Med Supp Guaranteed Issue from MAPD

[jdeasy]

Am I the only one that thinks this is BS. I mean they "cancel" a conract and if the client's notice got lost in the mail they are "automatically" crammed into a PPO or HMO plan without their consent, knowledge, or participation in plan selection.

I felt the same way last year when Coventry was changing the plans. If you did nothing, your plan was changed. To go back to original Medicare, the enrollee had to send a signed form to Coventry.

It should not be that way. If your plan ends, you should be returned to original Medicare unless you take action to enroll in something else.

We don't have that problem this year with Wellcare and Coventry completely ending with nothing to slam people into.

 

[Russ]

Speaking of Humana being BS....I use to write for Kanawha Insurance Company. They got bought out by Humana, which was paying me renewals each month through August 2009 and then they quit paying me. I phoned Humana last Friday and the lady said they would check into it and email me.

I'm still waiting for that email.

 

[jacobtn]

That person's plan is ending. They are entitled to a GI for a med sup.

Coventry ended several plans last year and, if you did nothing, you moved into another plan. Those folks still had the opportunity to get a med sup on a GI basis. I did several. I had to send in the letter that they got from Coventry with the med sup apps., but, everyone of them was issued.

Humana is just trying to pull another one their shady deals. Why any agent would write for them is just beyond understanding.

100% correct.

It's not up to Humana whether or not they are GI. You will get nothing but idiots up there so don't bother calling them. I had the same thing happen with Coventry when they ended Freedom 1 and autoenrolled folks into Freedom 1B (which was crap). They were GI and I wrote them Med Supps.

Coventry and Humana are both garbage. I literally walked out of a certification class in Nashville last year because I realized how sh!tty their 09 plans were, and the instructors were idiots. Guess it runs in the whole organization.

 

[Slade]

How can Humana get away with this? Two PFFS plans were available state wide in 2009:

Humana Gold Choice PFFS H1804-081, and
Humana Gold Choice PFFS H1804-210

Only one plan being offered for 2010:

Humana Gold Choice PFFS H2944-017

Members of both 2009 plans are automatically being migrated into the 2010 plan.

I told this client that they should be eligible for a med supp guaranteed issue should they choose to return to Original Medicare.

Now I have seen the ANOC letter Humana sent to this client. It states, "We want to let you know that we have changed our plan name from Humana Gold Choice PFFS H1804-081 to Humana Gold Choice H2944-017 (PFFS) for the upcoming year. If you do not choose another plan, or choose to return to Original Medicare, you will be enrolled in the Humana Gold Choice H2944-017 (PFFS) next year."

19 Counties will have no plan available and are being terminated. They are in a guaranteed issue period.

In 1 County, one 2010 plan is available called Humana Gold Choice H2944-072 (PFFS). Humana is not calling this plan change merely a "name change" as in the other counties. These members are being terminated and also have a guaranteed issue.

While I still believe this client should be eligible for a guaranteed issue, Humana will not provide a non-renewal ANOC letter need to satisfy the requirement of the med supp carrier.

Since CMS has so many intricate rules and regulations in place, supposedly to protect medicare beneficiaries, why do they allow this sleight of hand by Humana?

Oh no no no no no, we're not changing the plan, we're just changing the name of the plan.

How can you go from two plans to one plan and tell members of both plans it's just a name change! This is making me very angry!

 

[DS4]

Any MA plan non-renewing(including members being migrated to another MA) would be eligible for GI.