Leaving an MA in OO season?

[Guest]

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.

Um... wait a minute. AEP is Nov to Feb. They can make any change they want, right? They can change from one MA to another? They could drop MAPD and select regular Medicare AND sign for a different PD. There are no restrictions between Nov 1 and Feb 1, right?

When is the Open Enrollment Period? When they turn 3 months before/after turning 65?

Thanks,

Al

 

[sman]

Um... wait a minute. AEP is Nov to Feb. They can make any change they want, right? They can change from one MA to another? They could drop MAPD and select regular Medicare AND sign for a different PD. There are no restrictions between Nov 1 and Feb 1, right?

When is the Open Enrollment Period? When they turn 3 months before/after turning 65?

Thanks,

Al

AEP (Annual Enrollment Period) is November 15 to December 31. This is when they can make changes to their current plan regardless of which type of plan it is.

OEP (Open Enrollment Period) is from January 1 to March 31. During this period they can switch to a "like" plan and can only do this once. For example, if they have an MAPD they can switch to another MAPD or a stand alone MA and stand olne PDP. However, if they already have a stand alone PDP, they can only switch there MA plan during this period.

The IEP (Initial Election or Enrollment Period is the 3 months before/after going on Medicare.

 

[senior-advisor-indiana]

Are you sure you can convet back to origainal medicare at any time, even if you have been in the MA more than 12 months? Example. I talked to a lady the other day, she has been on an MA 2 yrs. She wants to get a med supp now, effective 7-1-07. She can health qualify. Can I write her a med supp and cancel her ma plan?
My FMO tells me no, midwest is telling me yes. Are you just trying to get my hopes up?

 

[honestagent]

Are you sure you can convet back to origainal medicare at any time, even if you have been in the MA more than 12 months? Example. I talked to a lady the other day, she has been on an MA 2 yrs. She wants to get a med supp now, effective 7-1-07. She can health qualify. Can I write her a med supp and cancel her ma plan?
My FMO tells me no, midwest is telling me yes. Are you just trying to get my hopes up?

I'd call Medicare and ask. I think but don't quote me that if the member writes to Medicare and the company and explains in writing that he or she is unsatisfied and unhappy then they're able to disenroll but I am not 100% for sure. I just know if someone is knew to MA - for the first 12 months they can drop an MA and go back to original Medicare. Check your 07 book on disenrollment too. Let us know... thank you.

 

[g1bass]

There are disenrollment procedures and here is the bible regarding that straight from the horses mouth ie CMS

 

[midwestbroker]

According to CMS, you can only dis enroll during the election periods. However, if you have a premium, and you do not pay, you will be dis enrolled by the carrier.

I know that I have had people drop coverage during a lock in period to go back to a supplement and they have had no problems.

 

[Cenla Agent]

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

If they do nothing, they will be re-enrolled in their current plan if it is offered for the coming year.

There are several ways to switch to Original Medicare with a PDP.

1. If they are in an MAPD, if they enroll in a standalone PDP it will automatically disenroll them from the MAPD since you can only be in one plan at a time. This is the way to do it if they are in a MAPD.

2. Contact the company and request disenrollment effective 1/1. Humana requires that this be done in writing, don't know about other companies.

3. 1-800-Medicare. They will disenroll them from the MAPD and enroll them in the PDP of their choice if they wish.

Anyone wanting to disenroll from a MAPD needs to make sure they enroll in a PDP or they will lose coverage and also face the late enrollment penalty if they don't have a PDP for more than a certain period, which I believe is 30 days.

If they have a standalone MA and want to keep their current standalone PDP then all they have to do is request disenrollment through either the carrier or Medicare directly.

 

[Cenla Agent]

Um... wait a minute. AEP is Nov to Feb. They can make any change they want, right? They can change from one MA to another? They could drop MAPD and select regular Medicare AND sign for a different PD. There are no restrictions between Nov 1 and Feb 1, right?

When is the Open Enrollment Period? When they turn 3 months before/after turning 65?

Thanks,

Al

Unless something has changed, the AEP is 11/15-12/31. That's the only time someone can change PDP's or enroll in one if they never have before. They can enroll/disenroll from MA/MAPD plans then too. The OEP is 1/1-3/31 for MAPD's. The OEP is for those who have Part D to be able to change their health coverage, which could be enrolling in a MAPD, switching to a different MAPD, or going back to Original Medicare and a PDP from a MAPD. If they are looking to enroll in a PFFS that is offered as MA only, then they have longer than the 3/31 date and others here can tell you exactly what the rules for that are. Regardless, the OEP allows members to make one change to their health plan.

There is a ICEP (IEP for standalone PDP) for those aging in, which is the three months prior to the month of their birthday, the month they turn 65, and then the three months afterwards, for a total of 7 months.

 

[Frank Stastny]

There is a ICEP (IEP for standalone PDP) for those aging in, which is the three months prior to the month of their birthday, the month they turn 65, and then the three months afterwards, for a total of 7 months.

I have been told that the Open Enrollment Period was the same as it is for Med Supps. You can write the app up to three months prior to them turning 65. However, their Open Enrollment Period starts the first day of the month their Part B goes into effect and lasts for the next 6 months

Even though they can sign up three months before they turn 65 those three months are not counted in the 6 month OEP. Their actual open enrollment lasts for 6 months after turning 65 or for the first 6 months after they receive Medicare Part B.

I don't sell a lot of MA plans so I have never run into that situation. That is just what I have been told.

 

[Cenla Agent]

I have been told that the Open Enrollment Period was the same as it is for Med Supps. You can write the app up to three months prior to them turning 65. However, their Open Enrollment Period starts the first day of the month their Part B goes into effect and lasts for the next 6 months

Even though they can sign up three months before they turn 65 those three months are not counted in the 6 month OEP. Their actual open enrollment lasts for 6 months after turning 65 or for the first 6 months after they receive Medicare Part B.

I don't sell a lot of MA plans so I have never run into that situation. That is just what I have been told.

I think it's different, and that the initial enrollment period for MA is the same as for PDP. But I'll try to remember to look it up tomorrow to make sure.

I also know there is an OEP for those just getting Medicare to change MA plans or go back to Original Medicare from an MA that is available for a limited time after getting Part B but I've never run into that situation.