MA-only letter

[jack3454]

For those familiar with MA-only plans...are they still requiring the enrollee to submit an attestation saying they have other drug coverage so they wont be disenrolled? No one seems to know the procedure. This is for Aetna.

 

[Fisher]

Nope. I've never even heard of that and I've been actively writing MA-only for 4-5 years.

 

[ValeRosso]

I had this happen, the insurance company will send the member a letter if they're new to the plan and they will have to say that they have other Rx coverage and that they wish to enroll.

First time it happened they auto enrolled the member into a random MAPD from the MA and it was a pain to fix.

Just tell the member to keep an eye out for any mail asking them to verify they wish to enroll in the MA plan and to respond to it.

 

[Fisher]

That's weird, every MA or MAPD app I've ever filled out asks if the applicant has other drug coverage. Always check Yes for an MA-only product and I don't recall any of these types of issues happening.

 

[ValeRosso]

Maybe its a state thing? IDK

 

[TwoCents]

You're either crossing wires or straight up making up something in your mind that doesn't exist.

For someone receiving Extra Help or Medicaid and they enroll into an MA-only they could be moved to an MAPD per CMS regulations. The client can opt out of this plan change.

For someone enrolling into an MAPD or PDP and CMS shows a drug subsidy is being paid out to their (former most likely) employer, the MAPD/PDP enrollment will be rejected until the plan can confirm (within a grace period)that the client understands that there could be an impact to other drug coverage they have and proceed to enroll into the MAPD/PDP.

Yes, coordination of benefits (other insurance info) collection does happen, but it's no reason for a plan to either deny the MA-only enrollment or later disenroll the client. Plans want that CMS money!