PDP Drops the Premium Ball

[somarco]

New client, 11/2022 effective date, PDP to be drafted from SSA benefit.

They took the Nov & Dec premium from SSA but failed in January . . . so they cancelled coverage. Aetna says it isn't their fault, Medicare says not their problem.

Client isn't on meds but now facing LEP when he re-enrolls in the fall.

Any way to rectify this?

 

[sman]

New client, 11/2022 effective date, PDP to be drafted from SSA benefit.

They took the Nov & Dec premium from SSA but failed in January . . . so they cancelled coverage. Aetna says it isn't their fault, Medicare says not their problem.

Client isn't on meds but now facing LEP when he re-enrolls in the fall.

Any way to rectify this?

I don't have an answer, but I find it interesting that they cancelled after missing one premium. I just called Aetna for a client who was having her premium deducted from her Social Security check and it somehow stopped at the end of December. They didn't say her plan was cancelled, but did say she owed a premium for January and February.

 

[TwoCents]

Any 5-Star plans in the area? Get client enrolled effective 3/1. Then in March use MA OEP to move client to PDP only starting 4/1.

 

[sman]

Any 5-Star plans in the area? Get client enrolled effective 3/1. Then in March use MA OEP to move client to PDP only starting 4/1.

I didn't even think of that. Great idea.

 

[StephanieCJ]

Had a client's Part B cancelled for non-payment a few years back (and her MAPD because of it). She actually paid in person at the social security office and obtained a receipt but they never applied the payment (it was just "sitting on her account"). We reached out to her local senator who had a person at his office that handles issues of the sort. Took about a week and a half, but it got fixed and her coverage was both reinstated and back dated. That's where I would try if you can.

 

[gregj]

We reached out to her local senator who had a person at his office that handles issues of the sort. Took about a week and a half, but it got fixed and her coverage was both reinstated and back dated. That's where I would try if you can.

This is the way, Somarco

 

[LostDollar]

(caveat not an agent)

You could consider trying SEP 13 or 20

https://www.medicareinteractive.org/pdf/SEP-Chart.pdf

If I was trying the political route, I would probably try Congressperson rather than Senator.

 

[Midlevel]

New client, 11/2022 effective date, PDP to be drafted from SSA benefit.

They took the Nov & Dec premium from SSA but failed in January . . . so they cancelled coverage. Aetna says it isn't their fault, Medicare says not their problem.

Client isn't on meds but now facing LEP when he re-enrolls in the fall.

Any way to rectify this?

Try sending an email to [email protected] Attn: Shelbey (yes, it does have the e in it but she responds to Shelby too?

She has been wonderful for me taking care of any problems I have had and she is the real deal and gets stuff done and actually cares.

 

[sshafran]

New client, 11/2022 effective date, PDP to be drafted from SSA benefit.

They took the Nov & Dec premium from SSA but failed in January . . . so they cancelled coverage. Aetna says it isn't their fault, Medicare says not their problem.

Client isn't on meds but now facing LEP when he re-enrolls in the fall.

Any way to rectify this?

Grace period must be at least 2 months.

https://www.cms.gov/outreach-and-education/outreach/partnerships/downloads/11338-p.pdf

 

[wehotex]

Any 5-Star plans in the area? Get client enrolled effective 3/1. Then in March use MA OEP to move client to PDP only starting 4/1.

Isn’t the OEP only supposed to be used IF the person was enrolled in a 2022 MAPD/MA plan? Unless the carrier doesn’t bother to verify?