GI, OE, Over Thinking This....?

agentjhc

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I received a call from a lady today. 66. On SSI so she is already on Medicare A & B. Also covered by husbands health insurance (small municipality) and he might be retiring. She has credible coverage through the city, and Medicare has been secondary. Will she have GI because she is losing CC? I was thinking yes, then no because she has been on MC for a year. maybe I am over thinking this and she is GI.
 
As far as I know, even with the Part B still already in effect, loss of CC is the only thing necessary for GI
 
Sounds like GI to me, involuntary loss of CC. I don't think OEP bc of the reason you already stated, been on part B over 6 months. I'm assuming you already tried to see if she will pass underwriting, and she couldn't..?
 
Think of it as Part B effective date always trumps everything, so always look at that first. If beyond 6 months, it's not OE (unless in cases where it's a disability case and someone took Part B years ago and is now T65. Then they get another OE).

She is GI though for 63 days if losing her group. Definitely want to avoid the GI route if possible and go UW on G or N. If GI is necessary however, your next step is to check your comp sheets. :laugh:
 
I received a call from a lady today. 66. On SSI so she is already on Medicare A & B. Also covered by husbands health insurance (small municipality) and he might be retiring. She has credible coverage through the city, and Medicare has been secondary. Will she have GI because she is losing CC? I was thinking yes, then no because she has been on MC for a year. maybe I am over thinking this and she is GI.
OE is gone because she did not decline Part B at 65. Unfortunately she not only lost OE but unnecessarily paid for Part B for more than a year by not signing the back of her Medicare card and returning it to them. She does get GI on reduced number (in most states) of med sup plans and SEP for a drug plan. She could try UW for any of the non-GI plans.
 
She is on 9 medications haven't looked at UW options yet.
Metformin (50mg X 2)
Atenolol
Levetiracetem
Ropinirole-hcl (she says for sleep/RLS)
Telmisartin
Atorvastin
Gabapentin
Vit B 12
Vit D 3
 
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She is on 9 medications haven't looked at UW options yet.
Metformin (50mg X 2)
Atenolol
Levetiracetem
Ropinirole-hcl (she says for sleep/RLS)
Telmisartin
Atorvastin
Gabapentin
Vit B 12
Vit D 3

Atenolol often for arrhythmia. Gabapentin for diabetic neuropathy
 
She said the atenolol was for high blood pressure, and yes the Gabapentin was for neuropathy.
 
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For BFLIC Ropinirole-hcl is a knock out drug IF for Parkinsons. However, I assume with documentation that it is for sleep/restless leg syndrome (she takes only before bedtime) it would pass UW. Would have to check.
 
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