- 6,457
I believe the rules talk about the minimum rights a consumer has in a given situation, NOT the maximum restriction they are required to submit to.
Enrolled in MA - Big Mistake
- Thread starter somarco
- Start date
- 29,487
No they don't if another company will give them GI in this situation.
As LD pointed out, "carriers do not always choose to interpret those rules quite as strictly as they are written".
No they don't if another company will give them GI in this situation.
As LD pointed out, "carriers do not always choose to interpret those rules quite as strictly as they are written".
I have had a few give GI, I remember AARP put me into GI even when it was plan N and client previously had plan F with Mutual before getting MA plan\ (this was super health no med person
I know I have had one or 2 other give me GI on plan F with trial right but besides AARP all gave me underwriting for G so far
No they don't if another company will give them GI in this situation.
As LD pointed out, "carriers do not always choose to interpret those rules quite as strictly as they are written".
All I know is what the CMS rule states, not what/when companies don't follow it. Whenever I've had to deal with the situation I didn't find a company that was willing to take them unless the original company they had didn't carry the plan anymore.
- 29,487
I understand that Todd, but if a company wants to vary from the printed rule, that's on them. I don't know if Oxford will still take someone on Trial Right that had been with another company, but they did. It seems like Aetna would too, but they don't pay squat.
Bottom line is do what's best for the client, and hopefully we can get paid for our efforts.
- 29,487
I have had a few give GI, I remember AARP put me into GI even when it was plan N and client previously had plan F with Mutual before getting MA plan\ (this was super health no med person
I know I have had one or 2 other give me GI on plan F with trial right but besides AARP all gave me underwriting for G so far
If a person can pass underwriting I never go GI...I want some money!!!
I get the impression that a lot of agents don't realize that you can go underwritten in a GI situation.
That's why I was upset I got GI on AARP supp , I answered No to all GI questions and did plan N but they said because replacement form said disenrolled from MA due to trial right they put it GI
- 29,487
Another reason why AARP Insurance Company isn't very apealing.
I've done them with LCBA and they give approval at the end of the POS PHI. I told them at the beginning that it was a Trial Right situation, but were were doing underwritten, not GI. They had no problem with it, just said to be sure to send in a copy of the disenrollment letter. I always make sure that I make note on the cover sheet that it's underwritten, not GI.
I wsh all companies did POS PHI with approval at the end.
I'm sure it'll vary by company. AARP Insurance Company's saving money by paying you the GI rate.
- Thread starter
- #40
Back on track . . . .
Talked with the couple earlier and they don't want to press the issue. They claim they were confused and not the fault of the agent. (They now say it was an agent, not the carrier).
Plus the man had hip surgery and complications a couple of months back. His OOP (according to him) is $10,000.
Still don't know if the agent pulled a fast one or they missed something.
This really bites.
Talked with the couple earlier and they don't want to press the issue. They claim they were confused and not the fault of the agent. (They now say it was an agent, not the carrier).
Plus the man had hip surgery and complications a couple of months back. His OOP (according to him) is $10,000.
Still don't know if the agent pulled a fast one or they missed something.
This really bites.
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