IEP2 question

[kstein]

Client is on mapd bc of disability (10yrs ago) and t65 in May. If they sign up for a pdp on 2-20, what is effective date of pdp?

Also could this person enroll into a sup prior to 5-1 under OE?

I'm getting conflicting info across the map on this. It almost seems the IEP2 is insurer specific.

 

[sshafran]

Client is on mapd bc of disability (10yrs ago) and t65 in May. If they sign up for a pdp on 2-20, what is effective date of pdp?

Also could this person enroll into a sup prior to 5-1 under OE?

I'm getting conflicting info across the map on this. It almost seems the IEP2 is insurer specific.

A sign up for PDP on 2/20 using IEP2 gives the client an effective date of 5/1/18.

This election period began on 2/1, includes May, and ends after 3 more months. If election is made prior to May - the effective date is 1st day of month the client turns 65.

 

[sshafran]

You just need to be careful to make sure that the client doesn't sign up using some other election period code like and SEP for extra help - which would make a 3/1 effective date.

Also - it's never insurer specific. It's CMS specific. That doesn't mean that agent support won't tell you the wrong thing...

 

[sshafran]

Also could this person enroll into a sup prior to 5-1 under OE?

Enroll prior, yes. Effective prior to 5/1, no. First of all, it's not their open enrollment for Med Supp prior to 5/1. Secondly, their MAPD will not end until the end of April when the IEP2 kicks them out of the MAPD and on to the PDP on 5/1, and they can't have MAPD and Med Supp at the same time.

 

[kstein]

A sign up for PDP on 2/20 using IEP2 gives the client an effective date of 5/1/18.

This election period began on 2/1, includes May, and ends after 3 more months. If election is made prior to May - the effective date is 1st day of month the client turns 65.

Could you provide a source for this information? I've tried to look everywhere and am having trouble finding a Medicare document .

 

[sshafran]

This is the .pdf that I normally use for elections. It's kinda old, though - I'm sure there is an updated version of it. If someone else has the updated version maybe they can post it - I'm sure it's available on UHC's portal... I'm just too lazy this morning to log in and get it.

 

[mcd]

This is the .pdf that I normally use for elections. It's kinda old, though - I'm sure there is an updated version of it. If someone else has the updated version maybe they can post it - I'm sure it's available on UHC's portal... I'm just too lazy this morning to log in and get it.

Here is the 2017-2018 version.

 

[kgmom219]

"You have a new OE for your 65th birthday"

From a practical perspective, its treated like they have never had Medicare in the past. BUT (and its a big one) make sure they know whatever Med Supp they pick is going to be the plan for the next 35 years. The "under 65 when you came onto Medicare" question is on all the apps. Its an auto-denial.

 

[somarco]

"under 65 when you came onto Medicare"

I have seen that question before and answered it "yes". Never got denied. Which carrier is doing that to you?

BX is the only carrier I recall using in the last few years where we answered "yes". Probably a few others. Just remember the lady had BX and they had paid for kidney transplant x2. She was on the list to have another after 65 and they took her.

I don't understand how a carrier can reject someone applying in their IEP. Either the first one or the 2nd one.

 

[kgmom219]

I have seen that question before and answered it "yes". Never got denied. Which carrier is doing that to you?

BX is the only carrier I recall using in the last few years where we answered "yes". Probably a few others. Just remember the lady had BX and they had paid for kidney transplant x2. She was on the list to have another after 65 and they took her.

I don't understand how a carrier can reject someone applying in their IEP. Either the first one or the 2nd one.

I'm talking about a UW app at age 70. Not OEP.