DOB 1/26/50... is She Still in Open Enrollment for Med Supp?

[Bevo]

It is rare. But this rare situation is the subject of this thread.

Right again WCMason. Honestly looking back now, I should have quoted some posts in the middle of the thread prior to my comment as I was not directly referring to the OP thread topic but other's comments.

That's what a day at the pool in Texas heat and a few glasses of Merlot will get you. Hopefully my comments will at least help a few of the newbies regarding Part B start dates and how to work leads efficiently.

 

[sshafran]

That's not true. A person would answer yes to the T65 within last six months question and no to the Part B last six months question if they were six months past the 1st day of their 65th birth month but not yet their birthday that month.

Technically, this person would still Not be in open enrollment.

Today is 7/4. If someone was born on 1/13/1950 with Part B effective on 1/1/15, and they sign an app today...

Technically, Yes, they did turn 65 within the last 6 months. But "Open Enrollment" is still over for them.

Page 14 of guide to choosing a Medigap policy limits the "6 Months" to the standardized start date of the 1st day of the T65 month if enrolled in part B. Therefore, it ends 6/30/15, regardless of When in Jan the 65th birthday actually happened.

From the guide, "begins on the first day of the month in which you're both 65 or older and enrolled in part B."

Now why Aetna's e-app lets this slide, I do not know. I know other carriers ask the same, did you turn 65 in the last 6 months, if yes, skip health questions.... But still, it's no longer open enrollment...

Sent from my iPad using InsForums

 

[finalexpenseguru]

I stand corrected, I should have mentioned that in 99.999% of the cases agents will see, what you stated will NOT be the case.

But you are correct, though it's an extreme case.

Equitable is who I was submitting this with. They ask "did you turn 65 in the last 6 mths" on their eapp which stumped me as I didn't want to cause someone to appear OE when they shouldn't be. Yes it is not normal which is why I posted the question, otherwise no need to post and would just be business as usual. Thanks

 

[WCMason]

Technically, this person would still Not be in open enrollment. Today is 7/4. If someone was born on 1/13/1950 with Part B effective on 1/1/15, and they sign an app today... Technically, Yes, they did turn 65 within the last 6 months. But "Open Enrollment" is still over for them. Page 14 of guide to choosing a Medigap policy limits the "6 Months" to the standardized start date of the 1st day of the T65 month if enrolled in part B. Therefore, it ends 6/30/15, regardless of When in Jan the 65th birthday actually happened. From the guide, "begins on the first day of the month in which you're both 65 or older and enrolled in part B." Now why Aetna's e-app lets this slide, I do not know. I know other carriers ask the same, did you turn 65 in the last 6 months, if yes, skip health questions.... But still, it's no longer open enrollment... Sent from my iPad using InsForums

I agree with all of this.

 

[Newby]

I've got a guy who is 63. Been on Medicare Part A due to disability for 15-years. Didn't take Part B due to he continued group plan from Bank he worked at and paid $650 monthly. Now wants to go on Part B and get a Sup and RX plan. But the problem is Medicare is going to penalize him for not taking part B 15-years ago. Turns out if he had been on his wife's group plan he would be fine. But since it was his own group plan it's treated like Cobra and not credible. So my next thought is at least he turns 65 soon and has a fresh start then. But Medicare says no. Still the same penalty.

I've never run into this before. Anyone else have any useful solutions?

 

[WCMason]

I've got a guy who is 63. Been on Medicare Part A due to disability for 15-years. Didn't take Part B due to he continued group plan from Bank he worked at and paid $650 monthly. Now wants to go on Part B and get a Sup and RX plan. But the problem is Medicare is going to penalize him for not taking part B 15-years ago. Turns out if he had been on his wife's group plan he would be fine. But since it was his own group plan it's treated like Cobra and not credible. So my next thought is at least he turns 65 soon and has a fresh start then. But Medicare says no. Still the same penalty. I've never run into this before. Anyone else have any useful solutions?

Once he ages into Medicare the penalty goes away. I believe the Medicate rep is mistaken. Same for Part D LEP. They are right that had his EGHP been through his working wife's employer instead of his own coverage due to disability he would have had no penalty.

 

[DS4]

Once he ages into Medicare the penalty goes away. I believe the Medicate rep is mistaken. Same for Part D LEP. They are right that had his EGHP been through his working wife's employer instead of his own coverage due to disability he would have had no penalty.

I agree..........................

"For beneficiaries age 65 and older, this penalty is for life.

If you are younger than age 65, have Medicare because of a disability and are charged the Part B penalty, it will be waived when you turn 65 and qualify for Medicare based on age".