I have a plan termination with Humana and i moved the guy to another mapd for 1/1/ . 2 weeks ago he got diagnosed with Cancer . I'm going to move him to a med sup. He's 78 . I have to move home to a Gi plan G correct? So if he enrolls in a humana plan won't they be able to look up his Humana mapd terminated or do i need to send the termination form in? What's the sep code for a mapd termination to sign him up on a mapd plan ?
Plan termination and moving GI to a med supp
- Thread starter DonP
- Start date
- 1,179
F as he probably has had medicare pre-macra?
- Thread starter
- #3
That's what i thought . He did have a plan f 2 yrs ago before he moved to mapd
I hate trial right. I probably have to do one today and it's a PITA. The Supp company won't approve until they get a letter from the MAPD, with start dates, proving coverage. And you can't get it until you do the drug plan. I think.
I'm going to call the MAPD with my client today to see if we can get a letter before doing the PDP. I've only done 2 trial rights in 16 years.
I'm going to call the MAPD with my client today to see if we can get a letter before doing the PDP. I've only done 2 trial rights in 16 years.
- Thread starter
- #5
On the pdp you can do dst to . That's easier to be honest
Best: Get the official letter from the member to provide to the med supp carrier. (And yes, it'll be F)
2nd best: Log into Humana and create a service request in the members profile and ask them to provide you with the loss of coverage documentation - tell them you need the document or some statement to provide to the med supp carrier for GI rights.
Special Agent
Guru
- 612
Not sure about humana but UHC recently surprised me with a UHC ma client who was using a trial period to get gi UHC aarp med supp.They internally got the verification that it was first time on ma and i didn't have to submit any documentation and it happened within a week.i know that previously the UHC MA and UHC med supp departments never intermingled but apparently UHC have changed their policy on this or maybe CMS did?
I wrote more GI than I care to admit this AEP. Stupid service area reductions and no great MA alternative options.
Humana absolutely positively will not internally look and see that they're terminating the member and need to honor GI.
They want the letter that they gave the member to be provided back to their med supp department.
They don't want to make it easy
