Trial Rights Question

Apr 25, 2016

  1. vic120
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    I know If someone T65 or dops Med Supp and gets MA first time can change and get PDP and Supp under Trial

    However I have a woman who is OE and 68 years old Signed up for MA in Jan thought it was supp and did not understand the restrictions,

    She has heart condition and other health concerns, She is OE so she doesn't need to pass underwriting But Needs out of MA plan

    Is there no Trial rights in her situation?
     
    vic120, Apr 25, 2016
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  2. cadylou
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    If her part B effective date was January, she should still be able to get a Med Supp with no UW since she's still within the 6 months from the Part B effective date. You may have an issue with dis-enrolling her from the MA plan, though, and may not be able to sign her up for PDP. If she pays a premium for MA, she could be termed for non-payment, but you'd still have the difficulty of establishing a standalone PDP.
     
    cadylou, Apr 25, 2016
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  3. vic120
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    That's it she cant get any trial period to get PDP, Her only option is nonpayment supp No PDP or stay MA

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    Seems strange this group the one that retire after 65 have been left out of trial rights but seems to be so
     
    vic120, Apr 25, 2016
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  4. cadylou
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    Well, if she really wants Med sup, you can do that now - while she can obtain one & worst case just have no PDP for the remainder of the year & put her in one for 2017. She'd have a small penalty, but not unmanageable.

    It depends on what's most important to her . . . .
     
    cadylou, Apr 25, 2016
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  5. TwoCents
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    I'm guessing she didn't drop a supp to enroll into an MA for the first time? Sounds like she's out of luck and locked into the MA until AEP.
     
    TwoCents, Apr 25, 2016
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  6. vic120
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    She does have 2 expensive Meds, I didn't take them down yet but are name brands.

    I will let her know the facts. it would be smart for her to get supp and do without drug cov till end of the year. Not sure she will see it that way, But I will show her and it is her choice. Sometimes people in these situation don't realize how lucky they are to even have a 2nd chance to get Supp, But If she waits she will never pass underwriting

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    No she retired from Group and got Pat B 1st time in Jan and agent sold her on BC MAPD, Did Not explain networks or the high cost in hosp. Told her $0 copay for generics but didn't explain that is through mail order only and that some expensive generacs don't get $0 even on mail order
     
    vic120, Apr 25, 2016
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  7. TwoCents
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    I don't seem to understand cadylou's recommendation. If both the sup and MA are active at the same time, the supp won't pay anything. And how would should go w/o drug coverage if she's not able to leave the MA?
     
    TwoCents, Apr 25, 2016
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  8. vic120
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    By getting cancelled by not paying premium, If there even is a premium
     
    vic120, Apr 25, 2016
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  9. TwoCents
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    Not every carrier terminates for nonpayment.
     
    TwoCents, Apr 25, 2016
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  10. vic120
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    Besides that I think it might be $0 premium. If we have to wait till end of the year I can still get her AARP's lowest premium as she is within 3 years of Part B

    Looks like that will have to be
     
    vic120, Apr 25, 2016
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