Guarantee Issue Question

[selfgen]

i have a prospect who is voluntarily dropping her group coverage because the group was only offering Medicare Advantage plans to their retirees, and she wanted to remain on original Medicare.

She has health issues so she needs to utilize her "guarantee issue" rights. Since she has been on Medicare since 2013, what Medicare supplement plan is she eligible to take? Does she have to take Plan F? Can she take Plan G? Does it depend on the state she resides in? Does it depend on the insurance company we apply with? I realize there will likely be no commissions on this, but I have to take care of this person. I can probably call some insurance companies during the week and get answers, but im in the middle of wrapping up AEP and I'd like to get an answer ASAP, if anyone on this board knows or can give insight.

thanks

tommy thevenot

 

[wehotex]

i have a prospect who is voluntarily dropping her group coverage because the group was only offering Medicare Advantage plans to their retirees, and she wanted to remain on original Medicare.

She has health issues so she needs to utilize her "guarantee issue" rights. Since she has been on Medicare since 2013, what Medicare supplement plan is she eligible to take? Does she have to take Plan F? Can she take Plan G? Does it depend on the state she resides in? Does it depend on the insurance company we apply with? I realize there will likely be no commissions on this, but I have to take care of this person. I can probably call some insurance companies during the week and get answers, but im in the middle of wrapping up AEP and I'd like to get an answer ASAP, if anyone on this board knows or can give insight.

thanks

tommy thevenot

It’s GI if their Medicare is already active. PLAN G only if Medicare Part A started before 1-1-20 (I believe) and Plan F if before. Maybe a Med Supp agent could answer if the applicant with Part A before
1-1-20 has choice to use EITHER F or G? F is sunsetted so not avbl to those with Part A after 1-1-20.

 

[somarco]

voluntarily dropping her group coverage

Some states and carriers allow a GI SEP when voluntarily dropping group . . . most only allow GI when loss of group is INvoluntary

Guaranteed issue rights | Medicare

 

[LostDollar]

i have a prospect who is voluntarily dropping her group coverage because the group was only offering Medicare Advantage plans to their retirees, and she wanted to remain on original Medicare.

She has health issues so she needs to utilize her "guarantee issue" rights. Since she has been on Medicare since 2013, what Medicare supplement plan is she eligible to take? Does she have to take Plan F? Can she take Plan G? Does it depend on the state she resides in? Does it depend on the insurance company we apply with? I realize there will likely be no commissions on this, but I have to take care of this person. I can probably call some insurance companies during the week and get answers, but im in the middle of wrapping up AEP and I'd like to get an answer ASAP, if anyone on this board knows or can give insight.

thanks

tommy thevenot

Caveat, not an agent.

Just for clarity here; Is the client dropping employer coverage because the employer has stopped offering a non-medicare advantage option, or has she actually been on a Medicare advantage plan for employer coverage?

 

[policywunk]

In Florida Med supp carri

i have a prospect who is voluntarily dropping her group coverage because the group was only offering Medicare Advantage plans to their retirees, and she wanted to remain on original Medicare.

She has health issues so she needs to utilize her "guarantee issue" rights. Since she has been on Medicare since 2013, what Medicare supplement plan is she eligible to take? Does she have to take Plan F? Can she take Plan G? Does it depend on the state she resides in? Does it depend on the insurance company we apply with? I realize there will likely be no commissions on this, but I have to take care of this person. I can probably call some insurance companies during the week and get answers, but im in the middle of wrapping up AEP and I'd like to get an answer ASAP, if anyone on this board knows or can give insight.

thanks

tommy thevenot

In Florida when voluntarily dropping EGHP state law does not guarantee a GI for med supps however UHC will give GI with submission of termination letter.May be other carriers that do as well.

 

[selfgen]

Caveat, not an agent.

Just for clarity here; Is the client dropping employer coverage because the employer has stopped offering a non-medicare advantage option, or has she actually been on a Medicare advantage plan for employer coverage?

 

[selfgen]

She didn’t realize she was on an Advantage plan through her group-but she is. As of this year, that’s all they offer. So she’s been on a group MAPD all year and she’s going to drop her group coverage so she can have original Medicare. In Louisiana, voluntary loss of group coverage qualifies for GI.

 

[LostDollar]

She didn’t realize she was on an Advantage plan through her group-but she is. As of this year, that’s all they offer. So she’s been on a group MAPD all year and she’s going to drop her group coverage so she can have original Medicare. In Louisiana, voluntary loss of group coverage qualifies for GI.

(caveat, not an agent)

Thank you for taking the time to explain your situation in more detail. I'm glad the GI circumstance is working for you.

In relation to F and G, I can't remember for sure, but it seems like I have seen comments going both ways, some saying the equivalent of she can get only F, others saying the equivalent of she can get F or G. I had been hoping @StephanieCJ would have some experience with this type of issue and chime in.

I have a feeling you are going to wind up having to do something like picking your two best G plans and talking to the carriers to get a "for sure" answer, but don't know. It sounds like a PIA--I applaud you for working on helping this person.