Leaving an MA in OO season?

[GreenSky]

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?

If she is in an MA plan without drugs, she can make a once a calendar year move back to original medicare. If her plan is MAPD, then she's locked in until Dec. 31.

 

[Cenla Agent]

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.

Does anyone know how long that takes? I am sure it more than just one month and is probably a good while longer than it would take for a supp to lapse. But I don't know that there is any hard and fast rule on this.

 

[sman]

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.

Frrank,

I believe someone has given you inaccurate information. The OEP (Open Enrollment Period) for MA plans refers to the period of time in which a person can make a switch to a like plan and is from January 1 - March 31 which is after the Annual Enrollment Period (November 15 - December 31). It is not the same as the guarantee issue period for Med Supps.

The IEP (Initial Election Period) is when people just going on Medicare Part B and have their first opportunity to enroll in an MA plan. And this time period is 3 months prior to, the month of, and 3 months after turning 65 or going on Medicare Part B. Not 6 months after turning 65 or getting Medicare Part B as you described above.

Just thought you should know.

 

[sman]

Does anyone know how long that takes? I am sure it more than just one month and is probably a good while longer than it would take for a supp to lapse. But I don't know that there is any hard and fast rule on this.

As you said, I don't know that there is any hard fast rule, but I've been told after 90 days of no payment, the plan would lapse. Of course, I'm sure each carrier has their own guidelines.

 

[Frank Stastny]

Frrank,

I believe someone has given you inaccurate information. The OEP (Open Enrollment Period) for MA plans refers to the period of time in which a person can make a switch to a like plan and is from January 1 - March 31 which is after the Annual Enrollment Period (November 15 - December 31). It is not the same as the guarantee issue period for Med Supps.

The IEP (Initial Election Period) is when people just going on Medicare Part B and have their first opportunity to enroll in an MA plan. And this time period is 3 months prior to, the month of, and 3 months after turning 65 or going on Medicare Part B. Not 6 months after turning 65 or getting Medicare Part B as you described above.

Just thought you should know.

Thanks for the info. I was referring to the Open Enrollment period for a Med Supp and saying I had been told that it was the same for an MA plan.

With Med Supps there is a difference between Open Enrollment and Guaranteed Issue. The two are not the same.

The Open Enrollment period for a Med Supp is 6 months after the effective date of Medicare Part B that a person can get a Med Supp policy without having to answer any health questions.

Missouri and Calif are the only two states that I am aware of that have a Guaranteed Issue provision for Med Supps. In Calif it is on their birthday and in Missouri it is on the anniversary date of the policy.

A Med Supp person can also get Guaranteed Issue of they are cancelled by a Medicare Advantage plan, HMO, PFFS, etc. I have written supps on people who have had their HMO cancel them and they didn't have to answer health questions.

 

[sman]

Thanks for the info. I was referring to the Open Enrollment period for a Med Supp and saying I had been told that it was the same for an MA plan.

With Med Supps there is a difference between Open Enrollment and Guaranteed Issue. The two are not the same.

The Open Enrollment period for a Med Supp is 6 months after the effective date of Medicare Part B that a person can get a Med Supp policy without having to answer any health questions.

Missouri and Calif are the only two states that I am aware of that have a Guaranteed Issue provision for Med Supps. In Calif it is on their birthday and in Missouri it is on the anniversary date of the policy.

A Med Supp person can also get Guaranteed Issue of they are cancelled by a Medicare Advantage plan, HMO, PFFS, etc. I have written supps on people who have had their HMO cancel them and they didn't have to answer health questions.

I understand that Open Enrollment and GI aren't the same when speaking of Med Supps. My only point was that MA plans don't have the same rules as Med Supps when it comes to "Open Enrollment". And I am definitley aware of the rules regarding when a person can get a guarantee issue Medicare Supplement. In addition to your reference above about getting a GI Med Supp if cancelled by a MA plan, they can also get one if they leave a Med Supp for a MA plan and in the first 12 months cancel the MA plan to go back to a Med Supp. Written a few of those myself.

 

[Frank Stastny]

I understand that Open Enrollment and GI aren't the same when speaking of Med Supps. My only point was that MA plans don't have the same rules as Med Supps when it comes to "Open Enrollment". And I am definitley aware of the rules regarding when a person can get a guarantee issue Medicare Supplement. In addition to your reference above about getting a GI Med Supp if cancelled by a MA plan, they can also get one if they leave a Med Supp for a MA plan and in the first 12 months cancel the MA plan to go back to a Med Supp. Written a few of those myself.

Thanks, I don't know why CMS had to make it so confusing and difficult. There just doesn't seem to be any rhyme of reason to it.

I have seen other posts where there was confusion between the two. I was only asking so I could understand what we were talking about. I'm going to stick to Med Supps. I know I'm not going to screw up with them. I hope.

 

[senior-advisor-indiana]

The only companies that I know of that do the GI med supp after ther 1st time on an MA plan is United World and Unicare. CMS rules states they can go back to thier original med supp, not a new one. Some companies allow it though. It is the companies choice not a rule. So dont assume that they can get any medicare supplement after the decide they don't want an MA in the first 12 months.

It sound to me like United World will be going down hill with their horrible underwriting and GI choices. Targeting turning 65 and GI after leaving a MA. They wont get my business.

 

[Cenla Agent]

The only companies that I know of that do the GI med supp after ther 1st time on an MA plan is United World and Unicare. CMS rules states they can go back to thier original med supp, not a new one. Some companies allow it though. It is the companies choice not a rule. So dont assume that they can get any medicare supplement after the decide they don't want an MA in the first 12 months.

It sound to me like United World will be going down hill with their horrible underwriting and GI choices. Targeting turning 65 and GI after leaving a MA. They wont get my business.

Horrible underwriting being their acceptance of insulin dependent diabetics?


Someone recently sent me info on Provident American with the hook being that they have the same rates for smokers and non-smokers. They are in the ballpark but there are several companies whose smoker rate is a little cheaper. Since they are not cheaper on smokers than the cheapest competitors, maybe it's not that bad but what do I know?

 

[sman]

The only companies that I know of that do the GI med supp after ther 1st time on an MA plan is United World and Unicare. CMS rules states they can go back to thier original med supp, not a new one. Some companies allow it though. It is the companies choice not a rule. So dont assume that they can get any medicare supplement after the decide they don't want an MA in the first 12 months.

It sound to me like United World will be going down hill with their horrible underwriting and GI choices. Targeting turning 65 and GI after leaving a MA. They wont get my business.

Haven't we been down this road before? The Medicare & You book states that they can get their old supp back OR get a new one. Each state will have different rules as to which Plan is to be offered, but the Medicare & You book clearly states that a person can get a new Med Supp.