ESRD Regs/Medicare

[asher]

Once again to all the great agents on this forum who are always willing to teach and advise.

Many many thanks!!!

Happy 4th.

 

[somarco]

Happy 4th.

You are 3 ahead of me.

Bartender bring me 2 doubles.

 

[sman]

You are 3 ahead of me.

Bartender bring me 2 doubles.

Overachiever!

 

[kstein]

I'd also suggest the client buy that gtl hospital indemnity plan as it's GI at 65. Often it's worth grabbing on top of a supplement bc esrd clients usually have frequent, lengthy hopsital stays!

 

[Travis Price]

I'd also suggest the client buy that gtl hospital indemnity plan as it's GI at 65. Often it's worth grabbing on top of a supplement bc esrd clients usually have frequent, lengthy hopsital stays!

I guess I'm not thinking enough outside the box...

All of the popular Medigaps cover Part A. What's the benefit of a Hospital Indemnity?

Unless it's a really good reason I just can't think of, you're over-insuring the client.

 

[StephanieCJ]

Just my two cents, so you are welcome to disregard...

If client has ESRD, the cost of dialysis on MA may be a deal breaker (in our area, every plan is 20%) unless its covered better where you are. I would generally try to push a Med Supp in this instance because when they get the first bill (there again, if the coverage in your area is similar to mine), you could get a rapid disenrollment when they realize how much they are paying versus a supplement.

If client has had a successful transplant or there is a SNP for ESRD, then MA may still possibly be the way to go depending on other factors which haven't been discussed here.

 

[Travis Price]

I would only disagree because it's only two months. Under 65/ERSD is crazy expensive. It doesn't appear that client is under dialysis.

 

[bluediamond]

Hello All,

I have a 64 yr old client on an ACA who had a kidney removed in Dec '2018.
I received a call yesterday that he just received Medicare A&B as of 10/1/2019.
He turns 65 because of age in Jan 2020.

I recommended the MAPD for 10/1-12/31 with same carrier as his ACA plan because he is underage
Then in Dec. I recommended we do a medicare supplement since he is aging-in in we have open enrollment.

I have been searching for the regs that allow me to do this.
Can't find anything on Medicare.gov.
maybe I'm phrasing/querying incorrectly?

can anyone help me find pronted rules of what I'm allowed to do??

thanks for any input.

You said he had a kidney removed is he on dialysis? What for? ESRD you are either on dialysis or making yourself comfortable for whatever short life you have left.

 

[Northeast Agent]

What State is he in? Mine (PA) offers a Chronic Renal Disease Program, but you have to be at 300% or below of the FPL.

 

[Northeast Agent]

kstein said:

I'd also suggest the client buy that gtl hospital indemnity plan as it's GI at 65. Often it's worth grabbing on top of a supplement bc esrd clients usually have frequent, lengthy hopsital stays!

Unfortunately, it's not GI at that age in every State, such as NJ or PA...