Client Has Wife's Employer Health Insurance and Medicare A/B

[Tennesseehorn]

I don't sell a lot of Med Supps and most have been turning 65 clients. However I have a client who is 73 and is on his wife's employer's health insurance and has Medicare Part A/B. He uses his wife's coverage first then Medicare is secondary. His wife is retiring next month at 65 and will lose her healthcare coverage and go to Medicare. I know she is guaranteed issue or enrollment but since her husband already has Medicare A/B is he still eligible for guaranteed issue since he is losing his primary medical coverage?

I am in Tennessee and I have searched the internet for this exact situation but haven't really found an exact answer. Any help/guidance would be appreciated.

Thanks

TH

 

[goillini52]

I don't sell a lot of Med Supps and most have been turning 65 clients. However I have a client who is 73 and is on his wife's employer's health insurance and has Medicare Part A/B. He uses his wife's coverage first then Medicare is secondary. His wife is retiring next month at 65 and will lose her healthcare coverage and go to Medicare. I know she is guaranteed issue or enrollment but since her husband already has Medicare A/B is he still eligible for guaranteed issue since he is losing his primary medical coverage?

I am in Tennessee and I have searched the internet for this exact situation but haven't really found an exact answer. Any help/guidance would be appreciated.

Thanks

TH

Your answer is in your bag. Read a Med Supp app, Choosing A Medigap Policy, Medicare & You and https://www.medicare.gov/

 

[Tennesseehorn]

Your answer is in your bag. Read a Med Supp app, Choosing A Medigap Policy, Medicare & You and https://www.medicare.gov/

I looked at this earlier and keyed on this:

When your employer coverage ends, you'll get a chance to enroll in Part B without a late enrollment penalty. That means your Medigap open enrollment period will start when you're ready to take advantage of it. If you enrolled in Part B while you still had the employer coverage, your Medigap open enrollment period would start. Unless you bought a Medigap policy before you needed it, you’d miss your open enrollment period entirely.

Since he has Medicare Part B already then he did miss the open enrollment for Medigap and must go through underwriting which may be a problem.

 

[LostDollar]

I looked at this earlier and keyed on this:


Since he has Medicare Part B already then he did miss the open enrollment for Medigap and must go through underwriting which may be a problem.

something I saw yesterday suggests to me that wife may still be able to apply for spousal SS benefit and her own work benefit separately. If that is the case, she can take the lesser of the two now (even though it would be reduced) and go to the max option when she hits 70. That would give them some extra cash flow to deal with these other medical costs while you work on that solution.

 

[goillini52]

I looked at this earlier and keyed on this:


Since he has Medicare Part B already then he did miss the open enrollment for Medigap and must go through underwriting which may be a problem.

I'm assuming that he's had Part B more than 6 months, so yes he missed the Open Enrollment.

He's eligible for GI. You'll need to send a copy of the termination letter from his wife's insurance with the application. He has 63 days from the date of termination.

This is all covered in the app and the UW guides the companies give you.

 

[Tennesseehorn]

I'm assuming that he's had Part B more than 6 months, so yes he missed the Open Enrollment.

He's eligible for GI. You'll need to send a copy of the termination letter from his wife's insurance with the application. He has 63 days from the date of termination.

This is all covered in the app and the UW guides the companies give you.

Got it thanks. I never came accross this type of situation so now I know.

 

[goillini52]

Got it thanks. I never came accross this type of situation so now I know.

You're welcome, but seriously read the apps and UW guides.

 

[somarco]

And most carriers pay $25 or less (one time) for GI Medigap business. Aetna reduced their GI comp to .75%.

 

[goillini52]

And most carriers pay $25 or less (one time) for GI Medigap business. Aetna reduced their GI comp to .75%.

Well, it won't hurt so bad if he sells the wife and adds a dental plan.

 

[G.Gordon]

I'm assuming that he's had Part B more than 6 months, so yes he missed the Open Enrollment.

He's eligible for GI. You'll need to send a copy of the termination letter from his wife's insurance with the application. He has 63 days from the date of termination.

This is all covered in the app and the UW guides the companies give you.

This is your answer. He is GI (the required plans, not all) so be careful of the carrier you choose or you could get a $25 gift certificate for McDonalds as your only compensation.

Read and study more, this is one of the basics.