Methotrexate Med Supp Decline

[JordanS]

Hello all, I have a client in CA who never got a Med Supp and now he's 73. He has this methotrexate for Arthritis but he "claims" it's for regular Arthritis instead of Rheumatoid Arthritis. Humana declined his Plan F.

What companies are friendly to these types of drugs?

 

[somarco]

Methotrexate is used to treat certain types of cancer (such as acute lymphoblastic leukemia, non-Hodgkin's lymphoma) or to control severe psoriasis or rheumatoid arthritis that has not responded to other treatments

Methotrexate (Anti-Rheumatic) oral: Uses, Side Effects, Interactions, Pictures, Warnings & Dosing - WebMD

Find patient medical information for Methotrexate (Anti-Rheumatic) oral on WebMD including its uses, side effects and safety, interactions, pictures, warnings and user ratings.

www.webmd.com

 

[vic120]

More then likely its Rheumatoid

CSO/CSI used to be lenient on this, when under control, I don't know if Ace is the same underwriting or not

I just got them and its the same site

 

[JordanS]

Methotrexate is used to treat certain types of cancer (such as acute lymphoblastic leukemia, non-Hodgkin's lymphoma) or to control severe psoriasis or rheumatoid arthritis that has not responded to other treatments

Methotrexate (Anti-Rheumatic) oral: Uses, Side Effects, Interactions, Pictures, Warnings & Dosing - WebMD

Find patient medical information for Methotrexate (Anti-Rheumatic) oral on WebMD including its uses, side effects and safety, interactions, pictures, warnings and user ratings.

www.webmd.com

He said he had Arthritis, but it's more likely to be RA. In that case, am I correct to assume he is barred from getting a supplement and he's going to need to go MAPD?

 

[JordanS]

More then likely its Rheumatoid

CSO/CSI used to be lenient on this, when under control, I don't know if Ace is the same underwriting or not

I just got them and its the same site

CSI isn't offering new policies and ACE seems sketchy, so are there any other companies or is it MAPD only for this client?

 

[vic120]

CSI isn't offering new policies and ACE seems sketchy, so are there any other companies or is it MAPD only for this client?

RA is not accepted by any others as far as I know

Why Is Ace Sketchy?

 

[somarco]

He said he had Arthritis, but it's more likely to be RA. In that case, am I correct to assume he is barred from getting a supplement and he's going to need to go MAPD?

He may not know his diagnosis . . . or maybe he knows but not willing to admit it.

The number of possible underlying health conditions treated by methotrexate makes it almost impossible to get a Medigap approved. Some carriers will say no based on the med and don't care about the condition treated.

If one of the Blues will take him then you can roll him to another carrier during his birthday "open enrollment". And if you can place him, consider the G plan even though he is eligible for F.

Otherwise, it looks like MA is his only option.

 

[JordanS]

Blue shield and Anthem said no too. So MA it is

 

[sman]

Hello all, I have a client in CA who never got a Med Supp and now he's 73. He has this methotrexate for Arthritis but he "claims" it's for regular Arthritis instead of Rheumatoid Arthritis. Humana declined his Plan F.

What companies are friendly to these types of drugs?

If he's taking methotrexate for Arthritis, it's most likely Rheumatoid or Psoriatic Arthritis. Not sure about the health questions on apps in California, but here in Georgia and some of the surrounding states, that gets him declined. In Georgia, the AARP plan has a Level 2 rate for those who answer yes to some of the health questions. It's as close to a GI without being a GI. Not sure if they have that in California. If so, tat could be an option, but the premiums are pretty high. I've found that Plan N is the way to go in this particular scenario (Level 2 rates).

 

[goillini52]

CSI isn't offering new policies and ACE seems sketchy, so are there any other companies or is it MAPD only for this client?

Why is ACE sketchy? They're owned by CHUBB, the world's largest publicly traded P&C company and the leading commercial lines carrier in the U.S.

Also, ACE has an A.M. Best rating of A++. No other Med Supp carrier that I'm aware of can say that.

ACE will consider RA, case by case