Lady is Unhappy with Medicare Advantage

[Gary from Dallas]

I am pretty new to selling health insurance in general and particularly green at senior market. I have a lay who bought what looks to be a medicare advantage plan with Secured Horizons in Texas. She does not like it and wants me to suggest an alternative. she likes BCBS. I told her that I would take the certification training on Medicare advantage and Part D, but both BCBS and Unicare are no longer offering it and it sounds like they are out of the business. If I were to write her a plan F and she dropped the medicare advantage plan would she lose coverage? I know enough to know, I don't want to mess her up on prescription coverage. Or can you tell me how I can go about how these different options coordinate with each other. I know from other posts that there are lots of problems with Medicare Advantage. I need some basic training to know how to advise people properly. I would appreciate any help.

Thanks

 

[InsureGuy5]

In some cases, you can't just disenroll anytime from an MA plan. You may want to call UHC to see when she can do this. And you need to make sure you can underwrite her for a Plan F as well. Open enrolment for Part D is not until Nov.

 

[jdeasy]

I am pretty new to selling health insurance in general and particularly green at senior market. I have a lay who bought what looks to be a medicare advantage plan with Secured Horizons in Texas. She does not like it and wants me to suggest an alternative. she likes BCBS. I told her that I would take the certification training on Medicare advantage and Part D, but both BCBS and Unicare are no longer offering it and it sounds like they are out of the business. If I were to write her a plan F and she dropped the medicare advantage plan would she lose coverage? I know enough to know, I don't want to mess her up on prescription coverage. Or can you tell me how I can go about how these different options coordinate with each other. I know from other posts that there are lots of problems with Medicare Advantage. I need some basic training to know how to advise people properly. I would appreciate any help.

Thanks

Unless she qualifies for an SEP, she cannot drop the MA unless she is still in her ICEP.

Barring one of those situations, she is "locked-in" to her plan until Dec. 31 of this year. She can drop the plan during AEP, Nov. 15-Dec. 31 and the disenrollment will be effective Jan. 1, 2010.

 

[moonlightandmargaritas]

In some cases, you can't just disenroll anytime from an MA plan.

As a first-time enrollee in an MA plan, she can disenroll from MA in the first twelve months for any reason, or no reason at all. In addition, she is eligible for a GI Med Supp.

 

[Gary from Dallas]

Thanks for your responses. If she did drop her MA plan what impact would that have on her Medicare part D coverage if any?

 

[briko3]

I have a lay who bought what looks to be a medicare advantage plan with Secured Horizons in Texas.

I've never heard of anyone mixing business and pleasure in senior market, but I guess to each his own

 

[moonlightandmargaritas]

I've never heard of anyone mixing business and pleasure in senior market, but I guess to each his own

While I have no first-hand knowledge, colleagues have told me they can be a tad dry...

 

[jdeasy]

Thanks for your responses. If she did drop her MA plan what impact would that have on her Medicare part D coverage if any?

If she is dropping the MA as a first time enrollee in an MA plan during the first 12 months, she has to leave her PDP alone if it's a stand alone PDP. If she is in an MAPD, she would have to pick up a stand alone PDP. She can't just drop her PDP coverage whether it's stand alone or with the MAPD.

If she qualifies for any SEP, she can drop the MA or MAPD, she still would have to get a PDP. Either stand alone or combined with another MAPD.

 

[Gary from Dallas]

What can I say, she's pretty hot for 70.
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If she is dropping the MA as a first time enrollee in an MA plan during the first 12 months, she has to leave her PDP alone if it's a stand alone PDP. If she is in an MAPD, she would have to pick up a stand alone PDP. She can't just drop her PDP coverage whether it's stand alone or with the MAPD.

If she qualifies for any SEP, she can drop the MA or MAPD, she still would have to get a PDP. Either stand alone or combined with another MAPD.

So if the PDP is a part of the MA plan which I guess makes it an MAPD then she would need to also buy a stand alone PDP in addition to the med sup otherwise, dropping her MA would have no impact if she already has stand alone PDP.

OK, I think I have that, but what is an SEP? I know what simplified employee pensions are, but I don't think that is what you are referrring to.

 

[moonlightandmargaritas]

OK, I think I have that, but what is an SEP? I know what simplified employee pensions are, but I don't think that is what you are referrring to.

Before you get in trouble by harming somone, you need to get some basic Medicare/supplement/advantage/PDP education.