MAPD to Medsupp

[Mick_Keyou]

Trying to build my knowledge base and want to be clear with this info. Situations & solutions for clients who are on MAPD that want to go to a Medsupp.

1. From a previous thread: Client signs up for MAPD during ICEP can switch to Medsupp before the effective date. Just need to cancel MAPD and sign up with Medsupp. Client is still GI. Correct?

2. Client is in first year of MAPD. It is now past his effective date. He can only disenroll during Jan 1-Feb 14 or with an SEP? He can then apply to Medsupp but is subject to under writing?

3. Can only disenroll 1 time from MAPD?

4. Please post any other situations that you've experienced or info that could be helpful for us new guys!

 

[Josh]

Carriers put out guides to help with this stuff.

You can also learn an awful lot by reading through the Medicare and You guide.

 

[Mick_Keyou]

Carriers put out guides to help with this stuff.

You can also learn an awful lot by reading through the Medicare and You guide.

Thanks Josh. I got the Medicare and You book recently. I'm reading it, but sometimes it doesn't state some of the finer details that I read on this forum. I love reading all of the personal situations about topics that the handbook doesn't always address.
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BTW, pg 67 of the Medicare and You addresses my topic.

 

[ctg]

Client has 12 months to switch to Original Medicare if it's his first go. From Medicare and You-2013, page 67:

"If you join a Medicare Advantage Plan for the first time, and you aren't happy with the plan, you'll have special rights to buy a Medigap policy if you return to Original Medicare within 12 months of joining."

Remember also, if they drop a MA plan, they most likely will lose prescription drug coverage. Most medigaps don't have drug coverage.

www.medicare.gov/publications might help

Looks like you found it while I was typing!

 

[supersupps]

most gaps dont have rx coverage? which ones do?

 

[ctg]

I have never seen a Medigap with Rx.

From Medicare.com (not medicare.gov)

I have Medicare, and a Medigap (Medicare Supplement Insurance) policy with prescription drug coverage.
Your Medigap insurer must send you a detailed notice each year describing your choices for prescription drug coverage, and whether the drug coverage under your Medigap policy is creditable coverage. You have the following choices:

• You can keep your current Medigap policy with the prescription drug coverage included.
• You can join a Medicare Prescription Drug Plan and keep your current Medigap policy without the prescription drug coverage.
• You can join a Medicare Advantage Plan that includes prescription drug coverage. All your health care benefits and prescription drug coverage will be covered by the same plan.
• You should contact your Medigap insurance company before you make any changes.

Hence, my cover-my-behind use of the word "most".

I can't verify the reliability of the site, but as they say in the State Farm commercial, they can't put anything on the internet that isn't true.

 

[GreenSky]

I have never seen a Medigap with Rx. [\quote]

That's because you haven't been in the business since we still used carbon paper.

There were 3 plans that included Rx which could not be sold after our brilliant people in DC passed the completely unfunded Part-D program.

Most of those plans have become so expensive that the policyholders have dropped them. And since they have a maximum Rx benefit they are not creditable coverage.

You haven't been able to buy a supplement with Rx coverage since 2006.

BTW, regular gas in So Cal is now about $4.20. Just want to point that out.

Rick

 

[taterpeeler]

I have never seen a Medigap with Rx.

That's because you haven't been in the business since we still used carbon paper.

There were 3 plans that included Rx which could not be sold after our brilliant people in DC passed the completely unfunded Part-D program.

Most of those plans have become so expensive that the policyholders have dropped them. And since they have a maximum Rx benefit they are not creditable coverage.

You haven't been able to buy a supplement with Rx coverage since 2006.

BTW, regular gas in So Cal is now about $4.20. Just want to point that out.

Rick

U need to fing move to texas..we have hot chicks

 

[Nelson C. Janney]

All else fails, call medicare.

 

[G.Gordon]

All else fails, call medicare.

You are kidding, right?
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Trying to build my knowledge base and want to be clear with this info. Situations & solutions for clients who are on MAPD that want to go to a Medsupp.

1. From a previous thread: Client signs up for MAPD during ICEP can switch to Medsupp before the effective date. Just need to cancel MAPD and sign up with Medsupp. Client is still GI. Correct?

2. Client is in first year of MAPD. It is now past his effective date. He can only disenroll during Jan 1-Feb 14 or with an SEP? He can then apply to Medsupp but is subject to under writing?

3. Can only disenroll 1 time from MAPD?

4. Please post any other situations that you've experienced or info that could be helpful for us new guys!

1. Correct
2. Wrong on so many levels. Depends on when his ICEP was, MADP is not his ONLY choice, there are the 12 mo trial SEP, AEP, etc. Medsupp only with underwriting? Depends on when his part B was effective. Too many details missing to give an exact answer.
3. NO
4. NO, ask specific questions, we will answer or point you in the right direction.