When Does the Individual Plan End?

[abcsales]

Spoke with a guy yesterday who is t65 end of this month. He says he has an individual plan but will cover him to age 65.

If he should start A and B today, wouldn't his individual plan stop?

I can just imagine what would happen if there is a claim, who would pay???

 

[Josh]

There are pretty specific rules about it, but it's not really a big deal. If he turns 65 at the end of this month then he was probably signed up for part A and part B today. His individual plan could keep going and if it does, they would just work as coinsurance. I believe the IFP would only pay after Medicare, but either way they would just work together. Probably foolish to not just go on a supp or MA plan vs the IFP, but it's possible the IFP would keep running as long as he kept paying the premium.

 

[Dave020]

Talked to a person about 4 months ago who had an Anthem Blue Cross Share 500 PPO plan supplementing her pre-65 Medicare for over 7 years! At the tune of like $900 a month and was complaining about the premium since the plan "only pays 20%". Said no one told her about MAPD or Supplements.

I kindly suggested that she actually read the Medicare & You handbook she gets every year since her agent was long retired. Told her to call me back in October and we will look at MAPD plans for her since her GI window for a supplement ended when Bush was still President.

The carriers out here will allow a person 65 and over to "keep" their IFP plan so long as it was in place prior to Medicare. There is no reason to, but it is allowed.

 

[abcsales]

Interesting......I know that you can't even place someone over 64.5 years with some carriers.
I guarantee he's paying a lot more than the 130/month a supp would cost him

 

[Josh]

Interesting......I know that you can't even place someone over 64.5 years with some carriers.
I guarantee he's paying a lot more than the 130/month a supp would cost him

Don't ignore the drug coverage, but even at that you're probably 100% correct.

 

[BobbyMcGee]

Spoke with a guy yesterday who is t65 end of this month. He says he has an individual plan but will cover him to age 65.

If he should start A and B today, wouldn't his individual plan stop?

I can just imagine what would happen if there is a claim, who would pay???

What is he paying for this plan? Can't imagine he wouldn't go right into a MA, MAPD or Supp. Sign him up! The Supp would probably be way better than what he has now and cost a hell of a lot less.

If he's 65 this month, He already has Part A on 8/1 - Correct?

 

[bill3173]

The carriers out here will allow a person 65 and over to "keep" their IFP plan so long as it was in place prior to Medicare. There is no reason to, but it is allowed.

Yes, the same here, and I've run into some really good ones. I had a lady recently that had been paying $600 month for her individual plan for 3 years since she'd been on Medicare. After comparing price/benefits Provider vs. Supp, they decided to switch. Usually, when I run into that situation, the people have deep pockets, and just don't bother to change.

One thing though, a lot of these individual plans, particularly the older ones, have far better drug coverage than part d and that's one of the biggest objections to leaving the indy plan.

 

[G.Gordon]

Yep, this question needs to be asked of the plan. I've seen them term the member on the day Medicare is effective, but I've seen beneficiaries still paying individual plans well into their first year of being on Medicare.

Matter of fact, just had to put one on AARP since he was six days past his open enrollment season and that was his only choice.

 

[Aksarben68022]

If he has a IFP policy it would pay the claim, Medicare doesn't function as secondary it is always primary so medicare would never see the claim it would process the same as if he was under 65. In regard to when the policy would end his IFP policy would continue as long as he paid his premiums.

 

[DS4]

In the old days prior to HIPAA, if you turned age 65, and, enrolled in Medicare, your IFP carrier cx'd your a$$.
HIPAA precludes carriers from cancelling you.
If at age 65, you are not eligible for Medicare, your IFP plan will then pay primary.
If at age 65 you are eligible for Medicare, and, don't enroll, your IFP plan will then pay secondary. Your IFP plan will calculate their payment based on what Medicare would have paid.