WellCare and PDP SEP Problem

[WCMason]

Last October one of my MAPD client calls me just days before the one year mark of his MAPD enrollment at 65. He wants to exercise the trial right I had told him about when he enrolled and get a med supp and PDP. It turned out WellCare had the lowest annual cost for him. He was unable to use their PURL to enroll online because in step 2 of that online process it lists many--but not all--of the valid SEP available. This trial right was not one of those listed.

So, I had him complete a paper application (also no option to select this SEP). I include a letter with the faxed application and a page from a Medicare publication describing this SEP. Of course the application is declined. I have to call and complain, dealing with two reps that claim this SEP doesn't exist before I get this escalated to someone who knows how Medicare works (I can attest that they do have at least one person).

Fast forward to yesterday. Same exact situation. No change to their website or paper application, and no other drug plan close enough in annual cost for me to consider as an alternative.

I lost credit for one of their enrollments during the most recent GEP when no one at WellCare understood that GEP Part B enrollees get to enroll in a PDP 4/1 to 6/30 for a 7/1 start (also not offered as an option on their online or paper enrollment processes). I did have one person there tell me, "there is no such thing as a General Enrollment Period for Medicare." I just gave up and had the client enroll through Medicare, which I may do with this current case, but hate losing the credit because they don't understand enrollment periods.

Anyone figured out the way to navigate through their obstacles?

 

[keith48]

I had a case of someone last year that disenrolled in their first 12 months from a MAPD plan. I called Medicare with them and helped them. Medicare enrolled them in a PDP, I wrote the Med supp, and the next month I rewrote the PDP during AEP. There may have been a better way where I got the credit for the original PDP, but it w not worth the fight or the trouble for the small commission when I knew I was getting the supplement and we were rewriting the PDP in a few weeks anyway. Maybe someone else can help with an easier solution, but that is how I did the last one I had.