Losing Dual Eligibility SEP

[LewB]

I received a referral from a client. His friend is leaving California and is dual eligible with a separate Part D drug plan paid for by Medi-Cal. She is moving to Colorado and will no longer be dual eligible.

I know she has a SEP for a MAPD but another agent told me she also has a SEP for a Medicare Supplement. I can find no mention of SEP at Medicare.gov or at DORA (department of regulatory agencies) for Colorado.

Am I missing something?

 

[yogooglethis]

I received a referral from a client. His friend is leaving California and is dual eligible with a separate Part D drug plan paid for by Medi-Cal. She is moving to Colorado and will no longer be dual eligible.

I know she has a SEP for a MAPD but another agent told me she also has a SEP for a Medicare Supplement. I can find no mention of SEP at Medicare.gov or at DORA (department of regulatory agencies) for Colorado.

Am I missing something?

Yes you are. First SEPS do not pertain to med supps however she should qualify for GI do to a change of permanent residence.Part D LIS is funded through the Federal Gov. not the state .Medi-cal or Medicaid is a state program.Chances are if she qualifies for med-cal she will qualify for medicaid in Colorado.And usually a med supp is not suitable for a person who s income qualifies for medicaid unless it is a state that medicaid pay the med supp premiums

 

[LewB]

Thanks for the info. Her financial situation will be changing once she moves to Colorado so she will no longer be eligible for Medicaid.

As far as GI I did not see anything at Medicare.gov that would give her a right to a GI.

http://www.medicare.gov/supplement-...eed-issue-rights-scenarios.html#collapse-4693

 

[yogooglethis]

Thanks for the info. Her financial situation will be changing once she moves to Colorado so she will no longer be eligible for Medicaid.

As far as GI I did not see anything at Medicare.gov that would give her a right to a GI.

http://www.medicare.gov/supplement-...eed-issue-rights-scenarios.html#collapse-4693

You are right.The GI is only for people who have a med supp select that is not available in new state/county so in this case it wouldn't help.

 

[LewB]

Thanks for the help.

 

[jdeasy]

I received a referral from a client. His friend is leaving California and is dual eligible with a separate Part D drug plan paid for by Medi-Cal. She is moving to Colorado and will no longer be dual eligible.

I know she has a SEP for a MAPD but another agent told me she also has a SEP for a Medicare Supplement. I can find no mention of SEP at Medicare.gov or at DORA (department of regulatory agencies) for Colorado.

Am I missing something?

If she is in an MA plan now then she will be GI for a sup. If not in an MA plan now then check with the new state. Some states allow GI for loss of Medicaid.

I know mine is one that does not. No idea on Colorado.

 

[JimmyUt]

If she is leaving California and moving out of the coverage area, she is GI. It is right in the guide.

 

[LewB]

Unless I am missing something she has no GI rights but has a SEP to purchase an MAPD. She was on MediCal and never purchased an MAPD so as far as I can tell there are no GI rights when a person looses their dual eligibility.

 

[JimmyUt]

Unless I am missing something she has no GI rights but has a SEP to purchase an MAPD. She was on MediCal and never purchased an MAPD so as far as I can tell there are no GI rights when a person looses their dual eligibility.

Sorry, I read that she had mapd. My bad

 

[LewB]

Not a problem I just wanted to make sure I was providing her with the right info.