Having Both MAPD and Med Sup

[StephanieCJ]

We definitely strayed into an argument about semantics. Bottom line: It is technically possible to have both at the same time, but ultimately pointless. The Medigap picks up where Original Medicare leaves off. The MAPD is a Medicare Replacement (Original Medicare no longer managing your care, but a private insurance company doing it). There is no coordination of benefits and the Medigap will not pay anything toward claims as long as you are enrolled in the MAPD. Enrolling the client in a PDP will effectively disenroll them in the MAPD and revert their health coverage back to Original Medicare. At that time, they can begin using the Medigap policy again in conjunction with Original Medicare.

 

[LostDollar]

We definitely strayed into an argument about semantics. Bottom line: It is technically possible to have both at the same time, but ultimately pointless. The Medigap picks up where Original Medicare leaves off. The MAPD is a Medicare Replacement (Original Medicare no longer managing your care, but a private insurance company doing it). There is no coordination of benefits and the Medigap will not pay anything toward claims as long as you are enrolled in the MAPD. Enrolling the client in a PDP will effectively disenroll them in the MAPD and revert their health coverage back to Original Medicare. At that time, they can begin using the Medigap policy again in conjunction with Original Medicare.

Whether or not it is ultimately pointless is a debatable topic-and I am not going to inflict that on this thread.

AGAIN, for purpose of THIS THREAD, keep in mind op's original post is about A SITUATION WHICH HAS ALREADY OCCURRED. The question is not about the wisdom or utility of some future action--it is about CMS rule details, what is allowed, and how op can best correct the SITUATION his CLIENT IS ALREADY IN.

 

[Life Hawk]

Whether or not it is ultimately pointless is a debatable topic-and I am not going to inflict that on this thread.

AGAIN, for purpose of THIS THREAD, keep in mind op's original post is about A SITUATION WHICH HAS ALREADY OCCURRED. The question is not about the wisdom or utility of some future action--it is about CMS rule details, what is allowed, and how op can best correct the SITUATION his CLIENT IS ALREADY IN.

Just a quick interjection... I had a client who had a med sup... she was then enrolled in a MAPD by another agent who didn't follow up on the medsup, so she kept paying for it... by the time I got back to her... over 3 yrs later... I discovered the issue while browsing through her bank accounts trying to figure out why she hadn't paid for her life ins.... bingo... there it was... reported to the medsup company the issue and after providing proof of coverage on her MAPD... they sent her a check for more than $5k... she was very happy...

 

[StephanieCJ]

Just a quick interjection... I had a client who had a med sup... she was then enrolled in a MAPD by another agent who didn't follow up on the medsup, so she kept paying for it... by the time I got back to her... over 3 yrs later... I discovered the issue while browsing through her bank accounts trying to figure out why she hadn't paid for her life ins.... bingo... there it was... reported to the medsup company the issue and after providing proof of coverage on her MAPD... they sent her a check for more than $5k... she was very happy...

I’m honestly suprised they refunded it. I bet you have that client for life now.

 

[Life Hawk]

MOO... they do have some restrictions... as I remember she didn't get back 2 or 3 months worth... but yes very happy.

 

[LostDollar]

Ran into another MAPD where the agent didn't make sure the med sup was canceled.

What do you think would happen if I wrote a PDP and left her on the med sup? Would it go unnoticed? She might not pass underwriting if she had to go through it again.

Would be interested to hear what solution you and your client decide upon.