SEP Question

[insurance0707]

You're probably right to have the client call Medicare and disenroll. These rules and plans are fairly new and the insurance companies home office people don't seem to know all of the rules, when you can enroll, disenroll, etc. It's very frusterating to the agent!

 

[mcday]

Rules?

Can they really call it a "rule" when they make it up as they go???

Sometimes it would just easier to find another way to your goal than fight with 'em about Medicare "rules". What a mess!

 

[retread]

Rules?

Can they really call it a "rule" when they make it up as they go???

Sometimes it would just easier to find another way to your goal than fight with 'em about Medicare "rules". What a mess!

Sometimes it is difficult to tell if they design the "rules" with vagueness and/or ambiguity on purpose or if they are just functionally illiterate and can't see the problem. In one case they appear deceitful and in the other just plain dumb.

 

[insurance0707]

Ok..I called the home office of a PDP plan that I was going to write for the client. I needed to know what the code # was to enter in for the SEP. At first they told me "No" that person can't enroll in a PDP now. Yes they do have the right to go back to original Medicare and a Guaranteed Issue for med supp but not for Part D rx. After bickering back and forth, they checked with someone else and I was then told, Yes they do have the right to enroll in Part D also.

The SEP Code # you'd put down is S65. That is what lets the PDP plan know that this person is in there 12 month trial period with a MAPD and switching back to Medicare and a PDP plan.

Sheeeeeeeeeeeeeeeeesh!

 

[mcday]

All I want to know is... how ya gonna spend that $30 you just made on that PDP plan?

 

[senior-advisor-indiana]

There is nothing like working for free.

 

[insurance0707]

I'm not even going to consider spending the $30 until the home office actually issues the policy. Which I'm sure will take some phone calls after they send the client a rejection notice for enrolling outside of the enrollment period. Those letters are fun! Have any of you guys had that happen?

 

[mcday]

Fortunately, I've never had a rejection notice for enrolling outside the enrollment period.

I just did a J Plan yesterday with a $30 Humana PDP... keeping my fingers crossed.

 

[insurance0707]

Update on my client that tried to enroll in the PDP plan using her trial period. They had originally told me to put down S65 and that would let them know that she was using her trial period. Well, they rejected the app and said she didn't have a SEP. When I called on this, they told me it should be listed as OETNEW. So I had to send an email to the home office stating this. They give you a different answer everytime you call!!!!!!!!!

 

[Hagerstrom_JSA]

SecureHorizons has released the only SEP Guide that is CMS approved and outlines all of the possible election periods under the sun. Feel free to contact myself for a copy.