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I was given a referral for a long term care resident who has no other SEP available. I came across this one in old SEP cheat sheet from 2008. But is it still valid?
Is There an SEP for "Institutionalized Individual" Still?
- Thread starter wehotex
- Start date
- 15,319
Yes, but make certain they need an MA plan and that their doctor(s) are okay with it.
A large percentage of those in LTC are already or will soon qualify or Medicaid. Putting them in an MA plan may not be beneficial.
Rick
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Her doctor was the one who referred her to me.
This particular one is not any where Medicaid status. She has too many assets. She had a stroke a month ago and was hospitalized for 30 days. would a medigap be out of the question? That would probably work better for her since she has to spend her $$ anyway. Might as well enhance her quality of care.
Institutionalization creates a SEP to enroll in a MA or Part D. It does not create a Guarantee Issue period. She would be turned down by every Med Supp company given her stroke a month ago.
Put her on a MA and her MOOP costs will at least be capped and she may be able to save some of those assets.
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Obviously the institutionalized patient or family member with POA needs to initiate the contact. But that wasn't the question asked.
Rick
