New to MAPD commission

[RickT]

How does it pay for a past MA member who left to go back to pd only, then goes back to MA a few years later.

If they ever had MAPD in the past does it only the renewal rate?

 

[vic120]

Supposed to pay just renewal, I have a couple of times been paid new, But don't expect it does not happen everytime

 

[sshafran]

Yeah, the "true-up" is just their first time in that type of plan... this is not their first time in this type of plan.

 

[sshafran]

But as a side note, that would be AWESOME if we got the true-up each time they switched from Original Medicare to MAPD. lol

 

[Mike F]

I just had a new to MAPD client. He previously had employer coverage. His IEP was back in 2015 when he turned 65. So we used SEP for his 10/1 effective date. Came back from AETNA as replacement. I was told to call CMS. I did and CMS said because he was out of his IEP he was no longer new to medicare and only eligible for replacement. He signed up for Part A in 2015 and did not need to sign up for part B or D because he had employer coverage. Have you ever had this happen? Sorry, if I'm hijacking your thread, I can post a new topic if needed.