SirLurkAlot
Expert
- 59
I have a 72 y.o. male that was on a MAPD in 2012. Sometime during that year he was incarcerated and of course lost his MAPD. He was released in October 2013 and contacted me to enroll him in CIP (Nolan County TX- so options are slim). However, he had lost his Part B due to incarceration thus was unable to enroll in any MAPD. He immediately contacted Social Security to re-instate his Part B.
He called me last week because his Part B became effective 7/1/14. I scoped him, met with him and submitted the application using ICEP. Application was denied. (Note this is a regular MAPD- not a dual or chronic)
I was told that ICEP is not valid despite a 7/1/14 effective date for Part B. They told me he would have had to enroll in CIP prior to July with effective date of 7/1/14 for him to be eligible so now he must wait until AEP.
In studying SEP's for incarceration, the only thing I found was one related to a moving clause but that has a 60 day window and obviously he couldn't sign-up within 60 days of release last October because his Part B had been terminated.
Few questions: Is there an SEP that would be valid for this circumstance? Would Medicare grant a special SEP given the circumstance? If he would have contacted me in June (so we could have had it effective 7/1 as CIP indicated was necessary)- what election period code would I have used since ICEP is apparently not valid for a Part B reinstatement? I have contacted reps for UHC and basically they say he's SOL but none of them seemed confident in their answer.
Side note, this client is 500 miles roundtrip from me and I have driven it twice with nothing to show for it. It's not about the money- it's about helping someone who needs it (although not sure he deserves the help given the crime for which he was incarcerated but that is not my place to judge). I will help others anytime I can and, if deemed deserving,will reap the rewards in the future.
FYI, I found this forum today while researching something else and have wasted (or spent
) over three hours of my day reading threads. This is a great site and I plan to be a somewhat active part of it going forward.
He called me last week because his Part B became effective 7/1/14. I scoped him, met with him and submitted the application using ICEP. Application was denied. (Note this is a regular MAPD- not a dual or chronic)
I was told that ICEP is not valid despite a 7/1/14 effective date for Part B. They told me he would have had to enroll in CIP prior to July with effective date of 7/1/14 for him to be eligible so now he must wait until AEP.
In studying SEP's for incarceration, the only thing I found was one related to a moving clause but that has a 60 day window and obviously he couldn't sign-up within 60 days of release last October because his Part B had been terminated.
Few questions: Is there an SEP that would be valid for this circumstance? Would Medicare grant a special SEP given the circumstance? If he would have contacted me in June (so we could have had it effective 7/1 as CIP indicated was necessary)- what election period code would I have used since ICEP is apparently not valid for a Part B reinstatement? I have contacted reps for UHC and basically they say he's SOL but none of them seemed confident in their answer.
Side note, this client is 500 miles roundtrip from me and I have driven it twice with nothing to show for it. It's not about the money- it's about helping someone who needs it (although not sure he deserves the help given the crime for which he was incarcerated but that is not my place to judge). I will help others anytime I can and, if deemed deserving,will reap the rewards in the future.
FYI, I found this forum today while researching something else and have wasted (or spent
) over three hours of my day reading threads. This is a great site and I plan to be a somewhat active part of it going forward.
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