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SEP Question-Need Help!
- Thread starter insurance0707
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- 185
They get SEP loss of coverage ... they can do anything they want MA with PDP or MAPD or Supp w PDP or Medicare w PDP. Not to say CMS won't mess up thier enrollments or BCBS won't get confused and bundle them ... and trust me 0707 CMS and BCBS know less than you.
I understand they can do what they want under those perimeters, but they only have 1 Election opportunity, not unlimited.
...not trying to be dense, I come by it naturally, but... They used their 1 Enrollment opportunity with the Med Sup. The regs state 1 election for PDP and Medicare Plan, whether it is MA or Med Sup. I don't see in the regs where they can have an additional election period after they have made their choice.
Am I missing something?
But, jdeasy has done it before, which means it can be done, but it doesn't jive with my understanding of 1 election until AEP.
...not trying to be dense, I come by it naturally, but... They used their 1 Enrollment opportunity with the Med Sup. The regs state 1 election for PDP and Medicare Plan, whether it is MA or Med Sup. I don't see in the regs where they can have an additional election period after they have made their choice.
Am I missing something?
But, jdeasy has done it before, which means it can be done, but it doesn't jive with my understanding of 1 election until AEP.
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I never got around to calling Medicare today. I would think they have the 63 days in their SEP to do whatever they want, but I don't know if it's similar to the OEP where they can only make one change or the AEP where they can make more than one change. I got bogged down with the GM retiree's today. I'm in Michigan and they are not waiting until Oct/Nov. Alot of them want to know now what to expect, premiums, etc. I really don't have any good MA plans. That's why I didn't bring it up to him.
- 18,980
You are confusing the one election during this period. They have one election for an MA, an MAPD or a PDP. The SEP has nothing to do with med sups.
The SEP is for the medicare advantage and PDP only. There is a whole different set of rules for the med sup. They have 6 months from the time part B started to get a med sup with GI. That has nothing to do with their SEP for loss of credibe coverage.
It is sinking in. I was reading my reference as 1 Election for MA, PDP, & 'Original Medicare', thinking Original Medicare was Med Sup. It of course is not, it is A & B.
Thank you. I am just trying to understand, and since you had said you had done it before, I knew it could be done. I just wan't getting it because I have never done it before; cancel a new Med Sup and move them to an MA.
I worry about taking them off of a Med Sup in this case, but I am not privy to their history or the plans in his state.
Thank you. I am just trying to understand, and since you had said you had done it before, I knew it could be done. I just wan't getting it because I have never done it before; cancel a new Med Sup and move them to an MA.
I worry about taking them off of a Med Sup in this case, but I am not privy to their history or the plans in his state.
The Medicare Advantage program is part C of Medicare and they have an enrollment period following the loss of creditible coverage. Upon enrollment in Medicare C, they leave Original Medicare and no longer need the Med. Supplement. They have a 12 month window of time to return to the Med. Supp. with Guaranteed Issue. They can enroll in a MA only because they have exercised their option for Part D of Medicare when they enrolled in AARP RX Plan. You would need to enroll them in the Blue Cross MA only plan in the county of residence. I hope this helps.
Something I am curious about.
If they never enrolled in the Med Sup, they would lose the option of going into a guaranteed issue med sup. The way I see it they are going to get the best of both worlds by being enrolled in the med sup (even though just for 1 month) at the time they enroll in the MA. If they had not been enrolled in the Med Sup they would not have the option to go back to a GI Med Sup, ever.
Correct?
If they never enrolled in the Med Sup, they would lose the option of going into a guaranteed issue med sup. The way I see it they are going to get the best of both worlds by being enrolled in the med sup (even though just for 1 month) at the time they enroll in the MA. If they had not been enrolled in the Med Sup they would not have the option to go back to a GI Med Sup, ever.
Correct?
If they enrolled in MA at their first initial enrollment period, they have a 12 month window to change to Original Medicare and a Med. Supp. After the 1st 12 months on MA, they will be underwritten.
