Part B - Disenrollment & Later Re-enrollment

Feb 14, 2016

  1. BuckNasty
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    BuckNasty Super Genius

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    I have a relative who is 66 and is insured through a large group plan. The guy also enrolled in part B about a year ago thinking he would get help for a shoulder surgery.

    Anyway he is a high earner and Part B is costing him a lot of money. He wants to drop plan B now since he is still planning on working for a few more years and will have group coverage but want to know the ramifications of doing so. I am aware of Social Securty interview that is required and the form CMS 1763 which must be filled out, but I have a question about future rights on buying a Medigap Policy. Medicare.gov says the following in their Q/A section:

    "Question: I currently have Part B but I (or my spouse) have returned to work, and I now have group health coverage from my employer or union. I don’t think I need both Part B and group health coverage. What can I do?
    You may want to delay Part B if you or your spouse still work and have employer or union group health plan coverage. If you drop Part B, you can sign up for it again in the future during a Special Enrollment Period.

    Answer: Make sure your group health plan coverage is in effect before you drop Part B. In this case, you won't have to pay a late enrollment penalty. Remember, when you drop Part B, your coverage ends the next month. Also, if you drop Part B after you turn 65, you won’t get another Medigap open enrollment period when you restart Part B."

    So MEdicare is saying he won't get an "OPEN ENROLLMENT" for Medigap when he re-enrolls later on. But will he get a guaranteed issued enrollment since he will be leaving a group plan when he restarts Part B?

    Thanks in advance!
     
  2. WCMason
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    WCMason Guru

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    I've had clients get a med supp as OE in situations like this.
     
    WCMason, Feb 14, 2016
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  3. Glen Shelton
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    Glen Shelton Guru

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    Sounds like they should still be able to qualify for OE at a later date.
     
  4. WCMason
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    WCMason Guru

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    To expand a bit on the short reply earlier, I have seen that answer on the Medicare.gov Q&A, but in practice the med supp carrier's only question is "did you enroll in Medicare Part B in the last six months?" If yes, they get OE. Because there is not a follow-up "is this the first time you enrolled in Part B?" they go through as OE even if Part B was dropped and later reinstated. Med supp carriers either don't have or don't use a system similar to MARx that MA and PDP carriers use to verify eligibility.

    The couple of times I've helped people reinstate Part B then get an OE med supp was before I'd seen this rule on the Medicare.gov Q&A. Now that I know the rule I'll call the carrier to confirm they will take it OE before submitting if I know the applicant had dropped and reinstated Part B. I don't want to knowingly apply for something a person isn't eligible for according to the rules.
     
    Last edited: Feb 15, 2016
    WCMason, Feb 15, 2016
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  5. BuckNasty
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    BuckNasty Super Genius

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    Thanks for that answer. Did you happen to notice if they were issued a new medicare card and if it had the re-enrollment date or the original part b date on it?
     
  6. WCMason
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    They are issued a new card and it only has the most recent Part B effective date.
     
    WCMason, Feb 15, 2016
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  7. yorkriver1
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    yorkriver1 Guru

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    I agree with WC about not wanting to be enrolling someone in violation of a rule. I am often pleasantly surprised by the more generous rules at Med Supp carriers.
    Good to check with carrier. I also have not seen any Part B question on a MedSupp app beyond "did you enroll in Part B in the last 6 months?"
     
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