MA only member with LIS will be disenrolled by Medicare and enrolled auto in MAPD

[Special Agent]

Have a UHC MA only member who has LIS and medicare auto enrolled him in the UHC Regional PPO MAPD wichh happens to be the worst UHC plan.I was told by PHD this is something new CMS is doing and they said they couldn't tell me if they will do it again .I would have still retained AOR but i put him back on the MA only because he only uses VA and wanted the part B rebate UHC Patriot plan.

 

[Fisher]

Have a UHC MA only member who has LIS and medicare auto enrolled him in the UHC Regional PPO MAPD

Why?

 

[DonP]

Have a UHC MA only member who has LIS and medicare auto enrolled him in the UHC Regional PPO MAPD wichh happens to be the worst UHC plan.I was told by PHD this is something new CMS is doing and they said they couldn't tell me if they will do it again .I would have still retained AOR but i put him back on the MA only because he only uses VA and wanted the part B rebate UHC Patriot plan.

You were told wrong . Thats been going on for yrs with uhc only . I've had several duals auto enrolled in new plans yrs after my plans started . Uhc says cms is going it which is bs

 

[Special Agent]

You were told wrong . Thats been going on for yrs with uhc only . I've had several duals auto enrolled in new plans yrs after my plans started . Uhc says cms is going it which is bs

ok well now i know but this isn't a dual .I don't have many MA only with LIS so this is the first time i have encountered it.Wonder why they would enroll them in the regional PPO with the 23.00 premium instead of the better local PPO with 0 premium? Oh wait i know why because the regional ppo will have a premium in 2025 that UHC will get .lol

 

[TwoCents]

As DonP stated, this is nothing new. This is a CMS requirement to try to ensure that those with LIS and/or Medicaid have drug coverage. All carriers must do this per the Medicare Advantage and Part D Enrollment and Disenrollment Guidance issued by CMS.

Clients are sent information on how to opt out of the change from the MA-only to MAPD. If all you did was complete a new app for an MA-only, then more than likely that client will be picked up by UHC as needing to go through the process again.

The client must opt out of the MAPD assignment if they want to be removed from future moves. Depending on when the opt out request is received, the client either will be taken off the MAPD completely (as if the move never happened) or the first of the next month so there is some MAPD coverage.