Leaving an MA in OO season?

May 21, 2007

  1. Guest
    Online

    Guest Guest

    When Medicare OO season rolls around again this fall, what is the procedure a person who has an MA policy follows to 'go back' to regular Medicare and drop the MA? Does he just not renew or is there a form to complete and send to CMS?

    Thanks,
    Al
     
    Guest, May 21, 2007
    #1
  2. retread
    Offline

    retread Guru

    Posts:
    1,932
    Likes Received:
    7
    State:
    Kansas
    I think all he has to do is call 1-800-MEDICARE and ask to be disenrolled from the MA plan. It is done immediately. Someone correct me if I am wrong.
     
    retread, May 21, 2007
    #2
  3. senior-advisor-indiana
    Offline

    senior-advisor-indiana Guru

    Posts:
    11,251
    Likes Received:
    162
    State:
    Indiana
    Can't you switch back to medicare from a MA at any time? I thought the rules were only for MA to MA switches and MAPD to MAPD or interchanging.
     
  4. Insuranceman
    Offline

    Insuranceman Guru

    Posts:
    618
    Likes Received:
    3
    You can switch back to medicare any time within the first 12 months.
     
  5. midwestbroker
    Offline

    midwestbroker Guru

    Posts:
    2,371
    Likes Received:
    45
    State:
    Missouri
    Only if that is your first enrollment in a MA plan. If you have had a MA plan in the past, then the 12 month window does not apply.

    They can leave a MA plan at any time and go back to a supplement, subject to underwriting (if it applies).

    However, a MAPD plan is different. They will loose their drug coverage, and Medicare will penalize them for loosing coverage. They cannot enroll in another drug plan until AEP. From what I understand, Medicare is very hesitant to allow anyone to leave a MAPD plan.

    Now, they may qualify for a state drug assistance program (Missouri has a program called MO Rx) that creates a SEP to allow them to change plans.

    Clear as mud.
     
  6. senior-advisor-indiana
    Offline

    senior-advisor-indiana Guru

    Posts:
    11,251
    Likes Received:
    162
    State:
    Indiana
    So they can leave a MA at anytime no matter what, to go back to a supplement, as long as they can answer health questions?
     
  7. midwestbroker
    Offline

    midwestbroker Guru

    Posts:
    2,371
    Likes Received:
    45
    State:
    Missouri
    Yes. MA's only require a cancellation, MAPD's involve a fight with Medicare becuase of the Part D coverage, but it can be done.
     
  8. Guest
    Online

    Guest Guest

    Everyone is talking about 'exceptions.' All I want to know is that when the annual enrollment period (AEP) rolls around in November, what is the process for someone to drop their MA with PD and revert back to 'regular' Medicare and then sign-up for a stand-alone PD? Is there a form to fill out to alert Medicare to delete their MAPD enrollment?

    Al
     
    Guest, May 22, 2007
    #8
  9. sman
    Offline

    sman Guru

    Posts:
    6,223
    Likes Received:
    235
    State:
    Georgia
    Al,

    You have three options. Since you state they want to enroll in a stand alone PDP, when they complete the paperwork for the enrollment into the new stand alone PDP, it will automatically disenroll them from their current MAPD. Or the client can call 1-800-Medicare and disenroll. Or they can contact the carrier they have the MAPD with and ask what their requirements are. It's been my experience that they want something in writing from the client.

    But the simplest of these is to just complete the enrollment paperwork for the new stand alone PDP and the disenrollment from the MAPD is automatic. If you'll read the disclosures on and stand alone PDP application, it tells you this information.
     
    sman, May 22, 2007
    #9
  10. midwestbroker
    Offline

    midwestbroker Guru

    Posts:
    2,371
    Likes Received:
    45
    State:
    Missouri
    Sman has it down.

    Most apps I have seen ask about prior Part D coverage. Just mark yes (if that is the case) on the app and send it in.

    They will be disenrolled automatically by Medicare from their MAPD plan and have orig Medicare and Part D.

    Now, in OEP, they can:
    Change from a PDP to a MAPD

    They cannot get a new PDP or change PDP plans.

    The point to stress on this is they are only allowed one change during AEP and OEP. If they choose the wrong PDP in AEP, unless they get a MAPD in OEP, they are locked in.

    Then you have the CIA, FBI, and the PTA watching the NBA on CBS, NBC, and TNT while the DOI watches the IMO's and FMO's sell MA's, PDP's and MAPD's in AEP and OEP. He he
     
Loading...