Medicare Trial Right

Mar 9, 2016

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  1. sodaytongal
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    sodaytongal Expert

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    I understood the trial right to be if when T65 you take a supplement and later switch to an advantage plan, you could go back to your original supp (or a similar of that was no longer available) with 12 months with no underwriting.
    However, if you didn't take a supp when first eligible and later decided you wanted one, you would be subject to health questions. I remember seeing a chart in the Medicare & You handbook about this very thing.

    Today I was with a customer who said if you take an advantage plan when you T65 and within one year want a supp you can get it with no underwriting. I questionned this and looked up in the current Medicare & You handbook.
    He was right!

    Did this change or did I misread originally?

    Thank you!
     
  2. cedwards
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    cedwards Super Genius

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    It didn't change. Both are Trial Right scenarios. The one you are thinking of is if the client dropped a Medigap/Medsup to join a Medicare Advantage Plan for the first time and have been in the plan less than a year and they want to switch back, they have the right to buy the Medigap policy they had before they joined the Medicare Advantage Plan. Obviously, if it isn't available they can buy plans A,B,C,F,K or L.

    Check the Choosing a Medigap Guide. There is a table on Pages 22&23 that lays it all out.
     
  3. yorkriver1
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    yorkriver1 Guru

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    I learned this when I was newer from a client, too. Fortunately, client had friends who told him about this when he got cancer in the 1st 4 months of T65 and buying an MAPD because MedSupp was "too expensive".
    Then, suddenly, it wasn't.
    I searched high and low to find where trial rights were spelled out, and shockingly to me, many managers and full time carrier employees didn't know where to find it.
    I now use the Choosing a Medigap guide for all sales, if only for the great choice chart in first few pages. Good way to show MAPD is *not* a supplement.
     
  4. sodaytongal
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    sodaytongal Expert

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    Thanks for the info. I went back and read pages 22 and 23 and maybe that's where I first saw the info. Anyway, I was aware if you started with a supp and sometime later you could move to an advantage plan and back to the supp within 12 months. I really did not know; however, that if you did not get a supp when you were first eligible (took an advantage plan) and later wanted a supp . . that you would not be subject to health questions. I did not know it worked both ways. Interesting. Hmmm I've been doing this for quite some time. Guess you learn something every day!
     
  5. somarco
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    somarco GA Medicare Expert

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  6. Bevo
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    I distinctly remember a conversation with more than one underwriter on many different cases for MOO on this about 5 years ago or so, and their rule then was if they T65 and went MAPD first, then could NOT be trial right. They must have first went to original Medicare AND a Medigap plan (had to have a supplement), then at any point or age thereafter if they tried a MAPD they could get GI trial right within the first 12 months, even if they were 90 years old. Same thing for people coming off group. But, that was then.
     
    Bevo, Mar 11, 2016
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  7. somarco
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    somarco GA Medicare Expert

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    I used #4 a couple of times last year to write plan G and plan N. Wasn't easy. Had to school the carrier before they agreed to accept the app.

    https://www.medicare.gov/find-a-plan/staticpages/learn/rights-and-protections.aspx

    Before you get too carried away with aggressively pursuing GI business, keep in mind that many carriers pay almost nothing for GI apps.
     
    somarco, Mar 11, 2016
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  8. Bevo
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    Very nice! I just checked a 2009 CMP and it does say that, which is when I think I was having those issues way back then. I should have looked more carefully then faxed them that page!
     
    Bevo, Mar 11, 2016
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