Trial Right......

Aug 19, 2016

  1. agentjhc
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    Under guarantee issue, for Trial Right #5 from Medicare Guarantee issue page dropping MS to go to MA. What constitutes

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

    What are those circumstance?
     
    agentjhc, Aug 19, 2016
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  2. TwoCents
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    Let's try to clean this up.

    First you're referencing this page https://www.medicare.gov/find-a-plan/staticpages/learn/rights-and-protections.aspx right?

    Then you mean a person is dropping MA to go back to a supplemental plan, right?

    Don't have an answer concerning the extra 12 months, but might try to dig one up later.
     
    TwoCents, Aug 19, 2016
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  3. yogooglethis
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    In Fl. some carriers such as AARP/UHC extend GI for 24 months if they enrolled in MA at age 65 or dropped an AARP/UHC med supp to enroll in MA.Never tested it but I am not 100% sure if it matters if they dropped AARP/UHC Med supp originally or any med sup.

    of course the extra 12 months of GI only helps if they have a SEP to disenroll from the MA outside the AEP.
     
  4. agentjhc
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    agentjhc, Aug 19, 2016
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  5. agentjhc
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    UHC I am pretty sure extends the trial to 12 months. 24 months if coming back from UHC MAPD?

    Aetna, in field agent guide, looks to give 12 months.

    Bankers Fidelity appears to be just the 63 days.

    Anyone have experience with other carriers?

    I have not had any luck determining the "up to 12 months" conditions unless it is carrier specific.
     
    Last edited: Aug 24, 2016
    agentjhc, Aug 24, 2016
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  6. openmindedone
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    Let's say a person uses IEP right now to enroll in an MAPD. That MAPD exits the market January 1. That person could sign up for a new MAPD and have 12 months trial right with new plan.
     
  7. yogooglethis
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    12 month clock starts at T65 and in this case consumer could be screwed out of 12 trial period GI altogether because it would be their second enrollment into MA.Also they would be double screwed even if they passed underwriting for a med supp during the following year lock in because the SEP Trial for PDP to get off the second MA plan would not be valid anymore.
     
  8. yorkriver1
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    I got lucky on the 2nd MAPD in 12 months situation. Last year I had a similar second MA plan in 12 months scenario with someone about to turn 66, and a lot of phone calls later, because the 2nd plan was the same carrier and type of plan (HMO), no grief for the PDP SEP to drop MAPD. The new PDP was also same carrier as the MAPD being dropped. I took names/dates, etc. of who said yes at the carrier.

    Then UHC was fine with their MedSupp policy being issued under the trial rights rule, no medical questions. During my search, I spoke to a person who just happened to have been someone who reviewed SEP's for an MAPD carrier, and they said, go for it, CMS won't be the bad cop. I make no promises, but if I took the 1st no I got, my client wouldn't have had the Plan F to pay for expensive treatments.

    Re: the 2nd year offer for MedSupp trials rights offer. The client could still get the Med Supp, but would have to wait to do it for AEP to drop MAPD/get PDP in that 2nd 12 months that UHC would offer--they just brought that up in a UHC workshop this week--it only really works in AEP--. Don't know if any other MedSupp carrier does it, or somehow CMS would grant another 12 months for a reason we don't know.

    The rules about trials rights are on about page 22-23 of the Guide to Medigap Insurance we are mandated to give prospects/clients with their Med/Supp proposal/app. They hide things in there. :1cute: Maybe that was the document referred to earlier--I didn't recognize it as the same source, rules are probably listed elsewhere, too on Medicare.gov, but we should all have those 2016 Medigap booklets around.
     
    Last edited: Aug 26, 2016
  9. Cenla Agent
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    I want to say that some Blue plans give an extra year under some circumstances.
     
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