T65 MAPD Enrollment Eligible?

[GoPokes]

She is turning 65 in May, but she has had medicare A&B for 3 years now due to disability (started may 2012). Can I enroll her into an MAPD plan effective 05/01/2015? Or does she have to wait until OEP at the end of this year?

Thanks for the help

 

[TwoCents]

She is turning 65 in May, but she has had medicare A&B for 3 years now due to disability (started may 2012). Can I enroll her into an MAPD plan effective 05/01/2015? Or does she have to wait until OEP at the end of this year?

Thanks for the help

She qualifies for a 2nd IEP which can be used to enroll into an MAPD or PDP. The IEP begins 3 months prior to when she turns 65 and 3 months after. Probably check with the carrier to see how they like the election to be listed on the app.

Quote from CMS Chapter 3 PDP guide: Individuals eligible for Medicare prior to age 65 (such as for disability) will have another Initial Enrollment Period for Part D based upon attaining age 65.

To add to the fun to go along with the 2nd IEP for drug coverage, she has a coordinating SEP to enroll into an MA-only plan if she wishes. Of course her options are limited if she wants both a PDP and MA-only.

From CMS Chapter 2 MA Guide: An individual eligible for an additional Part D IEP, such as an individual currently entitled to Medicare due to a disability and who is attaining age 65, has an MA SEP to coordinate with the additional Part D IEP. The SEP may be used to disenroll from an MA-only or MA-PD plan to Original Medicare, or to enroll in an MA-only plan (regardless of whether the individual uses the Part D IEP to enroll in a PDP). The SEP begins and ends concurrently with the additional Part D IEP.

 

[GoPokes]

She qualifies for a 2nd IEP which can be used to enroll into an MAPD or PDP. The IEP begins 3 months prior to when she turns 65 and 3 months after. Probably check with the carrier to see how they like the election to be listed on the app.

Quote from CMS Chapter 3 PDP guide: Individuals eligible for Medicare prior to age 65 (such as for disability) will have another Initial Enrollment Period for Part D based upon attaining age 65.

To add to the fun to go along with the 2nd IEP for drug coverage, she has a coordinating SEP to enroll into an MA-only plan if she wishes. Of course her options are limited if she wants both a PDP and MA-only.

From CMS Chapter 2 MA Guide: An individual eligible for an additional Part D IEP, such as an individual currently entitled to Medicare due to a disability and who is attaining age 65, has an MA SEP to coordinate with the additional Part D IEP. The SEP may be used to disenroll from an MA-only or MA-PD plan to Original Medicare, or to enroll in an MA-only plan (regardless of whether the individual uses the Part D IEP to enroll in a PDP). The SEP begins and ends concurrently with the additional Part D IEP.

Thanks for the clarification. I thought this was the case, but another agent advised the applicant that she couldn't enroll at this time, then I called the producer help desk and the "helper" was unsure and advised me that she could not bc she already used her IEP. So I thought I would ask you guys.

 

[TwoCents]

If the Help Desk is that ignorant, then I guess they can't tell you what to write on the application. If you're just doing an MAPD/PDPI would put it down as "2nd IEP now turning 65 for existing Medicare benefiicary -- election code F" -- "F" is what the plan should be using when they send the transaction to CMS for approval.

 

[JimmyUt]

Thanks for the clarification. I thought this was the case, but another agent advised the applicant that she couldn't enroll at this time, then I called the producer help desk and the "helper" was unsure and advised me that she could not bc she already used her IEP. So I thought I would ask you guys.

The help desk are idiots. This person can enroll with zero issues.

 

[cadylou]

Thanks for the clarification. I thought this was the case, but another agent advised the applicant that she couldn't enroll at this time, then I called the producer help desk and the "helper" was unsure and advised me that she could not bc she already used her IEP. So I thought I would ask you guys.

Was the rep in Thailand?

 

[WCMason]

She is turning 65 in May, but she has had medicare A&B for 3 years now due to disability (started may 2012). Can I enroll her into an MAPD plan effective 05/01/2015? Or does she have to wait until OEP at the end of this year? Thanks for the help

Jumping on the she can do whatever she wants and anyone that says otherwise is wrong bandwagon, treat her as you would someone turning 65 who had never been on Medicare as far as eligibility. Just use a 2 after IEP for any app that asks for an eligibility code.

 

[yorkriver1]

Income may be a factor, but this is also a time when the person could buy a Medicare supplement and PDP. I have one now who will qualify to do that next year.
There are other options to get the Silver Sneakers membership, if that is a thing for the client on an MAPD with that perk. This all works well if they can afford Med/Supp.
This could be the one and only opportunity for the person to get a supp, depending on health conditions. If income is low enough, moot point, because high out of pocket on MAPD won't scare them.
I am amazed at times which MAPD clients use the gym membership, recent examples, heavy smoker on disability, but wants to take the boxing classes at the Y, can't thank me enough. 71 year old, lots of conditions, but loves to swim 3X week. They love Silver Sneakers.