53 Yr Old Male on Disability

[lcastellanos09]

I have a potential client who is a 53 and received medicare in January. He became disabled last year. He cant afford a med supp. I was wondering if he can get a medicare advantage? If so can he get it now using an SEP or does he have to wait till open enrollment in October? Thanks for you help.

 

[vic120]

Which SEP are you thinking about as a possibility? or based on what might he qualify for Los of cov, Low income subsidy or something else?

What line of Ins do you sell now?

 

[lcastellanos09]

I normally deal with med supps. I do some Medicare advantage during open enrollment. Not sure which SEP he may qualify for. What do you think? I saw on medicare.gov that disabled people under 65 have to wait 24 months after receiving medicare to get a medicare advantage. Don't know if that applies here. Need someones expert advice.

 

[yogooglethis]

I have a potential client who is a 53 and received medicare in January. He became disabled last year. He cant afford a med supp. I was wondering if he can get a medicare advantage? If so can he get it now using an SEP or does he have to wait till open enrollment in October? Thanks for you help.

Only if CMS comes out with a new SEP for this population such as:


SEP - Chronic Procrastination

or

SEP- Non Reader of Mail

 

[lcastellanos09]

Only if CMS comes out with a new SEP for this population such as:


SEP - Chronic Procrastination

or

SEP- Non Reader of Mail

Thanks for the sarcasm to a legit question

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He has to wait till open enrollment. I shouldve done more research. Thanks.

 

[yogooglethis]

Thanks for the sarcasm to a legit question

----------

He has to wait till open enrollment. I shouldve done more research. Thanks.

Once you have been in the industry for a while you may have a chuckle to yourself when you think back to the day you read my post about these silly SEPS because you will run in to many prospects who think they are really entitled to them

 

[bluediamond]

I normally deal with med supps. I do some Medicare advantage during open enrollment. Not sure which SEP he may qualify for. What do you think? I saw on medicare.gov that disabled people under 65 have to wait 24 months after receiving medicare to get a medicare advantage. Don't know if that applies here. Need someones expert advice.

LIS is the only one he may qualify for and no where on Medicare.gov does it say a disabled person has to wait 24 months after receiving Medicare to get a MAPD.

In most cases of disability they have to wait 24 months to receive Medicare from the date of disability.

 

[BeachBob]

Your post is interesting. Your client became disabled last year, is 53, and is already on Medicare? Please check this information. Your client may be on Medicaid. If so, after being disabled for 24 consecutive months he should receive Medicare. At that time, he would have a continuously open enrollment as long as he is both Medicaid and Medicare eligible. In that case, he may be eligible for a Medicare Advantage Special Needs Plan for dual-eligibles, depending on what type of Medicaid coverage he qualifies for. Get all the facts and talk with your sales manager for one of your Medicare Advantage products. Good luck.

 

[yogooglethis]

Your post is interesting. Your client became disabled last year, is 53, and is already on Medicare? Please check this information. Your client may be on Medicaid. If so, after being disabled for 24 consecutive months he should receive Medicare. At that time, he would have a continuously open enrollment as long as he is both Medicaid and Medicare eligible. In that case, he may be eligible for a Medicare Advantage Special Needs Plan for dual-eligibles, depending on what type of Medicaid coverage he qualifies for. Get all the facts and talk with your sales manager for one of your Medicare Advantage products. Good luck.

OP's question was actually a very basic IEP question .For some reason OP thought prospect may be eligible for a SEP because he is under 65 .Same rules apply for IEP for under 65 IEP and over 65 IEP :


IEP

7 month Election Period
Begins 3 months before
month of entitlement
Includes the birthday month
Ends last day of 3rd month
after month of the earlier
effective date of Part A/B
entitlement (usually 65th
birthday)

 

[lcastellanos09]

He actually got medicare in January so he already had been receiving ssi payments for 24 months. I was just confused about the IEP. hes past that. Thanks for your help guys.