Changing back from MAPD to Med supp 2009

[insurance0707]

For the people that I wrote from Nov 15 - Dec 31 in 2007 for a Jan 1st 2008 issue date all have a 12 month trial period because this was there first time on a MAPD plan. Can I switch them to a Med supp with a 1-1-09 issue date using the trial period or would they have to have a 12-1-08 issue date?

I want to offer them the Guarantee issue basis of going back to a Med supp.

Thanks in advance - I'm sure this answer will help not just me but the other agents that wrote MAPD plans that are now gutted for 2009

 

[GreenSky]

I believe the law states they have anytime in the 1st 12 months to get out of the plan. Therefore they can APPLY for coverage in that period - new coverage doesn't not have to start within 12 month.

So, to really answer the question, just make sure the application is dated before the 12 months is over. (I know this from experience).

Rick

 

[jdeasy]

For the people that I wrote from Nov 15 - Dec 31 in 2007 for a Jan 1st 2008 issue date all have a 12 month trial period because this was there first time on a MAPD plan. Can I switch them to a Med supp with a 1-1-09 issue date using the trial period or would they have to have a 12-1-08 issue date?

I want to offer them the Guarantee issue basis of going back to a Med supp.

Thanks in advance - I'm sure this answer will help not just me but the other agents that wrote MAPD plans that are now gutted for 2009

It's not just MAPD, it's any MA plan. If they joined an MA plan when they were first eligible for Medicare A at age 65, then thay have the "first year" to buy any Medigap policy sold in their state.

If they dropped a Medigap policy to join an MA plan for the first time and have been in the plan "less than a year", they only have the right to go back to the plan they left on a GI basis. Unless that plan is no longer available in their state. If it's not, they can buy any plan A, B, C, F, K or L that is sold in their state.

If a person was 66, 67 and so on and wasn't in a med sup and just didn't have anything but original Medicare and joined an MA plan for the first time, there is no GI right for them to get a med sup. Unless they are leaving the MAplan because the company hasn't followed the rules, or it misled them.

The answer to your question is on page 19 of the 2008 Chosing a Medigap Policy guide.

 

[insurance0707]

They have a 12 month trial period under MA and MAPD.

Mutual of Omaha/United of Omaha seems to be making the exception to the rule about going back to your old Med supp on a Guaranteed issue basis. Mutual of Omaha/United of Omaha is willing to issue on a guaranteed issue basis, even if they were with a different insurance carrier, such as Bankers Life

 

[jdeasy]

They have a 12 month trial period under MA and MAPD.

Mutual of Omaha/United of Omaha seems to be making the exception to the rule about going back to your old Med supp on a Guaranteed issue basis. Mutual of Omaha/United of Omaha is willing to issue on a guaranteed issue basis, even if they were with a different insurance carrier, such as Bankers Life

Not everyone that joins an MA plan for the first time has the trial period.

For example, you had a 68 year old that got A and B when he turned 65. He did not buy a med sup nor an MA plan at that time. He joined an MA plan last AEP for a Jan. 1, 2008 effective date, he does not have a trial period that would allow him to now get a med sup on a GI basis. If you believe he does, please find that for me in the statutes because I have several that would take advantage of that rule.

There are other situations as well where they do not have the trial period. That one is just the most common.

As far as some companies making the expection and allowing folks to come to them on a GI basis instead of going back to the original comapny, that is certainly their right and I wish they all would do that.

 

[Franz Kafka]

I'm still learning about Medicare so please excuse the "noobness". I understand if you are covered under employer plan post-65 and quit you can still get GI on your Supp, is that correct?

How about those who missed their 6 months deadline (for whatever reason) and have come down with "uninsurable" conditions? What are their options?

How is GI in MA different from traditional supp? Thanks in advance!

 

[scottfree]

How is GI in MA different from traditional supp? Thanks in advance!

You always have GI with MA during AEP and OEP unless you have ESRD. With a sup the other posts above pretty much covered it.

 

[retread]

You always have GI with MA during AEP and OEP unless you have ESRD. With a sup the other posts above pretty much covered it.

ALL MA plans are GI, regardless when they are signed up. The eligibility is always 1) Live in the service area 2) Do not have ESRD and 3) Have both Medicare Parts A and B. ....GI for MA plans have nothing to do with WHEN they are signed up.

Med Sups, on the other hand, have GI for the 6 months following enrollment in Medicare Part B, whenever that occurs, and it is a ONE-TIME chance unless they had a Med Sup and then chose to try an MA plan for less than 12 months.

If a client did not refuse Part B when they turned 65 (e.g. working and enrolled in group coverage), then they blew the GI provision permanently, with the only exception of having tried an MA plan and want out. This is because everyone enrolling in Medicare turning 65 is automatically enrolled in B when enrolled in A. You have to ask for a waiver of Part B and Medicare will send another card without Part B on it.

If a client only had the Original Medicare Plan (both parts A and B, but NO SUPPLEMENT) and then wanted to try a MA plan, he does not have any GI for a Med Sup, 12 months or not, unless he is still within the first 6 months of enrolling in Part B.

 

[scottfree]

You always have GI with MA during AEP and OEP unless you have ESRD. With a sup the other posts above pretty much covered it.

Well I guess I went with the quick answer and should have added ICEP and and all of many SEP's off a long list. But you are restricted when you can enroll.

 

[Franz Kafka]

Thanks guys. You're so kind. I did my research but couldn't find concise answers like you guys provided (reason why this forum is so great). So basically GI only deals with trad medicare supp and only within 1st 6 mo from the time of B issuance (pretty close?) I know a lady who's still working (70) and also has trad medicare. I don't know if she chose to opt out of B. If she didn't, her only option is MA? What if she's healthy and still gets Supp with underwriting? Will her Supp rate increase based on claims? Also is Supp underwriting simpler than regular IFP or pretty much the same?