Medicare.Gov Let my DIY Mb Switch Plans Without SEP!!

[wehotex]

Genius called to tell me that he switched over to Humana Gold through Medicare.gov and then realized that he lost his PCP. Now he wants to come back to Aetna. I told him to phone Humana to void the app and tell them that he didn't have a valid SEP to begin with. Does Medicare.gov allow ANYONE to switch in ANY SITUATION without SEP?

 

[G.Gordon]

He may have applied, but may not have switched. He is DIY because of the way you are handling your clients. He got himself in a jam going without out you... why? Think about that.

Now, get on a three way with him, Medicare, or Humana or whomever it takes, walk him through the fix, then burn his arse for doing it without. Ask him directly: "Do you like me as your agent?" "Then why did you fire me?"

He may be a rogue client, but he may be showing you systemic problems in your clients depending on you.

My clients won't do squate without me... nadda.

 

[midwestbroker]

Application and acceptance are two different things...just because he applied does not mean he will be accepted. Medicare.gov will let anyone apply at any time since people may have situations that allow them to have a SEP. Again, does not mean they will be accepted.

As for rouge clients, it happens. The only two sure things in life are taxes and death.

 

[TwoCents]

Genius called to tell me that he switched over to Humana Gold through Medicare.gov and then realized that he lost his PCP. Now he wants to come back to Aetna. I told him to phone Humana to void the app and tell them that he didn't have a valid SEP to begin with. Does Medicare.gov allow ANYONE to switch in ANY SITUATION without SEP?

If you've ever been out to Medicare.gov and used the enrollment form, you'll see that people can choose their own SEP. I would think that since they're saying they have it on the app, most times it won't be questioned and the enrollment will go through. If it was a 10/1 start date, he's out of lucky to cancel since that request had to be made prior to the start date. If he's able to cancel Humana, he should be auto-reinstated into his old plan by Medicare.

 

[wehotex]

He may have applied, but may not have switched. He is DIY because of the way you are handling your clients. He got himself in a jam going without out you... why? Think about that.

Now, get on a three way with him, Medicare, or Humana or whomever it takes, walk him through the fix, then burn his arse for doing it without. Ask him directly: "Do you like me as your agent?" "Then why did you fire me?"

He may be a rogue client, but he may be showing you systemic problems in your clients depending on you.

My clients won't do squate without me... nadda.

It's not for want of trying, but thanks for giving me the kick in the butt that I need I handle a wide variety of MA clients from nearly illiterate immigrants to very educated rich folk. Some need more help than others, but I try to make myself readily available when any of them needs help. I had never met this man in person (mailed app), but I did help him get his doctor in the network last year. He remembered that and that was the reason that he called me. He wasn't sure if I did multiple carriers (that's my fault). As you suggested, I did phone him this morning. He called Humana (he DOES show as ACTIVE) and was told to send a written letter of cancellation. Let's hope that it works. Otherwise, we'll be doing a three-way call to the dummies at 800-medicare.
Somehow, he says that the medicare.gov app didn't ask him to pick an SEP and put him right on the enrollment page. He didn't select an SEP choice which is a requirement on the app. The app says that it is the carrier's responsibility to verify the SEP for eligibility.

 

[midwestbroker]

Just remember...1-800 MEDICARE is not the government, it is a TPA (Third Party Administrator) that is contracted in to represent Medicare.

They fill the seats in the call center with the cheapest labor they can find. Good luck...I wonder how many of them could pass AHIP and certifications...

 

[TwoCents]

Let's level set. A cancellation transaction leaves a person without any coverage -- as if never enrolled. A termination/disenrollment request would leave them with some coverage. I'm assuming your guy started with Humana 10/1/14. It will do him no good to send in the disenrollment letter without having a valid SEP to leave the plan. Did Humana customer service ask him disenrollment SEP questions on that call? If he was really within his timeframe to cancel (prior to the effective date since he self-enrolled), then the cancellation request should have been accepted verbally. He's probably stuck with Humana until 1/1. Come 10/15 write an AEP application.