How to cancel Med. Advantage MAPD?

[honestagent]

I know one bumps out the other no matter which enrollment period one is in regarding Med. Adv.

I'm wondering, though, does anyone know if you have a client who elected a supplement during the AEP, does the client have to notify the Med. Adv. company that he elected that? Or call Medicare to disenroll?

He has an MAPD. Non dual.

I also know Medicare will require something in writing from the beneficiary when they opt to disenroll. Can anyone please advise me to advise this client on what to do regarding ridding the Med. Adv. company?

I would prefer to work with Medicare and not the carrier, if possible.

He has not received his new BCBS Supp. Card yet and I told him not to do anything until he gets his new card. He also opted to not participate in a stand alone pdp.

Any direction we would greatly appreciate. Thank you.

 

[fostever]

Call the MA company to disenroll. They will have them send a signed written statement. The company has to disenroll them or face CMS wrath.

 

[midwestbroker]

The client can:

Call Medicare direct and they will do it

Call the carrier - the client will probably have to send in a letter

Enroll in another Part D plan (MAPD or stand alone) and it will automatically kick them out of the prior plan

 

[MedSuppPro]

I'd do both.

My experience is to send a registered certified letter to the carrier and to call 1-800-MEDICARE.

Carriers are not always jumping up and down when they get these requests. I've have had several not happen. Educate the client that 5 bucks for a registered certified letter is money well spent. They should always make a copy of their properly crafted letter. Another good reason to notify the carrier is to timely stop any bank drafts.

Medi will need your client's permission to speak with you. Most of the time, I’ll give the entire call responsibility to my client and they get the job done. For some odd reason it is self-empowering. It solidifies the MedSupp sale. Use your judgment as to their ability to self-navigate the CMS system as it can be daunting. CMS has a standard warning that they read at the end of the call.

Letters eventually get mailed by the carrier. Some MedSupp carriers will issue based upon a copy of the client letter mentioned above. Others will need the disenrollment letter. Know your MedSupp carrier’s rules. We don’t want anybody left without coverage.

Watch the PDP droppers as they are the first to point fingers when they get walloped at the pharmacy. Prior experience has taught me that when I come across these people I get their desire in writing.

 

[MedSuppPro]

HonestAgent;

Isn’t your client now post AEP (November 15 – December 31st)?

If he has not requested AEP disenrollment as outlined in previous posts, prior to December 31st , then he may fall under a new set of rules. He may be eligible to proceed during the OEP. Unlike during the AEP, he may not be able to drop Part D drug coverage. So you may need to revisit his “opted to not participate in stand alone PDP” issue.

When “electing a supplement during the AEP” nobody is notified automatically. Replacing a MA or MAPD with Original Medicare + MedSupp requires the proactive agent–client disenrollment activity as outlined in previous posts. I doubt BCBS notified MAPD, nor Medicare, during the AEP.

What is his current status with the MAPD plan and the BCBS MedSupp? Has he paid MedSupp premium for January and is he still active with the MAPD? If he properly elects OEP, then see if BCBS will bump his effective date up.


Without all the facts it seems difficult to make specific advise.

Hope this helps!

 

[retread]

I know one bumps out the other no matter which enrollment period one is in regarding Med. Adv.

I'm wondering, though, does anyone know if you have a client who elected a supplement during the AEP, does the client have to notify the Med. Adv. company that he elected that? Or call Medicare to disenroll?

He has an MAPD. Non dual.

I also know Medicare will require something in writing from the beneficiary when they opt to disenroll. Can anyone please advise me to advise this client on what to do regarding ridding the Med. Adv. company?

I would prefer to work with Medicare and not the carrier, if possible.

He has not received his new BCBS Supp. Card yet and I told him not to do anything until he gets his new card. He also opted to not participate in a stand alone pdp.

Any direction we would greatly appreciate. Thank you.

If I understand this correctly, your client had an MAPD, but elected to take a Medicare Supplement during the AEP.

If so, he must disenroll from the MAPD in writing. Many MAOs have company disenrollment forms, others do not, so in the latter case a free-hand letter will suffice.

He has a 30 day free look, so once he has his Med Sup IN HAND, send in the disenrollment request with the first of next month the effective date. Then make sure he signs up for a PDP before the end of his 63 day limit of no drug coverage to avoid late enrollment penalty. The OEP allows him ONE PDP choice (unlike the AEP where the last one applied for rules). Since he had a MAPD, make sure his Rx is covered in the formulary of the PDP he chooses, or you will take the heat.

 

[honestagent]

You are all so wonderful for offering your prudent advice; I'm not sure what to do right now with them. This is a couple that will whine and cry about $1.00 more for co-pay to doctor, but they don't mind losing thousands of dollars in the stocks each quarter....go figure....

They are in their early 80s.

They waited tooooooooooo long to make up their minds what they wanted. I had contacted them early November and they waited to mid - to end December to opt into going back into their BCBS med supp.

I talked to them 2 days ago and BCBS said they should have their new cards by the end of this month. I had them on a decent MAPd with a GTL wrap around. GTL said they can call anytime to cancel and this can all be done by telephone.

I want to refrain from dealing with the MAPD carrier b/c this carrier has erred GREATLY with many of my cases... have not paid me, and now I recently received my commissions statements stating I owe them $$$ for chargebacks that I know are not. I'm so disgusted needless to say..

Back to the topic at hand. I want to make this about them and not me. What is the most effective way to rid them from the MAPD - calling Medicare? If they put something in writing, how do they send this to Medicare without going through the carrier, if at all possible? They do not take many meds. all but 2 generics; they were specific about not wanting a stand alone PDP. They didn't want to pay another 60 bucks on average for a decent plan. 'Okay cheif.. whatever you want.. I said.' This is one couple I'm glad to 'fire' if you will.

Question now is this: How the heck do I get rid of them once and for all to cancel their MAPD - yes there is a premium with the MAPD this year but they're set up I'm sure where the carrier will go into and eft that. How can they put a stop to that if that is the only way the carrier will let them go by not receiving payment from them?

Please advise. How would you handle this particular case?

 

[MedSuppPro]

The other day I was in the ACE hardware store picking out some nuts and bolts to fix an office chair. In the isle over I could hear a lady bitchen to the store owner about not servicing her leaky faucet. She actually thought the ACE hardware store should send someone out to fix her leak. The poor ACE hardware owner gracefully moved on. Then she started wining at her boyfriend about the new faucet's price.


Then it hit me. I recognized their voices. I knew who they were. They’re both clients of mine. Both are in their 80’s and are 20 + year clients of mine. So my first inclination was to make my way over to isle 9 to say hello.


Then I realized. I’m 5 days post AEP. I’ve worked my butt off and it was kind of relaxing looking at nuts and bolts in isle 10. Besides who need’s to go over to isle 9 to get bitched at about some leaky faucet. I held my ground till they left.


My point being – sometimes ya got to move on. Ya got to know when to hold-em and when to fold-em.


They have a MAPD, a GTL, and so what is their main problem? Do they suffer from an entitlement mentality? If you spent as much time as I think you did on this case and you gave it your best shot, then moving on may make sense.

 

[retread]

They waited tooooooooooo long to make up their minds what they wanted. I had contacted them early November and they waited to mid - to end December to opt into going back into their BCBS med supp.

I talked to them 2 days ago and BCBS said they should have their new cards by the end of this month. I had them on a decent MAPd with a GTL wrap around. GTL said they can call anytime to cancel and this can all be done by telephone.

Back to the topic at hand. I want to make this about them and not me. What is the most effective way to rid them from the MAPD - calling Medicare? If they put something in writing, how do they send this to Medicare without going through the carrier, if at all possible? They do not take many meds. all but 2 generics; they were specific about not wanting a stand alone PDP. They didn't want to pay another 60 bucks on average for a decent plan. 'Okay cheif.. whatever you want.. I said.' This is one couple I'm glad to 'fire' if you will.

Question now is this: How the heck do I get rid of them once and for all to cancel their MAPD - yes there is a premium with the MAPD this year but they're set up I'm sure where the carrier will go into and eft that. How can they put a stop to that if that is the only way the carrier will let them go by not receiving payment from them?

Please advise. How would you handle this particular case?

I do not have a fix-all answer, but I can tell you that for them to disenroll from a Medicare Advantage plan you have only two viable means: 1) Have THEM write a letter to the carrier (you may pen it, but they must sign & date it) 2) Have THEM call 1800Medicare. You, as an agent, cannot disenroll anyone.

Just a note about cancellation: Speaking of MA plans, one cannot "cancel" a policy after the paperwork is submitted. If you can catch the ap in process prior to its submission to CMS by the carrier, you MIGHT be able to "cancel" if the client calls immediately. Baut once the data is submitted to CMS, the only way to drop it is the "disenrollment" process. A disenrollment request will take effect (if requested) on the 1st of the following month. Like I said in a previous post, some carriers have required disenrollment forms, and others just need a free-form letter. Check with your carrier.

You know the rules: that during the OEP, they cannot drop a plan with drug benefits without picking up a "like" plan. Buying a Med Sup in December doesn't make a difference. They should have submitted a disenrollment request from their MAPD prior to 12/31 for it to be considered in the AEP. A Med Sup has a "free look" for 30 days, and does not automatically drop or disenroll an MA plan, and since they did not drop the MA plan last month and are now in the OEP, to follow through with the Med Sup, they MUST select a PDP. If they refuse to do this, I would call Medicare for a resolution. My guess is they will not be allowed the Med Sup until they do the required paperwork, or that CMS will require them to use the drug plan of the MAPD and pay the drug premium established by that carrier. Your duty, as their agent is to advise them of the rules. You cannot enforce them, you can only follow them.

I doubt non-payment of premiums will work to disenroll them. The carrier can only collect their premium with an authorized EFT form. They can always write a letter revoking that authorization. If they did not choose to have SSA w/h the premium, the carrier can bill them, then, if they don't pay, MAY cancel the policy. The small premium must be weighed against the $1500 or so that the carrier gets for administering this client's benefits.

And, as far as doctor or hospital co-pays is concerned, they may not encounter co-pays for months. When the collection process begins, it may take many more months, if at all. With the amount of money the doctor gets for the client, my bet is that a few dollars in unpaid co-pays will be ignored. It will cost the doctor more in collection than the trouble to complain to CMS. Hospital stays may be another matter, but the probability of hospitalization is fairly high if you say they are in good health.

In short, the quickest way to resolve this, is for them to call Medicare, ask to disenroll from the MAPD plan, and then enroll them in a PDP. If you don't want them, almost any major pharmacy will enroll them online if they aren't online themselves.

 

[honestagent]

Everyone, especially Retread and MedsuppPro, thank you again.

I called the carrier and spoke to a rep who was very knowledgable (surprisingly) and he instructed me to have them write a disenrollment short quick note on how to do & what to include.

The clients do not want the pdp. They did not want it during the AEP and do not want it now - though that could avoid the whole greivance process but no guarantee.

I also discovered after talking to the house that even if one were to go back to original medicare and a pdp during OEP, one could still have problems going back and would still have to go through some type of grievance process as Medicare may not recognize the change immediately.

Should be loads of fun fun fun!!!

Thanks again. I'll let you know if anything out of the ordinary occurs.

Thanks again!