2nd trial right is for someone who starts out with a supplement, moves to an MAPD and then decides to go back to a supplement. Again a full 12 months but the difference is that they can only go back to their original supplement. (Unless no longer offered, then it's GI)

Also, with both trial rights, they can't apply for the supplement no more than 60 days before their MAPD ends. That's probably where they are coming up with this Nov, Dec stuff.

So initially what I always thought is correct . On a Jan 1,2025 move to mapd they have until Dec 31st 2025 for a Jan 1st 2026 effective date to move Gi back to their supp. The note i read was wrong info then . I did a few Gi's with plan terms this aep . I started thinking how 100's of thousands of former mapd termed members went back to Gi med supps for 2025. I read an article that Gi sups have 70% higher claims than regular med sup people. This will definitely put claim pressure thus higher than regular rate increases in play for 2026

 

[LostDollar]

I read an article that Gi sups have 70% higher claims than regular med sup people. This will definitely put claim pressure thus higher than regular rate increases in play for 2026

Caveat, not an agent.

The Medigap pricing pressure comes from a "system" that allows healthy people to "escape" from Medigap coverage to "free" medicare advantage coverage when they are healthy and then return to Medigap coverage when they suddenly get sick. This forces a higher percentage of high service demand Medicare Beneficiaries into the Original Medicare coverage pool than might otherwise be the case.

(In my opinion.)

 

[axeman462]

This business is a never ending learning curve . On trial right 2 if you leave a med sup ever ( Your parts A and B must be the same date ) you have 12 months to return to the same med sup . But here's what i never knew . Let's say you sign up for mapd Jan 1st 2025. Ok that within 12 month trial period means i must return to that same med sup by Jan 1st 2026( within 12 months). I just read that's not true . I must sign up by nov 30th 2025 for a dec 1 2025 start date . Jan 2026 is not "within 12 months " . Is that true ? If its true i didn't know that .

I've done quite a few of these over the years. The carriers I have worked with (mostly UHC and Humana), have always considered when the date of the application.

So as long as the customer signs the application within 12 months of when they last left the medsupp, you are fine if the medsupp starts in month 13.

For example: customer has medsupp in 2023, then goes MAPD January 2024, did the app to go back medsupp November 2024, and the medsupp starts January 2025 (technically month 13), you are fine.

 

[LostDollar]

That's not the way I understand it.

From Ritter's site:


"2. Med Supp Clients Who Switched to MA (or Medicare SELECT) for the First Time Less Than 12 Months Ago[/H3]
What if your client joined a Medicare Supplement plan when they became eligible for Medicare, then decided to try out a Medicare Advantage Prescription Drug plan? If they'd like to return to their previous plan (and Original Medicare), they can do so if their Medicare Advantage effective date is less than 12 months ago.


In this case, your client will only have the right to rejoin the Medicare Supplement plan they had before the switch. If their previous Medicare Supplement plan is no longer offered (i.e., the insurance company no longer sells it), they may buy a guaranteed issue plan sold by a different company in their state. They must apply for Medicare Supplement coverage no earlier than 60 calendar days before the date their Medicare Advantage coverage will end and no later than 63 days after that date. They can also pick up a stand-alone prescription drug plan."

Not true.

There are two trial rights but both are a full 12 months.

The 1st trial right is for someone who starts out with a MAPD and decides that they want to move to a supplement. These people can go with any Medicare supplement they want without insurability.

The 2nd trial right is for someone who starts out with a supplement, moves to an MAPD and then decides to go back to a supplement. Again a full 12 months but the difference is that they can only go back to their original supplement. (Unless no longer offered, then it's GI)

Also, with both trial rights, they can't apply for the supplement no more than 60 days before their MAPD ends. That's probably where they are coming up with this Nov, Dec stuff.

The gist of OP's question comes across to me as:

Must the GI coverage be in effect before the end of the 12 month period or is it only necessary there be an application in process before the end of the 12 month period with coverage to take effect the first of the month immediately following the end of the 12 month period?

edit:
(my post crossed with axeman's. he provided an answer to my question based on his experience.)

 

[rmhaire]

So initially what I always thought is correct . On a Jan 1,2025 move to mapd they have until Dec 31st 2025 for a Jan 1st 2026 effective date to move Gi back to their supp. The note i read was wrong info then . I did a few Gi's with plan terms this aep . I started thinking how 100's of thousands of former mapd termed members went back to Gi med supps for 2025. I read an article that Gi sups have 70% higher claims than regular med sup people. This will definitely put claim pressure thus higher than regular rate increases in play for 2026

GI for supplements is about conversion rights. Not the same as GI for final expense.

Doesn't matter if they stay with a MA plan or go back to a supplement. Their health condition remains the same.

 

[rmhaire]

I've done quite a few of these over the years. The carriers I have worked with (mostly UHC and Humana), have always considered when the date of the application.

So as long as the customer signs the application within 12 months of when they last left the medsupp, you are fine if the medsupp starts in month 13.

For example: customer has medsupp in 2023, then goes MAPD January 2024, did the app to go back medsupp November 2024, and the medsupp starts January 2025 (technically month 13), you are fine.

Yep. Part of the 60/63 rule.

They have 63 days from the end of their MA/MAPD coverage to get the supplement. So more like 14 months.