Med Supp - MAPD - Med Supp GI

[billyg]

I am wondering if anyone has actually tried this for Med Supp customers stuck in a high premium plan due to health issues. The way I read the regs is that if a person drops a Med Supp to switch to an MA, and in the first year decides to go back to the Med Supp, they are allowed to do this to the original plan and original carrier. However, if the original Plan from the original carrier is unavailable (oh, let's say it was Plan N by MoO), then they are GI for Med Supp from any other carrier.

On paper this looks like a way of getting someone off of a spiraling plan, I'm just curious if anyone has actually done this and if so, what issues were encountered.

 

[Frank Stastny]

I am wondering if anyone has actually tried this for Med Supp customers stuck in a high premium plan due to health issues. The way I read the regs is that if a person drops a Med Supp to switch to an MA, and in the first year decides to go back to the Med Supp, they are allowed to do this to the original plan and original carrier. However, if the original Plan from the original carrier is unavailable (oh, let's say it was Plan N by MoO), then they are GI for Med Supp from any other carrier.

On paper this looks like a way of getting someone off of a spiraling plan, I'm just curious if anyone has actually done this and if so, what issues were encountered.

I believe the rule says that if they switch from an MA plan to a Med Supp they can go back to the same company and get the same Med Supp within the first 12 months of taking the MA plan without having to go through underwriting.

However, there were companies that were taking anyone coming off of an MA plan and issuing a Med Supp GI regardless whether or not the person had their Med Supp with that company. I think one company was even taking them within the first two years.

I have not encountered that in quite a while and I would have to check it out to see if the company is still doing that.

To answer your question, in theory yes, that does seem feasible.

 

[DS4]

In California, in 2008, in my county, there were 20 MA options. Now, we have 4.
Every time a MA non renews, you can GI that person back to a med supp.
Just pick a MA that is on thin ice and then they non renew the next year.

 

[somarco]

Guaranteed Issue (Your Rights to Buy a Medigap Policy) | California Health Advocates

You have the right to purchase certain Medigap plans during Medicare Trial Period #2: You switch from a Medigap policy to an MA plan, PACE organization, Medicare SELECT plan, or any other health care organization contracting with Medicare, for the first time since becoming eligible for Medicare, and you disenroll from that plan within the first 12 months. You have the option to return to your previous Medigap policy if it is still available. If it is not available, you can choose plans A, B, C, F, K, L, M or N from any company.

This may or may not apply in your state
- - - - - - - - - - - - - - - - - -
Guaranteed Issue (Your Rights to Buy a Medigap Policy) | California Health Advocates

You have the right to purchase certain Medigap plans during Medicare Trial Period #2: You switch from a Medigap policy to an MA plan, PACE organization, Medicare SELECT plan, or any other health care organization contracting with Medicare, for the first time since becoming eligible for Medicare, and you disenroll from that plan within the first 12 months. You have the option to return to your previous Medigap policy if it is still available. If it is not available, you can choose plans A, B, C, F, K, L, M or N from any company.

This may or may not apply in your state

 

[billyg]

I believe the rule says that if they switch from an MA plan to a Med Supp they can go back to the same company and get the same Med Supp within the first 12 months of taking the MA plan without having to go through underwriting.

However, there were companies that were taking anyone coming off of an MA plan and issuing a Med Supp GI regardless whether or not the person had their Med Supp with that company. I think one company was even taking them within the first two years.

I have not encountered that in quite a while and I would have to check it out to see if the company is still doing that.

To answer your question, in theory yes, that does seem feasible.

The rule I am talking about as presented in the "Choosing a Medigap Policy" booklet from CMS is:

(Trial Right) You dropped a Medigap policy to join a Medicare Advantage Plan (or to switch to a Medicare SELECT policy) for the first time, you have been in the plan for less than a year and you want to switch back.

You have the right to buy... The Medigap policy you had before you joined the MEdicare Advantage Plan or Medicare Select policy, if the same insurance company you had before still sells it, you can still get the same policy, but without the drug coverage.

If your former Medigap policy isn't available, you can buy Medigap Plan A, B, C, F, K, or L that is sold in your state by any insurance company.​

So the way I read this, if a MoO Plan N Med Supp customer (who has never been on a MA before), switches during AEP to a MAPD, and within the first year switches back to original medicare, that customer would be GI to Plan F (also A, B, C, K, or L) since MoO no longer offers Plan N.

 

[The Rabbi]

I really believe that Medicare is going to be privatized and that will put MAs in the front seat. MAs are still better than what any other country has.

 

[senior-advisor-indiana]

I really believe that Medicare is going to be privatized and that will put MAs in the front seat. MAs are still better than what any other country has.

And how does that answer the OP's question?

 

[wehotex]

In California, in 2008, in my county, there were 20 MA options. Now, we have 4.
Every time a MA non renews, you can GI that person back to a med supp.
Just pick a MA that is on thin ice and then they non renew the next year.

which county is that?

 

[DS4]

which county is that?

Butte..................

 

[SportsNut]

And how does that answer the OP's question?

There ya go... gettin technical again.......