After the Age Based Guaranteed Issue Period => Dropping Company Plan = Guaranteed Issue?

[zergkiller]

I met a woman who has turned 65, but who is almost beyond her guaranteed issue period. By the looks of her, she couldn’t pass the medical questions today. She plans on keeping her Sam’s Club company insurance for another year, and then getting a supplement. My conviction that she wouldn’t pass the health questions in another year is even stronger.

She doesn’t plan on quitting the company, just dropping their plan. So she isn’t “retiring” whatever that means.

I understand guaranteed issue if you get thrown off your company plan, or if your company doesn’t want to carry people after 65, or whatever, but in her case, the decision to drop the plan is completely arbitrary and personal. In a year, she will be out of the guaranteed issue period as judged by her age alone, and I’m wondering if she would still be guaranteed issue.

I asked the Med Supp people from my provider, and they said that you were guaranteed issue the very first time you applied for Part B. But then, the woman said she wasn’t certain, and to call Social Security. There, I got an attendant who started reading scripts to me, none of which related to my question.

So does anyone know the answer to this one? What if you’ve never been on Medicare, but are outside the guaranteed issue period by age, and then just arbitrarily decide you want in?

What happens then?

 

[WCMason]

Open Enrollment applies to age-ins and those taking Part B at a later age. No med questions. Some states will offer GI after OE if leaving employer coverage (for those who took B prematurely).

 

[zergkiller]

WCMason:

For some reason, the site doesn't believe me when I say I would like to have email notification on my questions, however:

Thank you for answering my question. I called Medicare again and got the answer I was looking for plus an explanation. In order to buy a Med. Supp., you have to be older than 65 AND have part B. Therefore, if you didn't get Part B, you will still have six months after leaving a company plan to get a Supplement, AND there will be no health questions asked. And that's true, even if you did so whimsically.

I found that it really depends on who you ask and HOW you phrase the question. But your answer jives with my last contact with Medicare, so that's what I'm going to use as an answer. It's the same as my provider's answer too. The application for part B triggers your open enrollment AND guaranteed issue period.

Thanks again.

 

[bigeats]

WCMason:

Therefore, if you didn't get Part B, you will still have six months after leaving a company plan to get a Supplement, AND there will be no health questions asked.

Not quite. Leaving a company has nothing to do with it. The triggering event is the enrollment in Part B.

 

[WCMason]

Not quite. Leaving a company has nothing to do with it. The triggering event is the enrollment in Part B.

The triggering event for OE is enrollment in Part B. A triggering event for GI may be loss of employer coverage, depending on the state. And this GI event can be years after Part B effective date.

 

[somarco]

Your Rights To Buy A Medigap Policy

Is the WalMart plan considered creditable coverage?

 

[WCMason]

Your Rights To Buy A Medigap Policy

Is the WalMart plan considered creditable coverage?

Their EGHP? Yes. I have several clients who used to work there. Got their SEP for Part B

 

[somarco]

WC Mason, have you seen this woman's benefit plan or are you just guessing?

 

[WCMason]

WC Mason, have you seen this woman's benefit plan or are you just guessing?

I've seen the EGHP for many Walmart/Sams employees. They've been the same for each one and all creditable. So the answer to your question is neither. I have not seen this particular woman's documents. But not a guess.

 

[somarco]

If you have not seen the plan the woman has, then you are just guessing. Thanks for confirming.