First Time on MA Wants Original Medicare

[axeman462]

came across a lady that enrolled in an MAPD during AEP. This is her first time ever on an MA, and she hates it. she wants to go back to Original Medicare, and get a supplement.
I have never encountered this before, but it is my understanding that she can go back to oringal medicare within the first 12 months. How do we go about this?

 

[yorkriver1]

Happened to me 1st time about 3 years ago. Looked like mad, finally found the info "hiding" in the "Choosing a Medigap Policy" CMS booklet that is supposed to be given to everyone who receives a proposal for a MedSupp. P. 23 says they have a right to drop the MAPD and go back to Original Medicare if in their 1st year/1st time on an MAPD. I was actually surprised at the number of company managers and carrier broker service reps who didn't know where to find the info.
You will need to write a drug plan, of course, and that app will automatically kick out the MAPD. Ask the PDP carrier what SEP code they want you to use on the PDP app for this situation.
I would get the MedSupp issued ASAP and then do the PDP/auto drop of the MAPD. Ask the MedSupp carrier how they want the questions answered on the app about current coverage, dropping, etc. if it's not clear. Save some time/delay on issuance. Will need replacement form signed on all carriers I have used.
My first one "couldn't afford" a med supp, until getting a serious illness a few months in after T65. Then plan F looked super good. I was so glad to be able to help.

 

[vic120]

You just need to do PDP under trial period SEP

then you can sign supp

Now the main thing is going to be did they get get mapd as of turing 65 or did they drop supp to get mapd

If the dropped supp the only way it would be GI is if they return to same company and letter

I've done these as non GI both ways

Once they are approved for PDP under the SEP (there are 2 choices 1 for dropped supp and 1 for as of turning 65)

Then they are free to purchases Supp.

I've usually done the 2 at the same time but it is the PDP SEP that dictates

 

[GreenSky]

If she wants to "get a supplement" and did not have one before going into the MAPD she will be subject to underwriting,

Rick

 

[TwoCents]

If she wants to "get a supplement" and did not have one before going into the MAPD she will be subject to underwriting,

Rick

Good point. OP never mentioned that she carried a supp prior to the MAPD. If that's the case, she's not going to be able to enroll into a PDP/drop the MAPD.

 

[vic120]

Good point. OP never mentioned that she carried a supp prior to the MAPD. If that's the case, she's not going to be able to enroll into a PDP/drop the MAPD.

If she is in first 12 months of mapd by T65 can still get SEP

 

[GreenSky]

If she is in first 12 months of mapd by T65 can still get SEP

He said she enrolled during AEP. It's unlikely he would have said that if she enrolled at age 65.

Rick

 

[vic120]

He said she enrolled during AEP. It's unlikely he would have said that if she enrolled at age 65.

Rick

Whatever it is still useful to have that on this thread for anyone looking

He probably meant she dropped Supp if she had done it during AEP

He did say 1st time ever on MAPD

these are the 2 ways a person would qualify to make a change

 

[axeman462]

thanks for your helps guys. sorry I couldnt get back sooner. I just got off the phone with humana for some help too.

She is on Medicare Disablility since 1999. she enrolled in a UHC MAPD during AEP. and is age 59.
Humana just told me because she used an AEP, and not IEP or ICEP she does not qualify for the 12 month MAPD rule.

----------

Good point. OP never mentioned that she carried a supp prior to the MAPD. If that's the case, she's not going to be able to enroll into a PDP/drop the MAPD.

she never had a supp or a pdp. only medicare Pt A and B

 

[vic120]

thanks for your helps guys. sorry I couldnt get back sooner. I just got off the phone with humana for some help too.

She is on Medicare Disablility since 1999. she enrolled in a UHC MAPD during AEP. and is age 59.
Humana just told me because she used an AEP, and not IEP or ICEP she does not qualify for the 12 month MAPD rule.

----------



she never had a supp or a pdp. only medicare Pt A and B

If some one told me they had nothing but A & B for years I would ask why

Maybe she is of low income qualifies for Medicaid or State assistance
Usually something is wrong that I might not want to deal with
If they went A & B only for a long period of time