Voluntary Disenrollment from PD and Med Supp

[BuckNasty]

I have a prospect who retired a few years ago, and and employer "benefit" was to help her enroll in a Medsupp (plan C) which is now costing her $388 per month. She could be in an equivalent Med Supp for $166 per month. She's in excellent health so the switch should be routine. However, she's also in a Prescription Drug plan.

The premiums for both are automatically deducted from her pension. So, if she dis-enrolls now voluntarily for both, would she have a special election period on the Part D drug plan or would she need to wait until the open enrollment period?

Thanks in advance. I don't do any Part D or Med Advantage other than some small assistance navigating Medicare.gov to find PD plans, so I am not totally up to speed on the enrollment rules.

 

[vic120]

Can she keep PDP and just disenroll from Med Supp?

 

[BuckNasty]

I tried to get her to do that as a fall back position, but she really wants to do both now. Obviously the med sup switch is no problem, but I just am unclear about the PD rules.

 

[vic120]

I would think that it is still leaving employer group SEP However I am not 100% on that. Some one should chime in on it soon

 

[kstein]

Is the rx plan a "street" offered plan (ie one that shows up in med.gov)? Check the contract number, look at the card, or find out the premium she pays specifically for the rx portion of the plan and see if you can find that on med.gov.

If it is different then you can SEP into a stand alone PDP now. I would also check to see if her employer rx plan has a donut hole as that may be a difference she should be aware of. (Even though the premium savings makes it a no brainer)

I'd say you could probably switch her regardless of what you find above but if it is a non street plan you would be on more solid ground.

 

[vic120]

I know I have had People on employer MAPD plans retire and disenroll and get SEP, The main difference though is they were working and by retiring they would have opportunity to disenroll

The other thing is if the employer or human resource allows beneficiaries to disenroll at will then I would really think they would have SEP

 

[kstein]

I don't think it really matters if they are working or have been retired from the company for x amount of years. I've taken a lot of retirees off their employer plans without issue, regardless of their retirement dates. It may be employer specific but in St. louis I've never seen it.

Some employers "offer" a retiree medical and PDP but it is really identical to what the person could buy in their own with no group benefit at all. I've seen this happen most frequently with aarp and bcbs plans. If the person has a stand alone PDP that any joe could enroll into, you might have an issue.

 

[yorkriver1]

Both times recently I have had a client disenroll from an employer retiree plan due to cost, it was OK for PDP SEP. I think both employer plans were more custom to that employer, not street available. I have contacted the PDP provider I plan to sell to get their guidance in gray area SEP situations.

 

[BuckNasty]

Thanks for the feedback guys. I'll keep you posted.