MA Plan Leaving Area - Cancer Patient

[Bob_The_Insurance_Guy]

Just thinking out loud. Welcome all responses, both positive and negative.

Here's the situation: Female, age 74, currently going through Chemo for Stage 1b Ovarian Cancer. Chemo treatment ends mid-November 2013. Current MAPD is through UHC, and her plan is leaving the area. UHC is still in town, so are other UHC Plans, just not hers.

I see this as a opportunity to put her on a Med Supp + PDP (currently applying for LIS), so that networks would not be a problem. Also, if she needs to go to MD Anderson, or Cancer Treatment Centers, there is no issue. Applying for LIS, so that any future costs of Cancer Meds would be lowered, and if there is a future cancer med that is not on formulary, it will be easy to switch/get an exception.

She, in no way, qualifies for full Medicaid, so no Dual-Eligibility is on the table.

This would put her in an SEP GI situation for Med Supps.

This is for the State of Georgia.

Yes, No, Concerns, Questions?

 

[goillini52]

Just thinking out loud. Welcome all responses, both positive and negative.

Here's the situation: Female, age 74, currently going through Chemo for Stage 1b Ovarian Cancer. Chemo treatment ends mid-November 2013. Current MAPD is through UHC, and her plan is leaving the area. UHC is still in town, so are other UHC Plans, just not hers.

I see this as a opportunity to put her on a Med Supp + PDP (currently applying for LIS), so that networks would not be a problem. Also, if she needs to go to MD Anderson, or Cancer Treatment Centers, there is no issue. Applying for LIS, so that any future costs of Cancer Meds would be lowered, and if there is a future cancer med that is not on formulary, it will be easy to switch/get an exception.

She, in no way, qualifies for full Medicaid, so no Dual-Eligibility is on the table.

This would put her in an SEP GI situation for Med Supps.

This is for the State of Georgia.

Yes, No, Concerns, Questions?

I'm sure that it's the plan that she has that's not being offered any more that makes it GI, even though the carrier still offers other plans in the area. I think you're right about it being a good time to get her into a supplement, and the PDP's GI.

 

[G.Gordon]

I agree with what you have in mind. Get it done.

 

[northdude]

Does GA have Medicare Cost Plans?

 

[JimmyUt]

I agree with what you have in mind. Get it done.

x2. This is exactly what I would recommend. If and when she does get LIS and decides she no longer needs the expense she could also go back to MAPD if premiums got too high.

 

[bigeats]

It's too bad that doing the RIGHT thing will earn you a cool $25 one-time commission... maybe a few more bucks if you happen to broker the best PDP for her... :-(

 

[JimmyUt]

It's too bad that doing the RIGHT thing will earn you a cool $25 one-time commission... maybe a few more bucks if you happen to broker the best PDP for her... :-(

AARP med supp pays full commission