OE and PreEx waiting periods

[socal401]

?

Coming in without credible coverage when the app is underwritten. No prex in OE or GI with AARP/UHC.

 

[somarco]

I rarely run into someone who does not have creditable coverage prior to 65, but some carriers do apply a PX waiting period. Varies by state and carrier.

New Era / PALIC does / did have a PX waiting period in GA but only applied to Part B expenses. Can't recall if they still have it in GA or not.

PX pro-rated if they had coverage for at least some of the 6 months prior to T65. Some had STM (which is not creditable) but it "passed" any way. They just want to know if they had something.

Ask New Era / PALIC what they do in your state.

I think BFLIC also has a PX waiting period, but not in GA.

Maybe GA banned it? Can't say.

 

[somarco]

@vic120 how long before this person is Medicare eligible? Can they qualify for a STM plan?

Now that I think of it, I had someone recently approved with PALIC that had a crappy indemnity plan (like Mega). PX did not apply.

She could probably buy an accident plan or HIP (but not from New Era / PALIC) and slide through "underwriting".

I have never had a carrier ask for a copy of the plan or letter of creditable coverage on someone turning 65. A bit different for a GI situation where they have had Part B for more than 6 months. They want a letter then before they accept the application.

 

[DS4]

Coming in without credible coverage when the app is underwritten. No prex in OE or GI with AARP/UHC.

I agree with this statement

 

[hockeyday]

Should I feel confident to write the phil american even though when I called today to add the appointment and juist asked them this OE question I was told there would be a 3 month waiting period even though its OE

Should I just go on that was misinfo or not?

I would call back and talk to someone else, probably get a different answer kinda like the marketplace, call twice get 2 completely different answers

 

[jacobtn]

I would call back and talk to someone else, probably get a different answer kinda like the marketplace, call twice get 2 completely different answers

Have the policy sent to you if you write it so you can tell. From my experience they will stamp it if the waiting period applies.

 

[vic120]

@vic120 how long before this person is Medicare eligible? Can they qualify for a STM plan?

Now that I think of it, I had someone recently approved with PALIC that had a crappy indemnity plan (like Mega). PX did not apply.

She could probably buy an accident plan or HIP (but not from New Era / PALIC) and slide through "underwriting".

I have never had a carrier ask for a copy of the plan or letter of creditable coverage on someone turning 65. A bit different for a GI situation where they have had Part B for more than 6 months. They want a letter then before they accept the application.

I didn't think of that, I know she had health issues wouldn't qualify for Supp with underwriting Think it was mostly back issues pain meds but might have been other stuff too

 

[somarco]

@vic120 pain meds don't work well with PALIC, and probably others as well. Just had one turned down that was on heavy duty opioids 3+ years ago. Since it was within 5 yrs, even though he now deals with the back pain with PT and non-addictive meds they still said no.