Insurance Agent Forum

[IOA-MI]

With colon cancer called me today and asked if he could purchase Blue Cross and Blue Shield PFFS and could I refer him to the best plan available for him as a senior.

Is he able to purchase this?

[MedSuppPro]

Assuming "Mr. 82" is like most seniors, he's outside of the AEP and OEP election periods. And some seniors can make changes if they qualify under one of the following:

• Initial Election Periods - 1 per lifetime or
• Open Enrollment Period For Newly Eligible Individuals (OEPNEW) - 1 per lifetime, or
• Special Election Periods - multiple circumstances mandated by CMS

Without more specific information it isn't possible to make a specific recomendation for "Mr. 82". Did you ask "Mr.82" WHY he wanted to purchase the BCBS PFFS plan?

[IOA-MI]

Originally Posted by MedSuppPro

Assuming "Mr. 82" is like most seniors, he's outside of the AEP and OEP election periods. And some seniors can make changes if they qualify under one of the following:

• Initial Election Periods - 1 per lifetime or
• Open Enrollment Period For Newly Eligible Individuals (OEPNEW) - 1 per lifetime, or
• Special Election Periods - multiple circumstances mandated by CMS

Without more specific information it isn't possible to make a specific recomendation for "Mr. 82". Did you ask "Mr.82" WHY he wanted to purchase the BCBS PFFS plan?

He lost his regular insurance from GM last December and is concerned he will exhaust his lifetime benefits from Medicare.

[GreenSky]

Originally Posted by IOA-MI

He lost his regular insurance from GM last December and is concerned he will exhaust his lifetime benefits from Medicare.

Exactly which lifetime benefits does he think he could possibly exhaust?

Rick

[Cenla Agent]

Originally Posted by GreenSky

Exactly which lifetime benefits does he think he could possibly exhaust?

Rick

The only lifetime benefits I can think of off the top of my head are the "lifetime reserve" days in Part A that kick in on very lengthy hospital stays, starting on the 91st consecutive day in the hospital. I'd be interested to know how many people ever use so much as one of those days while on Medicare.

The question for Mr. 82 is whether he will exhaust his savings paying for his treatments, etc. I'd imagine that's probably what he's mainly concerned with.

[GreenSky]

Originally Posted by IOA-MI

He lost his regular insurance from GM last December and is concerned he will exhaust his lifetime benefits from Medicare.

Too bad he wasn't concerned about this in January. A Med Supp would work a great deal better than a PFFS.

However, when he enrolls for January he'll be happy knowing that a year later when the plan gets dropped, he'll once again be eligible for a Med Supp.

Rick

[insurance0707]

What kind of plan did he take out last December when he lost his GM insurance. GM brought in Extend Health and I believe they contacted the GM employees to make sure they were set up with some kind of plan. Also, GM gives them so much a month to go out and buy insurance on their own. Alot of independent agents in Michigan wrote health plans for GM retiree's, it wasn't just extend health helping the GM retiree's

[MedSuppPro]

Originally Posted by GreenSky

However, when he enrolls for January he'll be happy knowing that a year later when the plan gets dropped, he'll once again be eligible for a Med Supp.

Rick

Bingo – Rick just uncovered a reason to be Certified for the 2010 season. MedSupp’s are often unavailable to most with pre-existing conditions. However, odds are his county will fall short and it’s an Open Enrollment for 2011!

Otherwise AARP has a pre-EX that will need to be explained.

As for “Mr. 82” he needs to look around his flat and maybe, just maybe, he has another ID card with a SS deduction (or zero premium plan) attached. I’ve had this happen!

[Cenla Agent]

Originally Posted by MedSuppPro

Bingo – Rick just uncovered a reason to be Certified for the 2010 season. MedSupp’s are often unavailable to most with pre-existing conditions. However, odds are his county will fall short and it’s an Open Enrollment for 2011!

Otherwise AARP has a pre-EX that will need to be explained.

As for “Mr. 82” he needs to look around his flat and maybe, just maybe, he has another ID card with a SS deduction (or zero premium plan) attached. I’ve had this happen!

Particularly in the early days when Part D was rolling out, I remember asking prospective clients to bring out all of their mail. There were times when we discovered two or three cards and enrollment kits for various plans.