Trial Rights/Med/Supp 1st 12 Months

[yogooglethis]

Section 3 b "Was this your first time in this type of Medicare plan?"

Although they ask that question and it has to be answered honestly either way I believe the " first time rule" only applies when using the Trial Period for those who are past the T65 Open Enrollment when they dropped a med supp to go with MA for the first time .If it is Trial period for those who chose MA when T65 I don't think it matters if they had 4 different plans as long as they are within the 12 months and they can go with ANY carrier whereas when using the Trial Period after the T65 Open Enrollment the consumer can only go back to the med supp carrier they had-if available.

These are the Fl DOI rules .the carriers can be more lenient i.e. 24 months instead of 12 etc. if they choose too.

 

[cadylou]

Although they ask that question and it has to be answered honestly either way I believe the " first time rule" only applies when using the Trial Period for those who are past the T65 Open Enrollment when they dropped a med supp to go with MA for the first time .If it is Trial period for those who chose MA when T65 I don't think it matters if they had 4 different plans as long as they are within the 12 months and they can go with ANY carrier whereas when using the Trial Period after the T65 Open Enrollment the consumer can only go back to the med supp carrier they had-if available. These are the Fl DOI rules .the carriers can be more lenient i.e. 24 months instead of 12 etc. if they choose too.

Ok do what u think
Is ok. Never has been my interpretation because of the phrase "was this your first time" in a MA plan question. Do what u want.

 

[goillini52]

Although they ask that question and it has to be answered honestly either way I believe the " first time rule" only applies when using the Trial Period for those who are past the T65 Open Enrollment when they dropped a med supp to go with MA for the first time .If it is Trial period for those who chose MA when T65 I don't think it matters if they had 4 different plans as long as they are within the 12 months and they can go with ANY carrier whereas when using the Trial Period after the T65 Open Enrollment the consumer can only go back to the med supp carrier they had-if available.

These are the Fl DOI rules .the carriers can be more lenient i.e. 24 months instead of 12 etc. if they choose too.

In the Choosing a Medigap Policy booklet it says that "Your rights may last for an additional 12 months under certain circumstances." It doesn't say what those circumstances are.

As far as going back to the carrier they had...that must be up to the carrier. Oxford Life will take somebody that went from Med Supp to MA that wants to go back to Med Supp within a year, even though it hadn't been with them.

 

[somarco]

Carriers do have the ability to interpret GI anyway they want as long as they are not more restrictive than CMS rules. That being said I wouldn't encourage a client to lie on the app even if a rep or underwriter suggested it.

 

[WCMason]

In the Choosing a Medigap Policy booklet it says that "Your rights may last for an additional 12 months under certain circumstances." It doesn't say what those circumstances are.

This is true, but not relevant in this case as the beneficiary is still in the first 12 months. At issue is the "first time." I'll be writing three eapps with them tomorrow. As a test I'll answer no to the first time question to see if it allows me to proceed GI.

 

[goillini52]

Carriers do have the ability to interpret GI anyway they want as long as they are not more restrictive than CMS rules. That being said I wouldn't encourage a client to lie on the app even if a rep or underwriter suggested it.

And I would never do that either. I also don't see where a Rep or underwriter suggested it.

Question 3. List start date of current MA covered by in past 63 days(as of tomorrow the only coverage they've had in past 63 days is current MA). 01/01/2015 - End date leave blank because still covered.

A. Yes (Intend to replace with new Medicare Supplement?)

B. Yes (It was their 1st time in this type of Medicare plan. They hadn't had a Med Supp in between MA's, so it's still their 1st time in this type of Medicare plan)

C. No (Did you drop a Medicare Supplement plan to enroll in the Medicare plan?)

I see no problem and I certainly see no lie.

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This is true, but not relevant in this case as the beneficiary is still in the first 12 months. At issue is the "first time." I'll be writing three eapps with them tomorrow. As a test I'll answer no to the first time question to see if it allows me to proceed GI.

B. Yes (It was their 1st time in this type of Medicare plan. They hadn't had a Med Supp in between MA's, so it's still their 1st time in this type of Medicare plan)

 

[WCMason]

They hadn't had a Med Supp in between MA's, so it's still their 1st time in this type of Medicare plan)

Except it would have been the second time in this type of Medicare plan. The question is in reference to the current enrollment, whether or not there was a med supp between them.

That said, I hope it works. I'm all for more options.

 

[somarco]

"Is this your first time in this TYPE of Medicare plan?"

I suppose it depends on what your definition of is, is ............

 

[goillini52]

I suppose it depends on what your definition of is, is ............

https://www.youtube.com/watch?v=j4XT-l-_3y0



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I suppose it depends on what your definition of is, is ............

And Oxford's definition of is, is different than ACI's definition of is. Took a while to get the answer, but the person I talked to put the question to a Regional Director(Drew), and they say that since they switched MA's, no GI...it would have to be underwritten.

 

[somarco]

That is today's definition but who knows what tomorrow may bring?