Move out of MAPD Service Area- GI for Med Supp?

[NJ Medicare]

Hi Everyone,

I have a prospect who has UHC MAPD in Missouri and is moving to NJ. The prospect has health issues and can not qualify for a Medicare Supplement unless it is Guaranteed Issue. Medicare's website states that he will have guaranteed issue rights if: You’re in a Medicare Advantage Plan, you move out of the plan's service area.

I ran into this same situation last year with a prospect who had Humana MAPD in FL and moved to NJ. Humana would not provide a letter stating involuntary disenrollment from the MAPD because Humana was informed of the disenrollment by her switching to a PDP in NJ. I was in the process of fighting with Humana about GI when the prospect passed away.

Has anyone successfully helped a client get GI on a Supplement plan based on moving out of a MAPD service area?

I know I won't be paid for his supplement but it's the right thing to do for the client.

Thank you!
Andrew

 

[TwoCents]

Some Medigap carriers do require the specific letter saying that the MAPD was termed due to moving out of the service area. So the trick is that the client has to report the move first, get the letter, then apply for the PDP. When is your client moving?

 

[bill3173]

Yes, they will be qualified for a GI med supp. I've used Aetna, here in NC, and they always require a letter.

 

[vic120]

Some Medigap carriers do require the specific letter saying that the MAPD was termed due to moving out of the service area. So the trick is that the client has to report the move first, get the letter, then apply for the PDP. When is your client moving?

They can apply first, and get a letter later

If I am on with the lead not the current client I will take the app then have them call and cancel the request letter

Its a pain but other way around some will get lost

However, you are right it won't issue without a letter with some carriers

 

[TwoCents]

They can apply first, and get a letter later

If I am on with the lead not the current client I will take the app then have them call and cancel the request letter

Its a pain but other way around some will get lost

However, you are right it won't issue without a letter with some carriers

Completely agree with this approach. I think the key is to not write the PDP business too early because you don't want that to be the first reason why the MA plan was terminated.

 

[Lawsonhj1]

Completely agree with this approach. I think the key is to not write the PDP business too early because you don't want that to be the first reason why the MA plan was terminated.

Why would it matter if out of the area move?

 

[vic120]

Why would it matter if out of the area move?

Lost cov but not of own choice, I understand moving is a choice but this si the way its been explained to me like retiring and losing coverage

I am not sure if the same holds true if an MA plan DIsconitnues But I think I have heard that before too Its been a long while ago that I heard that one though

 

[Lawsonhj1]

I am working on one of these right now AZ to CO from MAPD to Plan G can't learn experience but I try to learn from others experience.

 

[vic120]

I am working on one of these right now AZ to CO from MAPD to Plan G can't learn experience but I try to learn from others experience.

Question is GI needed?

I don't do GI unless needed

I don't know CO's GI situation out of my states only a few have Paid GI rules most times I only do GI if its ref, or spouse of someone I am signing or someone who has been a client and needs it

But Yes If GI is needed it will work only you will have to get a letter from MA with many carriers You can submit after app is in system too

 

[Lawsonhj1]

It is a bit tricky commission schedule chart makes me dizzy looks like the GI pays in CO situation existing client is moving thanks.