Med Supp for Someone Already on a Plan

[deg929]

I've got a potential client who is very displeased with the Med Supp plan that she has....

Actually, it's not the plan, it is the service she gets from the provider. She got the supp through an open enrollment through her retirement package. Their open enrollment comes up in Dec/Jan, as I guess most do.

My question is, if she wants to change the plan that she's on, does she have to go through open enrollment, and does she have to choose from one of the carriers that her employer recommends for them?

Looking for any helpful advice you could give me......

Thanks!

 

[DavidD1]

I've got a potential client who is very displeased with the Med Supp plan that she has....

Actually, it's not the plan, it is the service she gets from the provider. She got the supp through an open enrollment through her retirement package. Their open enrollment comes up in Dec/Jan, as I guess most do.

My question is, if she wants to change the plan that she's on, does she have to go through open enrollment, and does she have to choose from one of the carriers that her employer recommends for them?

Looking for any helpful advice you could give me......

Thanks!

what advice does your GA give?

 

[Newby]

I've got a potential client who is very displeased with the Med Supp plan that she has....

Actually, it's not the plan, it is the service she gets from the provider. She got the supp through an open enrollment through her retirement package. Their open enrollment comes up in Dec/Jan, as I guess most do.

My question is, if she wants to change the plan that she's on, does she have to go through open enrollment, and does she have to choose from one of the carriers that her employer recommends for them?

Looking for any helpful advice you could give me......

Thanks!

If she's on a true Med Sup she can enroll and disenroll any time she wants to and as many times as she wants to each year. There are no restrictions.

It sounds like she is more likely on a Medicare Advantage type of policy which is entirely different. You would be her hero if you teach her the difference and sign her up for a Med Sup.

I would get a more experienced agent to help you with this one to make sure you are taking her in the right direction and so you can learn about it correctly.

 

[deg929]

She is on a true Med Sup....It is a BCBS plan, and she loves the plan that she has, but BCBS will periodically report to the providers, and send her the benefit statements, that something wasn't paid because she didn't have coverage at the time of service, and things like that.

Like I said before, she really likes what she's got, but doesn't care for the carrier....

 

[Frank Stastny]

She is on a true Med Sup....It is a BCBS plan, and she loves the plan that she has, but BCBS will periodically report to the providers, and send her the benefit statements, that something wasn't paid because she didn't have coverage at the time of service, and things like that.

Like I said before, she really likes what she's got, but doesn't care for the carrier....

That doesn't sound like a provider problem. It sounds more like either her doctor is not coding the claim correctly or she is getting treatment not approved by Medicare. If Medicare approves a claim then the insurance company almost automatically pays it.

If you would like to give me a call we can talk about it further.

 

[bourbonlegend]

My guess is that the procedures she got billed for weren't approved by medicare. Make sure she's healthy before you spend a lot of time on this case. You need to talk with an experienced agent about this. Heck, you might even talk to her ex-employer and have their whole shooting match transfered over to another "A" rated medicare supplement carrier with better rates and customer service. I'm sure Frank can help you but you can shoot me a PM if you'd like.
Also, the Sooners are going to win a national championship this year ;>

 

[Guest]

If she's on a true Med Sup she can enroll and disenroll any time she wants to and as many times as she wants to each year. There are no restrictions.

Huh? As I understand it, in most states once you choose a Med Sup company you can only change if you are healthy enough to get through underwriting. Do I understand it correctly? Frank... you here? Rick? (Frank and Rick are our resident Medicare experts.)

Perhaps some states allow unlimited GI for Med Sups?

Perhaps there are GI Med Sups out there? I'm told AARP/UHC has one but I've not checked it out.

In CA we have a "birthday" rule in which person can change in their birthday month without UW.

Frank, Rick... get your butts in here and clear this up for us.

Al

 

[GreenSky]

Al:

Your understanding is correct. Nice to know that after all these years you finally learned something.

California has the birthday rule where a Med Supp policyholder can switch to any carrier's plans of the same or lesser benefit (read F to A-F; C to A-C; etc.). Missouri allows a change to the same plan on the policy anniversary.

No other state has this GI provision. Therefore, if the insurance carrier requires medical qualification, you must pass underwriting. The underwriting is not as complicated as an IFP plan and even people with medical issues can typically qualify.

The only plan that is basically always GI is from AARP. In most cases, unless the applicant has ESRD, the policy will be issued.

Frank would have been here with this answer but he's trying to stay on good terms with his wife and took her on vacation.

Rick

 

[Guest]

The only plan that is basically always GI is from AARP.

Is that sold by indie agents or only by AARP in-house/captive agents? I don't plan to sell it, just curious.

Frank would have been here with this answer but he's trying to stay on good terms with his wife and took her on vacation.

I thought he was out taking pix of his goats for his new goat-porn site. (Hmmm, where did the goat stuff start? With Oleg? STI? It's been years now... part of the 'culture' here... sort of like bashing liberals.. whom as we all know are the most frequent viewers of goat porn!)

Al

 

[GreenSky]

Is that sold by indie agents or only by AARP in-house/captive agents? I don't plan to sell it, just curious.

Both. I have a contract with UHC and have several agents in my downline. We all can sell the UHC/AARP Med Supp.

Rick