Panda1
Expert
- 37
"Stuck with no OOP". Interesting here is the whole story in a nutshell. Leaving MA without a MEDSUP is truly the end of the game. Without "unlimited funding " is a one way ticket.
New Proposal Would Require Insurance Agents To Disclose More About Medicare Advantage Plans
- Thread starter Duaine
- Start date
No need to face financial ruin on OM without a supplement when you can get around it. Here's how:
1) Drop part B and ride it out for a few months with only part A.
2) Reapply for B during OEP (1/1 thru 3/31)
3) Apply for any medsup that doesn't ask if you've had part B before.
4) You've got 120 days to apply with no health questions
Risky? Hell yes. But still better than being on OM with no supplement.
And where is this in all the rule books? It's not.
Interesting loophole. Don't know if I would advise doing it, but thanks for the tip.
Not all agents discuss this.
Totally by accident I was in an office and someone was on the phone with her MAPD customer service having a fit. (she is T65 and has one month left to change). She was put on a MAPD by an agent starting Dec 1 who apparently pushed hard to get her to sign up for one. She was flipping out over what she wasn't told - the fit at the time was that her PCP was out of network which she only found out after she saw him and the copay they wanted up front was pretty big (she didn't check these things herself, as many don't, even though they should and if her agent asked about it/told her I have no clue) and the expenses she would encounter being out of network with her PCP she liked.
So I stopped what I was doing, talked with her to see what was going on and explained to her she has one month left to swap without medical underwriting (she would fail); gave her the rundown of the differences between OM + supp and D vs MAPD, found a MAPD network her PCP was in (called that office and asked), answered questions, asked her questions... Asked her to tell me (rather than me, in summary tell her - this tells me what they remember) what she saw, after our discussion, that were the pros and cons of each and filled in a few things she had overlooked. Then I asked her what her priorities were and had her walk through her choices (G vs MAPD) to see how they fit.
The upshot is that because she has so many medical issues she is planning to switch to G (the MAPD's MOOP still the issue even with the one that her PCP accepted)... I told her to go to medicare.gov and check out her D's (I had to leave - nothing like doing this in off the cuff). She then begged to call me (I was driving 550 miles to day and about the same tomorrow - at extended family for christmas). So I told her when she could call. I hope I get a commission out of this but who knows.
Anyway it was abundantly clear that particular agent left out a significant number of details that mattered and I am sure she is not the only one (of course many are ethical and do a good job). As a result, in my opinion, more rules are needed for the agents who have no desire to do anything other than push what they want to sell rather than what the client needs. Folks who already do that stuff anyway should have no worries.
I give a 13% chance that she'll buy a med supp.
I give an 92% chance that the agent did in fact explain what she claims was omitted.
People who throw an absolute fit over a $30 copay aren't good candidates for $130/mo w/ $257 deductible + $590 on Rx's
And - even if she did have Plan G - imagine the fit she would throw when the bill came for $163 because "the agent didn't tell her" about the deductible.
But, good luck!
ValeRosso
Guru
- 637
I don't know if this actually works. People have said it does, but I've never seen it happen in real life
Today's lesson brought to you by the letters E & O . . .
That may work, may not.
Seems like there are some challenges to dropping B.
You may need to schedule an interview to review the risks of dropping coverage and get assistance with your request
Your coverage will end on the last day of the month after you file your request. For example, if you submit your request on April 1, your coverage will end on May 31.
Canceling Medicare Part B can have some risks, including: A health coverage gap, A late enrollment penalty, and Higher monthly premiums.
There are things in life you can do, and things you probably should not do.
This would fall under the "probably should not do" clause . . . or at least not advise someone to do.
I've never recommended that a client drop their part B and I'm going back 50 years with this stuff.
What I have done is help a boat load get their part B back and apply for a supplement. And it's always someone that is still working and paying their part B premium quarterly. They simply got behind on their part B premiums and Medicare cancelled it.
It's really simple. Everything Medicare revolves around your part B effective date. Never part A. And when a beneficiary reapplies they get a new part B effective date. Not their old one.
You simply work off the new date. Medicare nor most medsup companies ask. The only company that has a question on their app about it (that I write for) is ACE.
Agree.
The less drastic option (though, still drastic) for someone who really wants out of MAPD is to move to a county where the plan is not, if they're mobile and able to do so - for at least 6 months; the loss of coverage triggers GI.
