MAPD disenrollment

[insurance0707]

If a person turned 65 in December 2007 and took out a MAPD plan and would like to go back to a Medicare supplement and prescription plan on a guaranteed issue basis with a 12-1-08 effective date for the Med supp, how long does he have to enroll in a PDP plan. I know they have 63 days to enroll in the Med supp once disenrolled, do they have the same 63 days to enroll in a PDP?

Any help would be appreciated.

Thanks

 

[G.Gordon]

I'd think he'd have to enroll by 12/1 to avoid a penalty since he already had D under the MAPD. Also... enrolling in the PDP would ensure that the MAPD gets kicked off.

 

[GreenSky]

I'd think he'd have to enroll by 12/1 to avoid a penalty since he already had D under the MAPD. Also... enrolling in the PDP would ensure that the MAPD gets kicked off.

Agreed. Plus you'll actually get paid for your efforts if you do it with a 2008 effective date.

Rick

 

[insurance0707]

Are you guys sure? It seems like they have 63 days to enroll - I don't know where to look and find that out

 

[jdeasy]

If a person turned 65 in December 2007 and took out a MAPD plan and would like to go back to a Medicare supplement and prescription plan on a guaranteed issue basis with a 12-1-08 effective date for the Med supp, how long does he have to enroll in a PDP plan. I know they have 63 days to enroll in the Med supp once disenrolled, do they have the same 63 days to enroll in a PDP?

Any help would be appreciated.

Thanks

It's an SEP for the PDP and I believe it is 63 days to enroll. I don't have time to lok thru and find it now, I'll try later. Still, it would be easier if he just enrolled before Dec. 31 for a Jan 1, 2009 effective date.

He should have 63 days from Dec. 1. But, trying to get that message thru to a PDP enrollment dept sometime in Jan. would not be worth your time and trouble.

 

[insurance0707]

Thanks JD, that's what I was thinking a 1-1-09 issue date would be a lot easier, whenever it's an SEP they just mess it up
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where do you look to find this info?

 

[jdeasy]

Thanks JD, that's what I was thinking a 1-1-09 issue date would be a lot easier, whenever it's an SEP they just mess it up
- - - - - - - - - - - - - - - - - -
where do you look to find this info?

I don't know where I got the belief that he would have an SEP for a PDP. I couldn't find that anywhere in writing. I called Medicare about it and was told that there is no SEP for a prescription drug plan when one is using the trial right. They said that only applies to getting a med sup.

I disagreed with the first person at Medicare and they put a manager on the phone. He said the same thing. If a person joined an MAPD plan when first eligible for Medicare, he would have 12 months to try it, if he didn't like it and wanted to drop it 6 months later, he could and would have up to 63 days to buy a medigap policy on a GI basis. That right does not extend to a PDP. If it was in July, for instance, the person could drop the MAPD and return to original medicare and buy or not buy a medigap policy. He could not buy a PDP plan until the AEP unless there was another reason that gave him an SEP.

In this case, it's not an issue because the person is in the middle of AEP. I can't find anything to contradict what Medicare said about this on the phone.

 

[G.Gordon]

I don't know where I got the belief that he would have an SEP for a PDP. I couldn't find that anywhere in writing. I called Medicare about it and was told that there is no SEP for a prescription drug plan when one is using the trial right. They said that only applies to getting a med sup.

I disagreed with the first person at Medicare and they put a manager on the phone. He said the same thing. If a person joined an MAPD plan when first eligible for Medicare, he would have 12 months to try it, if he didn't like it and wanted to drop it 6 months later, he could and would have up to 63 days to buy a medigap policy on a GI basis. That right does not extend to a PDP. If it was in July, for instance, the person could drop the MAPD and return to original medicare and buy or not buy a medigap policy. He could not buy a PDP plan until the AEP unless there was another reason that gave him an SEP.

In this case, it's not an issue because the person is in the middle of AEP. I can't find anything to contradict what Medicare said about this on the phone.

Read the Medicare and You book... it's the bible. This is in there.

I've had to force those retards at medicare to read it... and they are wrong in your case. During that first year in MA if they have a MAPD and excercise their right to get out they have the right to get what ever PDP they want. I usually have the medicare rep on the phone auto-enroll them so there is no mistake. Yea I don't get paid, but there is a high chance of a problem if you don't have medicare force it through while doing a disenrollment/enrollment. Wires get crossed and signals lost...

 

[MedSuppPro]

Middle of pg. 76 Medicare&You 2009

But, the PDP issue is another issue. Rick's got the better answer.

Take care of the Medsupp and call 1800Medicare and specifically ask for the SEP for the 12 month trial. Don't let the 1800Medicare contracted third part dip wit put your client in original Medicare without properly placing them into the correct SEP. And trust they will.

You see most people don't know that our 1800Medicare is not the home office of CMS. It is a contracted 3rd part telephone answering center with more consumer complaints and problems then us Rent-A-Agents. At least they have benefits. 101Ks and health insurance. Ya see us seasonal workers have only what we can piece meal together and we are overpaid according to CMS.

 

[jdeasy]

Read the Medicare and You book... it's the bible. This is in there.

I've had to force those retards at medicare to read it... and they are wrong in your case. During that first year in MA if they have a MAPD and excercise their right to get out they have the right to get what ever PDP they want. I usually have the medicare rep on the phone auto-enroll them so there is no mistake. Yea I don't get paid, but there is a high chance of a problem if you don't have medicare force it through while doing a disenrollment/enrollment. Wires get crossed and signals lost...

Where is it in the book? I believe you to be right, but, I couldn't find it in the Medicare and You booklet or in the Choosing a Medigap booklet or at medicare.gov.