Trial Right Back to MS

[agentjhc]

I am working with a man that took out a MS when he turned 65. He is now 75 and was on the plan from 65 to 75.Back in the fall he enrolled in a MAPD. Doc wasn't in network. He dropped his plan effective Feb 29 and went back to OM and enrolled in a PDP. Does he have a "trial right" back to his original Medigap at this time or does he have to go back within 63 days of coverage ending?

I ask because I saw this on medicare.gov

"Your rights may last for an extra 12 months under certain circumstances."

Didn't know the "certain circumstances"?

FYI---For the record, I was not the agent that moved him from MS to MA

 

[yogooglethis]

I am working with a man that took out a MS when he turned 65. He is now 75 and was on the plan from 65 to 75.Back in the fall he enrolled in a MAPD. Doc wasn't in network. He dropped his plan effective Feb 29 and went back to OM and enrolled in a PDP. Does he have a "trial right" back to his original Medigap at this time or does he have to go back within 63 days of coverage ending?

I ask because I saw this on medicare.gov

"Your rights may last for an extra 12 months under certain circumstances."

Didn't know the "certain circumstances"?

FYI---For the record, I was not the agent that moved him from MS to MA

should be good on GI but may have a waiting period for pre-ex

extra 12 months is a carrier specific thing.i know aarp/uhc offers it

 

[agentjhc]

Thanks, my thought as well. His was with a different company originally. I am waiting on them to call back. Would be cheaper than UHC. Hopefully he can return with his old company.

UHC offer it if they weren't the original company?

 

[jacobtn]

should be good on GI but may have a waiting period for pre-ex

extra 12 months is a carrier specific thing.i know aarp/uhc offers it

No waiting periods on replacements.

 

[yogooglethis]

No waiting periods on replacements.

because of amount of time w/o coverage would not be replacement would it?

 

[agentjhc]

I don't think he would mind the short term pre x.

 

[somarco]

Does UHC have one of those rules that you can rewrite all you want but no commission unless you were the original writing agent?

 

[agentjhc]

Does UHC have one of those rules that you can rewrite all you want but no commission unless you were the original writing agent?

Don't know. This guy was with a different company originally. I have received conflicting info on what he can or cannot do. I never asked him why he went to an MAPD plan. Don't know if he signed up direct or with an agent. I spoke with a T65 today that signed up over the phone with Humana. PPO. They checked her doc but didn't ask her about hospitals. She also wasn't aware that she would have a maximum out of pocket of $6700 and some other details. ----------

Got a call back this morning and he will be good to go with his old company. He will be a happy man.

 

[AllGold]

Pre-ex would only apply if he did not have any coverage. But he had original Medicare so no pre-ex.

 

[vic120]

Pre-ex would only apply if he did not have any coverage. But he had original Medicare so no pre-ex.

No Original medicare does not count as creditable cov for pre ex, However a MA, Supplement, Group , VA benefits are examples of creditable cov that would avoid pre waiting period