MAPD SEP for moving question

[sshafran]

I'm 100% sure that yes there's two months SEP after a move. That's one thing. Another thing entirely is that once the carrier is notifed of a move, then they're required to term the plan at the end of that current month. That does not affect the SEP which is still the full two months following the move.

You would think that the two events (drop of plan coverage and sep for new) would coordinate.

I wonder if, in this situation, if uhc would give one extra month of coverage?

I guess the prospect at least has OM for one month, so it's not like she has nothing... but still.

 

[vic120]

Well, that's not how it works, Vic. CMS would chew that up and spit it out.

I know how SEP works But I do get leads from time to time someone moved outside the service area and every here and there the called ins to tell them about the move a month before and cov has canceled the 1st of the month.

Now I know they have another 2 months to enroll in a new plan, I did not know that Ins company should not have canceled cov

Probably because my own client I make sure everything is done smoothly so I don't need to deal with it. The only time I run into it is with a prospect and in that case, I am writing a plan anyway

Also, I get leads from time to time someone has moved 6 months ago and did not call ins company and still has plan

 

[TwoCents]

I am not entirely sure that this is accurate. Supporting documentation, please.

Sure! Medicare Managed Care Eligibility and Enrollment - Centers for Medicare & Medicaid Services

pg 108 Chapter 2 50.2 ("Required Involuntary Disenrollment") and under 50.2.1 "Members Who Change Residence" -- explains it all.

As others have stated, using the SEP is a separate event from the plan terming the one you're moving out of.

There are rules for when a 3rd party (like a doctor) report a move and no way she should have been termed so quickly. So I'm in the pool with the folks thinking she reported the move, but isn't disclosing that info.

 

[springbokhouston]

Uhm...use OEP.

 

[TwoCents]

Uhm...use OEP.

That's a negative, Ghost Rider. OP said old plan termed 2/28 (3/1). So for March she's on Original Medicare and he wrote coverage for 4/1. People on OM can't use the OEP.

 

[fun2drum]

Assuming she moved in February she still has SEP MOV into April, so you can write her now for an April 1 effective date with the SEP. The fact she was termed Feb 28th doesn't affect her SEP to enroll for two months past moving.

 

[vic120]

I thought EP was resolved earlier in the thread not sure why OEP has come up, the SEP is valid, the Only question was if insurance can drop her when they know she has moved

 

[TwoCents]

Assuming she moved in February she still has SEP MOV into April, so you can write her now for an April 1 effective date with the SEP. The fact she was termed Feb 28th doesn't affect her SEP to enroll for two months past moving.

That's what OP did, but thanks for playing. The real question is about the 2/28 termination, but like how many licks it takes to get to the center of a Tootsie Roll Tootsie Pop, the world may never know.

 

[fun2drum]

That's what OP did, but thanks for playing. The real question is about the 2/28 termination, but like how many licks it takes to get to the center of a Tootsie Roll Tootsie Pop, the world may never know.

Okay I guess I missed that, I'm posting this stuff between phone calls lol. So anyway the carrier had no choice but to term the plan on the last day of the month following being notified of an out of service area address change. That's Medicare rules so there's no gray area. It sounds like it worked exactly like it was supposed to work.

 

[vic120]

Begins month before permanent move, Ends 2 months after notification of move or after notification of Plan term

I too post between calls and sometimes after taking a second look, However, the SEP is valid for 2 months after the move