Pre-existing Conditions Med Supp

Feb 12, 2016

  1. saintstigers
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    saintstigers Guru

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    Are there any med supp carriers that enforce a pre-ex (6 month look back/forward) on policies?
     
  2. socal401
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    There are a few that have pre-existing condition waiting periods of either 3 or 6 months. This only applies if the applicant doesn't have credible coverage. I believe this is also state specific.

    Off the top of my head I believe New Era has pre existing waiting periods in just a couple states only on plans F and C. Also Transamerica just implemented this, not sure the details.

    If writing T65s it's important to know how this applies to the carriers and states you are writing for/in.
     
    socal401, Feb 12, 2016
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  3. saintstigers
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    Agree! I do mostly T65. Thanks!
     
  4. somarco
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    somarco GA Medicare Expert

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    Can't speak for other carriers or states, but the New Era px applies for up to 6 months unless the applicant had creditable coverage.

    And it only applies to Part B charges.
     
    somarco, Feb 12, 2016
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  5. socal401
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    socal401 Super Genius

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    Taken from New Era's Med Supp U/W Guide

    "- 6 month pre-existing restriction for plans C and F only in Pennsylvania, Georgia, Indiana, Iowa and Nebraska.
    - 6 month pre-existing restriction for Plan F only in Utah.
    - 3 month pre-existing restriction for plans C and F only in New Jersey."
     
    socal401, Feb 12, 2016
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  6. somarco
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    somarco GA Medicare Expert

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    Maybe I am missing something, but what's the big deal over px?

    If they did not have creditable coverage before, they would be responsible for the entire bill. Medicare does not have a px clause so Medicare will pay their portion.

    Only bills not covered (until the px time frame expires) is the 20% balance. So the majority of their claim would be covered.

    They are better off than they were before when they had nothing.
     
    somarco, Feb 12, 2016
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  7. socal401
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    socal401 Super Genius

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    I agree but regardless of weather of bill is big or small agents and applicants need to know what applies to them so there aren't any surprises that may come back and bite them.

    Just answering the OPs question.
     
    socal401, Feb 12, 2016
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  8. Duaine
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    Trans America now has a Pre-X on folks without prior credible coverage. :twitchy:
     
    Duaine, Feb 12, 2016
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  9. GoPokes
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    Old Surety enforces it if they don't come from prior coverage. 6 month.
     
    GoPokes, Feb 12, 2016
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  10. somarco
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    somarco GA Medicare Expert

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    How do they treat creditable coverage?
     
    somarco, Feb 12, 2016
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