Newby With A Supp/MAPD ESRD Question

[jtow]

Oklahoma prospect. Lady has Stage 4 ESRD, been on Medicaid for several years, losing Medicaid soon (not sure when) as her ex husband just died and she will be receiving his Social Security so her income will push her out of Medicaid, she will still get RX help however. She is wanting me to look into a MedSupp or at the worst, a MAPD plan. Looking for ideas here on this case.
She should be able to go with any plan as she would be GI due to Medicaid loss? She is 73, NT.
Too late to call any carriers for guidance.

 

[somarco]

MA not an option.

Medigap F with carriers that pay full or at least half commission. Most will pay you $25 one time or less.

 

[senior-advisor-indiana]

I'm not 100% sure but I don't believe she gets GI for supp...

 

[goillini52]

I'm not 100% sure but I don't believe she gets GI for supp...

I think you're right.
V
V
V

"You lose your current coverage

I'm no longer eligible for Medicaid.

What can I do?
Join a Medicare Advantage Plan or Medicare Prescription Drug Plan.
Switch from your current plan to another Medicare Advantage Plan or Medicare Prescription Drug Plan.
Drop your Medicare Advantage Plan and return to Original Medicare.
Drop your Medicare prescription drug coverage.

When?

Your chance to change lasts for 2 full months after the month you find out you're no longer eligible for Medicaid.
If you lose your coverage for the following year, your chance to change is between January 1–March 31."

 

[WCMason]

MA not an option. Medigap F with carriers that pay full or at least half commission. Most will pay you $25 one time or less.

MA may be an option. Disqualifier for an MA, as we know, is end-stage renal disease. OP says she's stage four. Renal disease has five stages. I enrolled a stage four into an MAPD a couple years ago. I recommended med supp but she wouldn't consider it. Her disease turned to stage five about two months after enrollment and she didn't live but a few months after that, but the enrollment was processed. It was calling the doctor about her case prior to enrollment that I learned that her stage four wasn't end-stage.

(The "may be" an option is because the OP used both "stage 4" and "ESRD" making it unclear which one of those two she actually has)

 

[Millwood]

Oklahoma law doesn't look at losing Medicaid as a GI event. That being said a few companies do. Blue Cross ,Oxford .

Also be very careful about MAPD because many transplant centers will not put you on the transplant waiting list if you don't have a supplement or can verify resources to pay for anti-rejection drugs. Many MAPD's will not have the needed anti-rejection drugs on the formulary. They will not waste an organ if they are not convinced you have the resources to pay for the anti-rejection drugs

 

[senior-advisor-indiana]

I'm not 100% sure but I don't believe she gets GI for supp...

I was wrong. This is from Medicos UW guide.

"Loss of Medicaid Benefits (KS, OR, TN, TX,
UT, WI)
These states allow for guarantee issue when
Medicaid benefits are lost."

But some companies will allow in other states. Oxford being one of them.