Trial Rights/Med/Supp 1st 12 Months

[goillini52]

I called New Era and they say that when that person switched from one MA to another, even though within the same company they lose their Trial Right.

I called ACI to see if I'd get the same answer, but they're closed because of the weather. The suspense is killing me.

 

[WCMason]

I called New Era and they say that when that person switched from one MA to another, even though within the same company they lose their Trial Right. I called ACI to see if I'd get the same answer, but they're closed because of the weather. The suspense is killing me.

And the suspense will continue into next week. Aetna just announced they're closed today as well due to weather.

 

[yorkriver1]

Equitable said no, and checked with head of underwriting and compliance just to be sure. Waiting on another one.

 

[somarco]

Pretty sure you are going to get more no's than yes's but it never hurts to ask.

 

[yorkriver1]

Looks as if several carriers would do this, but now it's the issue of CMS letting them drop out when plan code for enrollment is not IEP, and they didn't drop a Medicare Supplement to enroll.
Calling CMS Region 3 for possible exception, grant SEP.
Also, if there's a 5 star PDP, they could have a SEP for 4/1/15. Don't think any in my state.

 

[yogooglethis]

Looks as if several carriers would do this, but now it's the issue of CMS letting them drop out when plan code for enrollment is not IEP, and they didn't drop a Medicare Supplement to enroll.
Calling CMS Region 3 for possible exception, grant SEP.
Also, if there's a 5 star PDP, they could have a SEP for 4/1/15. Don't think any in my state.

or you could use SEP 65 for the PDP application if they enrolled in MA for the first time when they turned 65


SEP 65 For PDP


Begins month enrolled in MA for first time

Ends 12 months after effective date

First day of the month following receipt of disenrollment request.
1 Election*

*Enroll into PDP if coming from MA-PD, or Disenroll into Original Medicare
Code: SEP

Reason: SEP 65

 

[goillini52]

Looks as if several carriers would do this, but now it's the issue of CMS letting them drop out when plan code for enrollment is not IEP, and they didn't drop a Medicare Supplement to enroll.
Calling CMS Region 3 for possible exception, grant SEP.
Also, if there's a 5 star PDP, they could have a SEP for 4/1/15. Don't think any in my state.

Which carriers besides ACI did you find that will do it?

 

[Ronnie Carter]

Another good tip on the e-app. Seems like the left hand needs to be introduced to the right.

Decided to look at the Aetna underwriting guide and refresh my memory, while not admitting there is anything wrong with my .......... uh

In two places, pg 4 (Choosing an Effective Date ), and 6 (Guaranteed Issue) it seems pretty emphatic that G (and N) are not options.

I suppose they don't count on someone like you actually referring to the chart and calling them out.

Somarco, I'm not currently contracted yet for Med supps with Aetna, but I did take a glance at the u/w guide you linked to.

Did you notice the wording of the last paragraph of page 6? It reads thusly:

-Applicant was enrolled under Medicare Supplement policy
and terminates enrollment and subsequently enrolls for the
first time in a Medicare Advantage plan and terminates
the plan within the first 12 months – applicant is eligible for
Guaranteed Issue with company if prior Medicare Supplement
plan is no longer available. Proof of prior Medicare
Supplement policy and Medicare Advantage policy is required.
[Emphasis in the original]

It implies that if the person's old Med supp plan IS available, they don't have any trial right. That, plus the hilarious misspelling of "creditable" coverage on at least two different pages, makes me think they should have chosen a more literate employee to compose the text for this guide!

 

[somarco]

It implies that if the person's old Med supp plan IS available, they don't have any trial right.

See #5 on this page. That provision is common. Can't say how often it is enforced.

 

[Ronnie Carter]

See #5 on this page. That provision is common. Can't say how often it is enforced.

I understand the trial right, but my point is, the way that u/w manual was written, it sounded like if you leave a Med supp, enroll in an MAPD, and then six months later decide you want your supplement back, then if it's still available (which is the usual case), you don't have any trial right -- but you do IF the supplement plan IS NOT available. The link you posted says, as I have always known, that if your old plan is still available, you can get it back on a GI basis.

My command of the English language isn't always the greatest -- lol. For example, I saw on a Cigna-HealthSpring training site that they want you to send in MA apps "within 24 to 48 hours." I found this extremely odd, as it seems to say you must wait at least 24 hours to send it in. Otherwise, why not say it needs to be sent in by 48 hours? Or say, we prefer you to send them in within 24 hours, but definitely, no later than 48?

Maybe it's just me. My wife thinks so.