Moving to a New State SEP

Dec 7, 2015

  1. beachbum2012
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    beachbum2012 Super Genius

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    So I've had a few clients now relocate to different state. So far they've let me know ahead of time or right afterwards and I tell them how to apply for a PDP for their new area. However, I just got a call last week from a client saying that she moved in the summer and wants a new drug plan because she hates the one she has. She hasn't notified her medsupp carrier or her PDP carrier.

    Does she have to do it today during AEP, or would she still have time under an SEP? It says on the Medicare website that they have that "SEP to switch to another private health or drug plan, beginning the month you tell your plan, plus two more full months thereafter." However, on some of the PDP apps it asks for the date of the move. I just wondered for the folks who have dealt with this before how they've handled it.

    Also, what about the medsupp? If the client never notifies the carrier, does the carrier just adjust the rate when they eventually find out? Or, is it considered a new policy in the new zip code that requires underwriting?
     
  2. Chazm
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    Chazm Guru

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    She has until today to pick a new pdp plan.
     
    Chazm, Dec 7, 2015
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  3. goillini52
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    goillini52 MAGA...Eat More Bacon & BUILD THAT WALL!!!

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    Check with the Med Supp company. With Aetna and Oxford, they stay on the original state's rates.
     
  4. TwoCents
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    TwoCents Guru

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    Practically speaking, that's correct since it's difficult to get anyone to understand the true use of the special election.

    Since she never notified her PDP of the move and is still active on the plan the SEP haven't gone into effect yet. On application when asked when the move occurred I would use the date she notified her current plan. See below for supporting information.

    From the CMS PDP enrollment guidance:
    When the individual notifies the organization of a permanent move out of the plan service area, the SEP begins either the month before the individual’s permanent move, if the individual notifies the organization in advance, or the month the individual provides the notice of the move, if the individual has already moved. The SEP continues for two months following the month it begins or two months following the month of the move, whichever is later.
     
  5. WCMason
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    WCMason Guru

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    As already noted, the SEP to get a new plan is two months from the date she notifies her current plan. So today would be the deadline if she notified her plan on October 7. Otherwise today's deadline is meaningless to her.
     
    WCMason, Dec 7, 2015
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