Med Sup GI ?

Aug 25, 2008

  1. jdeasy
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    I have a question about a GI for a med sup. I have a client, 81 year old female that just lost her medicaid, actually loses it Sept. 1. She wants a med sup. The health questions are not a problem. She is a smoker. I know she has an SEP for an MA. Is there anything like that for a med sup?

    I think I know the answer is no. The difference is solely in the smoker rates. It would save her about $15/mo if I could put her on a med sup as standard because of any GI period. I would like to tap into the vast knowledge of this board.

    I've got a call into the Ky DOI, but, they haven't called back yet.
     
    jdeasy, Aug 25, 2008
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  2. jdeasy
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    I got the call back from the Ky DOI. They said she has no additional protections under Ky law except that she could have suspended her med sup for up to two years while she was om medicaid. She didn't have a med sup when she went on medicaid, so, that's not a help.

    The Ky DoI person did say that some companies will do a GI in this instance. Anyone know of a comapny that may do that. I only have two med sup companies and neither of them will do a GI for her.
     
    jdeasy, Aug 25, 2008
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  3. deda15
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    United Health Care has an AARP Med Sup policy that is almost GI. The only reason it wouldn't issue is if they have ESRD or they are on kidney dialysis.

    If you don't have a marketer who has it, please let me know, I can help.
    Deanna Carlisle
     
    deda15, Aug 27, 2008
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  4. Winter_123
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    Has she had creditable coverage since she turned 65 without any gaps? If so, she might be eligible for guaranteed issue based on the loss of creditable coverage but you would have to know your state regs to see if that works and the facts of her case would need to line up too.

    Someone mentioned that AARP is guaranteed but for ERSD which is a good point, except that the pre-existing would not necessarily be covered for three or six months. Can't remember what the period is. But if, as you stated, "health questions are not a problem" then why bother with guaranteed issue. Just go with the best rate or whatever considerations you have.

    I think anyway.

    Winter
     
  5. jdeasy
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    The only reason for wanting the GI was because the smoker rate was $15/mo more. She has had medicaid every since she got on medicare. Her husband recently died and she is now receiving too much money to qualify as a QMB. That's why she lost medicaid.The Ky DOI told me that she could only hold her GI period for 2 years. She was fine with the health. I did the POS interview and everything is fine. She is paying $15 more per month.
     
    jdeasy, Aug 27, 2008
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  6. jdeasy
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    The health questions were not a problem, I just wanted to get her non tobacco rates. I can do the UHC, they were $20 month more than Admiral.
     
    jdeasy, Aug 27, 2008
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  7. Winter_123
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    Not to beat this to death but I don't follow it yet. Are you saying that if she were eligible for guaranteed issue that she would not have to answer any questions about tobacco use and could enroll as a non-smoker? That doesnt make sense to me. She would have guaranteed issue but at smoker rates yes? Hard to tell sometimes with state law variations.

    What is the right answer here.

    Winter
     
  8. jdeasy
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    During the GI period, the 6 months after one gets part B, there are no health questions here. Including tobacco use. At least with Admiral. I was hoping that she would qualify for a new GI period, {like an SEP, for example}, because of losing coverage through no choice of her own. The companies and the Ky DOI all told me that she did not qualify for a new GI. You could be right and, had we got that far, they may have told that she had a GI only on the health questions. We didn't get to that point since they told me that there was none to be had.
     
    jdeasy, Aug 27, 2008
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