Switching From Supplement To MAPD

[0b1kanobee]

I have a 90 y.o. couple who moved here to Florida. They currently each have a supplement. Where they moved from was a real rural area and there carrier is not here in Florida. Well I tried to put them in Gerber but she is a decline. So my UHC is complete and I was going to put them in a supplement with them HOWEVER I feel based on talking to them that a MAPD would be a better fit. They are currently paying about $650 per month for supplement plus drug card maybe even close to $700 and would be if I switched them to supplement for Florida.

If they go with UHC MAPD it will be much less money unlesss one ends up in the hospital and then it is like $800 more to reach maximum OOP. Anyway, he likes the idea of the MAPD and I don't think they have ever had the option of a MAPD where they came from nor have they ever been on one, only supplemental.

I have two questions I guess (one for sure).

1) How do I handle this SOA issue? So far everything has been done in the mail since they are about 3 hours away. Recorded phone call for SOA is out of the question sine he is too hard to understand. Do I mail it then mail the app or mail everything at the same time?

2) My second question is I feel like somebody is second guessing whether a MAPD is right for them. My FMO thinks it is. I personally like the supplement especially since she was recently in the hospital for a hip replacement a few months back (he is much healthier). HOWEVER, they are saying that they are having a hard time affording this $700 per month.

I just want to do the right thing for them or they choose the right option PLUS handle it according to CMS rules. I have talked to a couple of other agents I know and they are even less aware of how to do this properly 100% more than I am.
I plan on sending the SOA in the mail and them sending it back to me. What has me concerned is I'm the one who told them about MAPD might be an option instead of the supplement but I would have to check back with them which I did after I spoke to my FMO about it. I never had the intent of a MAPD for them. Like I said Gerber declined her and they never knew about MAPD options.

I just want to know the correct way to proceed.

 

[insurance0707]

they will have a 12 month trial period for the MAPD plan if this is the first time in an MAPD. If for any reason their not happy with the plan, they can cancel and basically go to any med supp and Pdp on a guaranteed issue basis...including Gerber

What's the monthly premium for them in the UHC Plan N Med supp, that should be a good option for them also if their considering a Med supp or Med Advantage

 

[jacobtn]

sell them lincoln heritage.

 

[0b1kanobee]

they will have a 12 month trial period for the MAPD plan if this is the first time in an MAPD. If for any reason their not happy with the plan, they can cancel and basically go to any med supp and Pdp on a guaranteed issue basis...including Gerber

What's the monthly premium for them in the UHC Plan N Med supp, that should be a good option for them also if their considering a Med supp or Med Advantage

So they can't go to a med supp on a GI now but can after a MAPD if they want because they have never had MAPD before? I'm a little confused on that.

Plan N would be $177 and F is $246 per month UHC. I was giving them quotes for plan F. I didn't look at N. Why should I look at N? What do you see that I don't. THANKS

 

[Frank Stastny]

I have a 90 y.o. couple who moved here to Florida. They currently each have a supplement. Where they moved from was a real rural area and there carrier is not here in Florida.

Do you know what company they currently have their Med Supp with and what plan they have? You may want to find out whether or not they have a standardized plan. It's kind of hard to believe that they are each paying around $350 per month for a Med Supp and a PDP plan especially since they are coming from a rural area in another state.

I assume that you do know that they don't have to do anything, they can keep the Med Supp plan that they currently have.

I would be very careful moving a 90 yr. old from a Med Supp into an MAPD. I would want to make sure that they understand every aspect of the difference between a Med Supp and an MAPD, especially the copays.

 

[tins]

Do you know what company they currently have their Med Supp with and what plan they have? You may want to find out whether or not they have a standardized plan. It's kind of hard to believe that they are each paying around $350 per month for a Med Supp and a PDP plan especially since they are coming from a rural area in another state.

I assume that you do know that they don't have to do anything, they can keep the Med Supp plan that they currently have.

I would be very careful moving a 90 yr. old from a Med Supp into an MAPD. I would want to make sure that they understand every aspect of the difference between a Med Supp and an MAPD, especially the copays.

Frank, if they try out a MA and don't like it, can't they go back to the Med. Supp as G.I. within the first 12 months? Or, is that just a Missouri law?

 

[b61mack]

Yes I agree with frank. I think because of their age, MED SUP is a better idea. They will still have control of their health care. Why start giving them deductibles at this stage in their life. A fixed cost, sounds better

 

[Frank Stastny]

Frank, if they try out a MA and don't like it, can't they go back to the Med. Supp as G.I. within the first 12 months? Or, is that just a Missouri law?

Yes they can but why put them through the hassle and uncertainty of switching and then switching back especially at their age. I think this is a situation where if it ain't broke why try to fix it.

 

[YouGotMyMoney]

they could be adding in their part b prems into the total?

 

[0b1kanobee]

So for future reference, how is the SOA supposed to be handled in a case like this seeing how everything transpired? (SEE MY FIRST POST)

*we have discussed some interesting details and have had some good opinions and advice BUT now I would like to know how the SOA would be handled*.........you'll have to read exactly everything which has happened to this point which is in post 1