Med Supp and Group Health

jemelton

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Guy took out a MedSupp with me and was not removed from his group health policy. Can he legally have both coverages?

The group health carrier does not want to refund his money for the time that he has been covered on the supplement.
 
Unless there is something peculiar about your state, that's a big fat no problem. He can absolutely legally have both coverages, the only part where the law gets particularly involved is in talking about what pays primary.
 
Turned 65 and it is a group health through the farm. They did not take him off the group health and he paid both. Now he wants his $$$ back from the group health. No, it was not over 20 employees.
 
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But should the group health carrier refund the money? Issue is that the group health (for a farm) costs about 10x th cost of the Medsupp.....
 
Yes, they should because they can't cover him at the same time a Medigap (Med Supp) is in force. It's against the Medicare rules.

What exactly are you basing that on?

I'll admit it's been a few years since I've been active with Medicare products, but it's even up for debate as to whether or not they can have a supp and an MA plan at the same time. It'd be illegal to sell an MA plan to someone with a supp, but they could have one and go to CMS.gov and sign up for one without breaking any "Medicare rules".

If the group can save a pile by having the Medicare beneficiary on a supp so they pay the premium, but want to leave them on the group plan for the drug coverage (or maybe to keep a dependent spouse covered) there is no rule I'm aware of that would prevent that from happening.

Do you have a source for this?
 
there is no hr...it is a farm that has group health. they simply did not notify the group health company that he had gotten a med supp and paid for both for several months and now hes out several thousand dollars....
 
The question is can he be covered under a GROUP PLAN (private health insurance) and a MED SUPP aka MEDIGAP at the same time. And he cannot.

I know a few things about Medicare. What's unclear to me still is what specific document you're referencing when you're stating that they cannot have a Medicare supplement plan and group coverage. You said it's "against Medicare rules", but there is nothing I've every seen in a Medicare & You guide that supports your claim. Again, I haven't ready through the last two as I did before that (when I was a carrier rep doing certification trainings for MA agents).

You're saying that it's "against Medicare rules" for him to have a group plan and a Medicare supplement; what is your source for that claim? Specifically, where in any of the above mentioned documents/guides does it state that a Medicare beneficiary cannot have their group plan AND their Medigap plan?
 
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