MA SEP Question

May 15, 2019

  1. vic120
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    I Believe he had 8 months to get part B after Group ended, He got it recently with a 06/01 effective. Had to bring the Part B form from employer to get part B,

    So group ended 12/01 Part B begins 06/01

    I know it can be done because I know I did get 3 or so in the past with 07/01 with Part B from GE in the past So I know it can be done just not sure I remember which code,

    I think it may be (IEP-Delayed Part B) I see in AARP booklet, A choice separate from IEP

    However, I don't see that option on Aetna App so Not sure if I just put IEP
     
    Last edited: May 15, 2019
    vic120, May 15, 2019
    #11
  2. vic120
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    Correct but does not fit this situation as the Prospect is 67 and lost group in Dec, However his part B begins June 1st
     
    vic120, May 15, 2019
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  3. J2727
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    J2727 Super Genius

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    For Part B

    GEP doesn't apply here because he didn't get Part B during the GEP, which would make Part B eff. date 7/1.

    His group coverage ended 12/1 and his Part B eff. date is 6/1.
    He had 8 months from 12/1 to 7/31 to get Part B. He got it recently for a 6/1 eff. date.

    For MAPD

    If he got Part B during the GEP, then that would also allow him to get MAPD during 4/1 - 6/30, also for a 7/1 eff. date. But this doesn't apply.

    He has(d) 2 options for MAPD:

    1) ICEP (Delayed Part B) - lasts 3 months prior to Part B eff. date. In this case, 3/1 - 5/31. MAPD eff. date would be 6/1 (same as Part B).

    "If the beneficiary is adding Part B because due to losing creditable coverage, the ICEP would be the three (3) months prior to the Part B effective date."

    See # 2, second point below.

    2) SEP (Employer Group Health Plan) - starts the month he loses group coverage and lasts 2 more months after.

    He missed this since he waited too long to get Part B. Need Part B first, then MAPD.​

    upload_2019-5-16_2-57-33.png
     
    J2727, May 16, 2019
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  4. vic120
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    This is the Problem On UHC handbook it's clear and I have done this before, However going over the Aetna MA App there is no such option ICEP Delayed Part B and I don't know how to do this with Aetna

    On Aetna App there are reasons listed, ICEP Delayed Part B is not there nor anything that seems to fit the bill
     
    vic120, May 16, 2019
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  5. J2727
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    What options does it give you? I haven't done an Aetna MAPD yet.
     
    J2727, May 16, 2019
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  6. vic120
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    It is like with reason and code, for instance, new to medical Turned 65 everything is written like that but no anything that fits Part B delayed except the one with Group cov which has to be within the time frame

    Its like Silver Script app not like AARP where you put SEP and reason in yourself

    Its a check off the list but each code has a sentence next to it like turned 65 or retired on date or moved on date
     
    vic120, May 16, 2019
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  7. LostDollar
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    Page 141 of the producer manual talks about the general concept you are talking about, but it looks like one has to have access to the ascend system to get more details relating to specific application forms and I can't get into that.
     
  8. vic120
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    Finally Found out from Aetna, There is no option even though it is a valid SEP

    So What I am supposed to do is on the front page I need to check T65 (even though the person is not T65) and then on the back of App , Check IEP and write next it the SEP code
     
    vic120, May 21, 2019
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  9. J2727
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    This is for a paper app?

    What about for their e-app?
     
    J2727, May 22, 2019
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  10. vic120
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    I was told many times by Aetna Reps that it is for face to face only, I did hear from one rep I can do over the phone, I was told by FMO I could use over the phone but at least 8 managers told me no it cannot

    So I am not sure if its more trouble then its worth
     
    vic120, May 22, 2019
    #20
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