Creditable Part B coverage but Not Creditable Part D Coverage

[LostDollar]

carriers verify via CMS. And although significant efforts may not at times be made, it is still best practice to advise as if the efforts were being made. Otherwise one may end up with an E&O claim.

Luckily for you, you are not an agent, and advising a client to try and "game" the system will not have any negative repercussions on you.

Caveat, not an agent

"carriers verify via CMS. And although significant efforts may not at times be made, ... " That is very unclear information because you are not stating with certainty whether carriers "do" verify, or just that they can verify if they choose to do so.

And that raises another question, if carriers can get a Medicare Beneficiary's information from CMS, why do they asses the Beneficiary a penalty if the Beneficiary is unable to provide it?

I was repeating what "real" agents have told me, via multiple postings on the site -- and that also matched my personal experience with one Medicare Beneficiary.

 

[axeman462]

Caveat, not an agent

"carriers verify via CMS. And although significant efforts may not at times be made, ... " That is very unclear information because you are not stating with certainty whether carriers "do" verify, or just that they can verify if they choose to do so.

And that raises another question, if carriers can get a Medicare Beneficiary's information from CMS, why do they asses the Beneficiary a penalty if the Beneficiary is unable to provide it?

I was repeating what "real" agents have told me, via multiple postings on the site -- and that also matched my personal experience with one Medicare Beneficiary.

 

[TwoCents]

Caveat, not an agent

"carriers verify via CMS. And although significant efforts may not at times be made, ... " That is very unclear information because you are not stating with certainty whether carriers "do" verify, or just that they can verify if they choose to do so.

And that raises another question, if carriers can get a Medicare Beneficiary's information from CMS, why do they asses the Beneficiary a penalty if the Beneficiary is unable to provide it?

I was repeating what "real" agents have told me, via multiple postings on the site -- and that also matched my personal experience with one Medicare Beneficiary.

Let's say a beneficiary turned 65 and then went 24 months before joining a Part D plan. CMS will tell the Part D plan "hey here's the maximum number of months the LEP could be based on" and then it's up to the plan to get the rest of the info.

CMS won't have visibility into some types of creditable coverage (such as VA). Also there are some circumstances (such as being jailed during those 24 months) where the gap months don't count towards the LEP and SSA might not have that info on file to pass to CMS so the beneficiary could attest to being in jail.