Suggestions On How To Return To Original Medicare?

Oct 12, 2007

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  1. MedSuppPro
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    MA's are so easy to get into and yet, so hard to get out of. If my client had a MedSupp and switched to a MA plan for the first time, but then wants to switch back within 12 months, then why doesn't Medicare (CMS) understand this and assist their customer?

    If I help a senior try to return to the Original Medicare program within their 12 month trial period it is like trying to get food and water after Katrina. We'll call Medicare and nobody knows about their right to return. So we'll get multiple transfers and some advising that the only time to switch back is from November 15 - December 31st.


    Any suggestions?
     
  2. midwestbroker
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    If it is a MAPD plan, enroll them in a PDP using a SEP election code. That will automatically dis enroll them.

    If it is only a MA plan, then have then call customer service (the insurance carrier) and ask for the enrollment department. The dis enrollment process should involve the client sending in (or faxing) a hand written letter saying they want to leave the plan. Make sure the client signs and puts their member ID on the letter.

    Then enroll them in the supp for the following month.

    That is what has worked for me in the past.
     
  3. Mr. Bill
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    It actually may be easier to simply nationalize healthcare!
     
    Mr. Bill, Oct 13, 2007
    #3
  4. Cenla Agent
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    What SEP? That works if they actually do qualify for a SEP at that time.


    The key to disenrolling is having the member emphasize to medicare or the MA company that they are in a MA for the first time and they are exercising their option to switch back within 12 months. If this is noted, Medicare should switch them back. One thing I have noticed is that Medicare will try to kick the member back to the carrier. I don't know about other carriers, but I know Humana will only disenroll a member if the request is in writing. It can be sent by fax or snail mail.
     
  5. midwestbroker
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    I am sure that all the health care problems would be solved that way.

    After all, look how great Medicaid is.

    (Please note the sarcasm)
     
  6. midwestbroker
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    Cenla -

    A SEP is a special election period where a beneficiary can make a change outside of the AEP & OEP times.

    If they are having that hard a time trying with the carrier to cancel their plan, they should contact the state DOI. That will get the insurance company to act quickly as they do not want the DOI breathing down their neck.
     
  7. senior-advisor-indiana
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    I haven't had any problems getting them disenrolled from a MA. I don't mess with the carrier I just call medicare at the clients home. If the person that answers gives me a hard time, I tell them to transfer me to someone that knows what they are doing.
     
  8. retread
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    Use the 1-800-MEDICARE with caution. When you do use this, the client is disenrolled immediately. This gives him/her no room to re-consider. Sometimes a client is upset because he does not understand something, and shoots first without looking farther into the situation. In this event he/she may very well change their mind, but if they have called Medicare, they have used up this opportunity!

    In short, the 1-800-MEDICARE is a last resort vehicle, but it works.

    And yes, to the former post.... all disenrollments must be in writing. Only time a verbal request is considered OTHER THAN CALLING MEDICARE, is when a client changes their mind PRIOR TO THE APPLICATION BEING FILED. This is called cancellation. Once the paperwork is sent to Medicare by the carrier, it comes under the rules of disenrollment, and must be in writing.
     
    Last edited: Oct 13, 2007
    retread, Oct 13, 2007
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  9. senior-advisor-indiana
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    Why would you disenroll them if that is not what they want? When I am calling medicare to disenroll it is because those people want to cancel their policy not because they are considering cancelling it.
     
  10. retread
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    Yes, and I have had clients regret it later.
     
    retread, Oct 14, 2007
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