MA to Med Sup Question

[jdeasy]

I met with a lady yesterday for FE. She is also interested in a med sup.

She was an underage medicare eligible and has Advantra PFFS. She was 65 in Dec. '08, so she is in open enrollment now. That's not an issue as she would qualify even with underwriting. The issue is being able to drop her MA plan now. She doesn't have any SEP available to her. I know I can enroll her in the med sup, but, if she can't drop the MA plan, the med sup won't pay.

Since Advantra PFFS is going away Dec. 31, she will have a GI period then for a med sup and that may be her best option to just wait. She doesn't want to wait. Is there something I'm missing on how to get her out of the MA?

 

[dandan]

I think she will have to wait, you wouldn't be able to enroll her in a med supp with out evidence of getting out of the MA plan.

I know nothing is clear cut or set in stone with cms so who knows for sure!

 

[magagent]

Imagine that wanting out of an MA...

 

[Cenla Agent]

She will have to wait unless she falls under the 12 month rule that some said only applied if you previously had a supp and others say had nothing to do with a supp.

Every time I tried to get clarification on it when I was selling MA it seemed that I got a different answer. I think maybe it was originally supposed to allow them to go back to their previous supp within the first year but I know of people who have been allowed to disenroll simply because it was their first 12 months in the plan, even if they did not previously have a supplement.

 

[Justin Bilyj]

I was under the impression they can sign up for the supp, THEN disenroll from the MA. Also, I thought they could unenroll from the MA at any time during the first year and go back to original medicare and pick up a supp. Wheres Frank?

 

[insurance0707]

Usually you have a 12 month trial period with an MA plan, if for any reason during the 12 months you're not happy with it you can go back to original Medicare, PDP and a Med supp. You can call the underwriting department of the Med supp company to get further clarification, if it's United of Omaha they're pretty up to date on the rules.

 

[jdeasy]

Usually you have a 12 month trial period with an MA plan, if for any reason during the 12 months you're not happy with it you can go back to original Medicare, PDP and a Med supp. You can call the underwriting department of the Med supp company to get further clarification, if it's United of Omaha they're pretty up to date on the rules.

That's not the case for "any reason". The 12 month trial is for one that "joined an MA plan when you were first eligible for Medicare Part A at age 65, and within the first year of joining, you want to switch to Original Medicare". She did not get Medicare at age 65, she is a disabilty Medicare and has had Medicare for years. The other trial right is, "You dropped a Medigap policy to join an MA plan for the first time, you have been in the plan less than a year, and you want to switch back." She was never on a Med. Sup., so, this doesn't apply.

Of course, these are only for a GI period anyway. She doesn't need a GI period for a med sup. The MA lock-in rules is where the problem comes in. She has no SEP that I can find. I was asking this board because there are many experts here that know about little exceptions that most don't know.

I have spoken to the underwriting dept. at 3 companies, one is MoO. I have spoken to CMS. I have spoken to several med sup and MA agents. I have read and reread the Medicare and You and the Choosing a Medigap Policy booklets and I can't fine any situation where this lady could drop her MA plan now.

If someone knows a way, please let me in on the secret.

 

[Justin Bilyj]

Email Frank Stasny, he knows more than most on here about medicare.

 

[insurance0707]

Here's the cheat sheet that lists all of the seps

http://www.dgshealth.net/medigap-plans/resources/election-period-booklet.pdf

When did this lady join the MA plan? Have you checked to see if she qualifies for assistance on prescription coverage, if so, once she's enrolled in that she can make changes anytime during the year. You'd be suprised how many people qualify for assistance

 

[stormtracker]

You can't disenroll MA's unless you first enroll in an MA. That's all I know.