Part D LEP

[JNav]

On year 2019 (the individual turned 65) and was working with a employer health insurance coverage.
On April 11, 2020, she was furloughed and reached out on June to apply for MAPD (with an SEP of COVID19). The plan took effect on July 1st. So there is a gap on the coverage correct? since she exceeded the 63 days? The individual received a payment booklet from the plan and requiring to pay by month or year.

How does it work with employer coverage, do the coverage ends "on the day" of the furlough or it ends "at the end of the calendar month" of when they were furloughed?

Any suggestions on how to resolve the LEP issue, besides applying for LIS?

 

[TRG1225]

On year 2019 (the individual turned 65) and was working with a employer health insurance coverage.
On April 11, 2020, she was furloughed and reached out on June to apply for MAPD (with an SEP of COVID19). The plan took effect on July 1st. So there is a gap on the coverage correct? since she exceeded the 63 days? The individual received a payment booklet from the plan and requiring to pay by month or year.

How does it work with employer coverage, do the coverage ends "on the day" of the furlough or it ends "at the end of the calendar month" of when they were furloughed?

Any suggestions on how to resolve the LEP issue, besides applying for LIS?

I would ask your client to be sure, as she should be able to find that out pretty quickly. If her coverage ended April 30th, then she should be good.

If coverage ended April 11th, then I don't know of any other way to get around the LEP in this scenario....does she have VA benefits?

 

[JNav]

Thanks for your response. No VA benefits.

 

[DonP]

Why didn’t the coverage become affective June 1?

 

[JNav]

Good question.
She reached out June 20th. Are health plans able to put an effective date for same month they applied ? even it's the last week of the month?

Thanks

 

[TRG1225]

Why didn’t the coverage become affective June 1?

All medicare plans can start the first of the following month at the earliest

 

[LostDollar]

How does it work with employer coverage, do the coverage ends "on the day" of the furlough or it ends "at the end of the calendar month" of when they were furloughed?

Caveat, not an agent.

My experience in KS with my employers has been that coverage goes to the end of the month of termination and any premiums due from me for the remainder of the month of termination were withheld from my final pay.

When I suggested that this was THE practice in a thread a couple of years ago, I had multiple agents making critical comments, saying that many companies stop insurance at termination or the week of termination.

So this would appear to be a question you can't hypothesize your way through, you and your client need the specific information from the employer about how they handle health insurance and terminations.

 

[somarco]

How does it work with employer coverage, do the coverage ends "on the day" of the furlough or it ends "at the end of the calendar month" of when they were furloughed?

Only your client or HR can answer that.