Quick SEP (PDP) Question

[insuranceconceptscindy]

Client is 68- got B in 2012. Accidentally signed up for MAPD in 2012, disenrolled and signed up for PDP. All this time he has also carried group insurance.
His PDP plan is a piece of crap- can I use the LEC-SEP to change to a better one?
I'm pretty sure I can, since he has a valid SEP, but I'm not 100% sure.

 

[kstein]

I'd try it. I've had those go through using that SEP.

 

[wehotex]

Client is 68- got B in 2012. Accidentally signed up for MAPD in 2012, disenrolled and signed up for PDP. All this time he has also carried group insurance. His PDP plan is a piece of crap- can I use the LEC-SEP to change to a better one? I'm pretty sure I can, since he has a valid SEP, but I'm not 100% sure.

Is he dropping the Group Coverage? They will ask for proof of the Loss of Group after you submit the new PDP app. I don't see that you have a valid SEP.

 

[GreenSky]

If he drops the group it is an SEP but how would Medicare issue a new PDP without cancelling the old one?

As far as proof, I've placed a few people in PDP plans this year and don't think they've asked for proof once.

I have a feeling he's stuck until AEP.

Rick

 

[vic120]

Why would he have PDP cov and need a better PdP

If he has group

unless his group does not include drug cov

or at least not drug cov deemed credible cov(at least as good as Medicare)
In which case not sure sep would apply

and if not why not use group most of the time group drug cov is better then Medicare anyway

 

[Chazm]

Sounds like too much of a hassle for a PDP. I'd move on to the next client honestly.

 

[insuranceconceptscindy]

I'm throwing the noodle against the wall and hoping it sticks. Truly, he has the SEP- group is terminating. Why he picked up a PDP when he had group coverage, I don't know. Sometimes they think having ALL the coverage is better. I have a couple of clients like this. . .

 

[GreenSky]

I'm throwing the noodle against the wall and hoping it sticks. Truly, he has the SEP- group is terminating. Why he picked up a PDP when he had group coverage, I don't know. Sometimes they think having ALL the coverage is better. I have a couple of clients like this. . .

This is just my opinion but since he already has a PDP it would invalidate his SEP. But it's an interesting issue.

Don't you have any "normal" clients?

Rick

 

[smokin goose]

This is just my opinion but since he already has a PDP it would invalidate his SEP. But it's an interesting issue. Don't you have any "normal" clients? Rick

I stopped reading after you said this is your opinion.

 

[txagent41]

I'm throwing the noodle against the wall and hoping it sticks. Truly, he has the SEP- group is terminating. Why he picked up a PDP when he had group coverage, I don't know. Sometimes they think having ALL the coverage is better. I have a couple of clients like this. . .

Group coverage probably cost him little to nothing, and the drug coverage wasn't very good. I have a lot of oil company retirees where this is the case. They keep it because it has dental, vision, etc.