Medicare Advantage

United World will accept ANYONE inside the 12 month period of being on a MA plan. If they chose an MA in the OE period then They can go to any med supp inside the 12 month period. All you need to provide is the expiration leter of the MA plan.
This is INCORRECT. I just got off the phone with United World to clarify what I had understood. Before I post the information, I wanted the company to "back me up."

Here's the bottom line:

If the member enrolls for the 1st time in an MA plan and leaves within the first 12 months, he or she may go back to their old Med Supp without proving insurability. If that policy does not exist, then they can go anywhere. Once they are past the 12 months, then they must be underwritten.

If the person moves out of the service area or their MA plan cancels, then they may go to any supplement on a guaranteed issue basis.

United World and every other carrier I know of follows the federal guidelines for guaranteed issue from an MA plan. You might be able to "slip something by the company", but I certainly wouldn't want to risk my client's coverage (not to mention my e&o) on that.

Rick
 
I just got an email yesterday from Senior Market Sales. IT was specifically to say that United WOrld was offering anyone GI regaurdless of their pevious med supp carrier. WIERD!

I believe SMAN and I had an argument about this before. I thought the same thing you did GS.
 
I know that Sterling Health Plans would allow a client to move from a MA to a Supplement at any time. They call it their choice and modility plan. Say a client is doing well and is on a MA plan, but suddenly comes down with something major. They call Sterling and they will move them to a supp. And when/if they get better they call back in a request to be moved back to a MA plan.
 
Here's what Senior Market Sales states:

Mutual of Omaha Accepting MA clients
Mutual of Omaha/United World will accept your Medicare Advantage Clients GUARANTEE ISSUE.
With the recent moratorium on Private Fee for Service Plans (PFFS) and coverage by the national media, your clients might be calling to see how to get back to Original Medicare and a Medicare Supplement. First of all assure your clients that recent action by CMS does not affect their coverage, only new sales.

With Mutual of Omaha/United World your clients have guaranteed-issue rights when:
* They joined a Medicare Advantage plan when they became eligible for Medicare and want to switch to a Medigap policy and Original Medicare within 12 months. Mutual will take them Guarantee Issue!
* They had a Medigap policy and switched to a Medicare Advantage plan for the first time since eligible for Medicare and they want to switch back within 12 months. Mutual will take them Guarantee Issue regardless of which company they previously had.

It's the 2nd point that Mutual disagreed with. I was told that the person must go back to their prior carrier. I think I'd rather have this information direct from the carrier, rather than an FMO.

Rick
 
I would rather have it direct from the carrier also. SMAN said that he called them direct and they said they could go to any company. SOmeone either mis understood United WOrld or someone was bluffing. I believe you Rick. I am not arguing about what CMS guidelines are because you are correct. SMS thinks different and so does SMAN. I don't see how the application can slip through as GI.
 
If the shoe fits, I have told some clients aging in... to get a med supp first because of their iffy health. (like recent heart surgery, etc) Then after a while, if they chose a med advantage, at least they could TRY IT OUT for up to 11 months, and then switch back to a med supp if they chose.

This way they were guaranteed insurability for the near future, and could try out the MA plan without being hurt.

(are these emotions smilies replicating, like Pokemon?)
 
I think you have a guarantee to re-enter Medicare on the same plan by any carrier? Meaning, if you go from Plan F to MA then leave the MA within 12 months, you have GI of a Plan F from any carrier.
or
If you age in straight to MA then you chose to leave MA within 12 months you have GI just like initial enrollment.
 
How can everyone be so confused on this subject? It is our job to know the senior market if that is our market. Regaurdless if you like certain plns or not you should know everything about them. To be an expert in the senior market you have to know the ins and outs of MA plans.
 
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