Moved Out of Service Area...

[G.Gordon]

Had a guy call. He moved out of his MAPD's service area. He's saying his letter says he has six months before coverage ends.

True/False?

 

[GreenSky]

Yes, it's true he received a letter.

I thought the 6 months was for people who spent half the time away from their permanent residence, not for people who have moved.

As you know, if he has moved he has an SEP to change his carrier.

Rick

 

[G.Gordon]

Yes he has a SEP, but I thought the old plan usually termed within a month or two. Not six.

The way the rule reads he has a SEP two months before and two months after he could lose coverage.

 

[DS4]

63 day SEP

 

[sman]

I've always thought you could enroll the month before you move and up to two months after you move. I've never known it to be any other way. Interesting letter though.

 

[G.Gordon]

The letter was not as stated. It was a addy verification letter wanting to know if they moved. Medicare let them know. We called the plan. I'm faxing them a cancel request to be effective 9/1, enrolled via 800-medicare into a drug plan, and took an application for Plan N with UOO.

Thanks guys. The mind was muddled in last night's Guinness.

 

[fetam]

So if someone spends more than half their time away from their permanent residence then they can drop their MAPD plan and go to a Med Supp plan at any time? I know this is not exactly what Rick wrote, but that's how I read it.

This would be great news since where I live has so many snowbirds that want to get into a Med Supp right now. Thanks for the answers!

 

[shauny2k3]

From working in sales/retention at UHC for 3 years, i've seen this come up frequently. If the address on file with the insurer doesn't match a SSA address that is outside of the plans area the plan sends them an address verification letter. If they do not respond, they are disenrolled after 6 months for being OOA longer than 6 months.

The OOA SEP can be used 2 ways:
1. Change in service area (notified plan within 6 months)
a. Notification before the move: begin month prior to move, ends 2 months after the month of move
b. Notification after move: begins the month enrollee notified the plan, ends 2 months after month of notification.

2. Change in service area (notified plan after 6 months, or termed 6 months after address verification letter):
Begins first day of 6th month OOA, ends last day of 8th month OOA.

I took this info from the training book we used in sales and retention to help with plan changes.

 

[G.Gordon]

Thanks, shaun. That explains that his letter might have said 6 months after all.

At the time of the appointment today he couldn't find the letter. So it very well may have said that. We called Mercy and all they said was that they sent a "Address Verification" letter. I didn't ask about exactly what it said.