Signing Up for Medicare 2 months After 65th B day Month...Part D LEP & Enrollment Period Question

[kev_60]

I had someone contact me last month who turned 65 in June 2022. Somehow they were under the impression that they could keep their Medi-Share plan and it qualified as creditable group coverage. After informing them that it was not, I advised them to sign up for Medicare A & B asap, which they did in August. Since they waited 2 months after their birthday month their Part B will go into effect 11/01/22.That part I'm familiar with(although it's changing in 2023). But if they sign up for a PDP or MAPD in October, will they receive a LEP for Part D? Since their IEP was over in September ? I assume they could enroll in October for a 11/01 effective date and wouldn't have to wait till AEP for a 01/01/23 effective date ? Is this correct?

 

[billyb]

Since he is comfortable with MediShare show him MediShare65+.

 

[somarco]

Medi-Share 65+ acts as secondary payer to Medicare A & B and therefore anything that Medicare covers will be shared in. If Medicare A & B considers a medical condition ineligible for coverage, it will be considered ineligible for sharing under Medi-Share 65+ guidelines.
Medi-Share Sixty-Five+

 

[billyb]

MediShare 65+ works like a supplement but is not insursnce. A supplement won't pay a claim either if Medicare doesn't spprove the charge. I think MediShare 65+ is a good deal at $99 a month.

 

[somarco]

MediShare 65+ works like a supplement but is not insursnce. A supplement won't pay a claim either if Medicare doesn't spprove the charge. I think MediShare 65+ is a good deal at $99 a month.

It is a good deal . . . as long as the providers are willing to accept you as a patient.

Even though 65+ is a secondary payer it is not insurance and no guarantee the plan will pay even if Medicare approves the claim.

I have maybe 5 clients who had a sharing program up to 65 but they had no interest in the 65+ program . . . wanted real insurance

 

[billyb]

I use it where the client has no other options. Couple went MA at 65. Was unhappy so changed every AEP and finally went back to original Medicsre. Now uninsurable so opted for MediShare 65+.

 

[billyb]

A provider will accept you as a patient because you have original Medicare. Never known one to decline treatment because of who your secondary carrier was.

I would think someone who was familiar with MediShare <65 would consider MediShare 65+. It is just another option. I would definitely rather have it than a MA.

 

[goillini52]

I use it where the client has no other options. Couple went MA at 65. Was unhappy so changed every AEP and finally went back to original Medicsre. Now uninsurable so opted for MediShare 65+.

Is it GI?

 

[billyb]

They don't ask any health questions. If written T65 works just like a MS. No pre-ex during AEP either. Any other time 6 months waiting but HO guy says how will they know if we ask no health questions. He told me there is a big push to do away with pre-ex.

 

[somarco]

A provider will accept you as a patient because you have original Medicare. Never known one to decline treatment because of who your secondary carrier was.

Hospitals routinely check insurance (and non-insurance) for planned admissions.

If you have a sharing plan, indemnity, discount plan, etc they can require you to make a significant deposit before admitting you.

A few years ago a man who needed surgery sat outside Kroger, along with his family, asking for donations. The hospital wanted a $40k deposit before scheduling his surgery. He had a sharing plan.

It was a very sad sight.

If you are on a transplant list, hospitals will make you raise several thousand regardless of your insurance. A lady we know had a 2x lung transplant and had to raise $25k before they would put her on the list. She had decent insurance (MAPD) but still, she had to raise money.