Having Both MAPD and Med Sup

[LostDollar]

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....but if I remember correctly, placing a med sup on top of an MAPD is strictly prohibited. I personally though would not attempt to place an MAPD over a med sup either. This lady has had the med sup in place since she aged in so has a preferred rate and the overlap is just one year. The med sup company will probably refund the full year, their agent services said, but no more than one year.

I don't have the time today to hunt up the references, but I can later in the week if you want.

The key here is the direction-If one has an MAPD plan, they may not acquire a medigap in addition to it. However, if a medicare beneficiary already has a Medigap plan, they can purchase an MAPD without dropping the Medigap plan. They can continue to pay premiums on the Medigap and keep it in force. They are just not allowed to use the medigap plan during the year(s) they are using the MAPD. Those are the rules I found while researching holding a Medigap plan and an MSA type of MA plan at the same time.

If your client has paid the Medigap plan premiums all along, but has not used the medigap plan during the full years the MAPD plan has been in force, The reading I have done here on the forums over the last two years and the research I did for the MSA plan would suggest to me that Your client can continue to pay her preferred premium on the Medigap plan, continuing to keep it force-and that you can write a Jan 1 eff PDP which will cancel the MAPD, leaving her with the Medigap PDP combo starting Jan 1.
As I said I am not an agent, but if I were, or if I were advising a family member in this situation, that is the starting point I would work from.

If your client got payments from both Medicare/Medigap and the MAPD in given year, I don't know what her situation would be.

 

[LostDollar]

Getting colder LD......send me a PM and (for a fee) I would be happy to arrange a time to educate you on how Medicare coordination of benefits work.

I'm not going to pay you for anything. In fact I am going to save myself a lot of grief and just put you on ignore.

I would be quite interested in a civil discussion about whether having an MAPD plan and using its dental, vision and drug benefits also removes you from the original medicare provider network and eligibility for original medicare and medigap payments. I have no need to read more sniping posts.

 

[Stephen]

If your client got payments from both Medicare/Medigap and the MAPD in given year, I don't know what her situation would be.

]

If you understood how Medicare coordination of benefits works you would know this. Too bad that I am ignored now , I was going to offer you a discount.

 

[Hopes]

1) A Medicare beneficiary may have a supplement/PDP combo OR an MA/PDP - not both.

2) I've, personally, had a client with a MOO supplement who was moved to an MAPD. His supplement caught up after about four months and was going to cancel. Of course, he contacted me and the appropriate actions were taken to make sure this didn't happen.

3) Anyone who thinks they can skirt the system and have a medigap in addition to an Advantage plan is mistaken.

 

[LostDollar]

A medicare beneficiary may own both an MA or MAPD AND a Medicare supplement IF the MA or MAPD is acquired after the supplement.

For example, I currently have a Medigap plan. I could enroll in an MAPD for next year. As long as I pay my Medigap premiums too, I can own both the Medigap and MAPD plans and the Medigap carrier may not cancel my coverage just because I also own an MAPD or MA plan.

 

[Hopes]

Based on my client's experience the med supp insurer can cancel you.

 

[Hopes]

whether having an MAPD plan and using its dental, vision and drug benefits also removes you from the original medicare provider network and eligibility for original medicare and medigap payments.

Yes, it does.

 

[LostDollar]

There was another post that showed up while I was typing. Re med supp carrier cancelling.

There is a CMS document somewhere that says otherwise. I did not save the link and do not know how to refind it at the moment.

What the op's situation sounds like is that his client got an MAPD during the 2017 AEP and has had both plans during 2018. As long as the client has only used the MAPD during 2018 there have been no prohibited transactions and op will be doing his client a major disservice if he gets this medsupp cancelled and writes another one.

 

[Newby]

A Med Sup can’t pay anything if you have an active MA plan. Med Sups only pay after original Medicare A&B. Your A&B are inactive if you are on Part C.

I have run into a lady that had 6-straight years of Humana MAPD cards and had paid for an AARP Med Sup Plan F the entire time. I called United Healthcare with her to cancel the Med Sup since it was during lock in. They basically talked her into keeping it and would not let me explain anything to them at all because I was an agent. Poor woman couldn’t really understand any of it.

 

[LostDollar]

A Med Sup can’t pay anything if you have an active MA plan. Med Sups only pay after original Medicare A&B. Your A&B are inactive if you are on Part C.

I have run into a lady that had 6-straight years of Humana MAPD cards and had paid for an AARP Med Sup Plan F the entire time. I called United Healthcare with her to cancel the Med Sup since it was during lock in. They basically talked her into keeping it and would not let me explain anything to them at all because I was an agent. Poor woman couldn’t really understand any of it.

Yes, I agree about the payment issue. That is exactly what I got to in researching. If you already have a MedSupp you can buy an MAPD and own both. You just can't receive
payment from both. And I know that somewhere I specifically saw the statement that a Med Supp carrier cannot cancel your plan just because you OWN an MA or MAPD.

So far, op has only talked about owning the plans and has talked about his client owning both a supp and an MAPD, wanting to go back to supp and having health issues that would probably prevent getting a good supp rate on a rewrite. Op has provided no discussion about whether or not any of his client's providers erroneously received payments from the Med Supp carrier during the one year of two plan coverage. In essence the client has retained her right to return to using that plan by paying premiums and keeping the plan in force.