SEP Eligible if MAPD Active?

[kstein]

What state is this in?

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Whoops, just learned how to read and saw Texas. I'd send it in to 2-3 carriers at the same time that tend to be more lenient on gi rules and see what happens. Take the best overall outcome.

 

[yorkriver1]

Worst case, review the medical questions on UHC. Check current knockout questions for them, then it's the medical questions for whether the rate is lower or the higher tier, if there's no way to get GI for medsupp.

 

[WCMason]

73 year old Texas resident enrolled in a Humana MAPD at 65 years old. Later he started a full-time job that provided him BCBS employer coverage but he also has kept his Humana MAPD. He is leaving his job and losing the BCBS coverage as of Sept. 1 and wants to get a med supp due to health issues. I assume because he already has a MAPD in place that he does not get an SEP, but wanted to just make sure. Appreciate the feedback!

He doesn't need an SEP, at least not for the med sup. He needs GI. Loss of GHP entitles him to that. Carrier will likely ask for documentation that GHP has been in place within last 63 days. He should get SEP for Part D for leaving/losing employer coverage. Presence of the MAPD could complicate that, though. Not sure. If so you could write GI med sup in Oct for 1/1 start and make the MAPD to Part D switch in AEP, no SEP required.