Insurance Agent Forum

[Nwit]

I have a prospect who turned 65 in January. He had credible coverage through his wife until 6/1. He enrolled in a Medicare Advantage program (free) effective 6/1.

He is now concerned that the Advantage policy will not give him adequate coverage.

Can he now enroll in a Medigap policy? Will he still qualify for guaranteed enrollment because of the above mentioned dates?

Any help or suggestions will be greatly appreciated.

[InsuranceJosh]

When did he get on part B?

[Frank Stastny]

I would check with the company you want to put him with for his Med Supp. If he turned 65 in January isn't July his sixth month of Open Enrollment?

[Nwit]

Part B was effective 6/1

[Frank Stastny]

Originally Posted by Nwit

Part B was effective 6/1

His Open Enrollment runs for 6 months from the effective date of Medicare Part B.

[InsuranceJosh]

I would also look at a special enrollment b/c of the coverage with work if you can't get him in on open enrollment.

[InsuranceJosh]

Frank is right. Go with the open enrollment.

(did not see post about effective date till after I posted)

[GreenSky]

I disagree with Frank even though he is correct.

You can enroll the guy in a PDP plan using IOEP which should take him out of him MAPD. You can enroll him in any Med Supp on a GI basis.

Rick

[Frank Stastny]

Originally Posted by GreenSky

I disagree with Frank even though he is correct.

You can enroll the guy in a PDP plan using IOEP which should take him out of [COLOR=Red]him MAPD.[/COLOR] You can enroll him in any Med Supp on a GI basis.

Rick

What is a "him MAPD"???????? Is that anything like "him car or him lawnmower?"

Why would you go through all that when he can very simply be written Open Enrollment?

All you are going to do is confuse him even more. He is apparently new at this and doesn't know much about Medicare or Med Supps or he wouldn't have asked the question in the first place.

I'm surprised that agents go out selling this stuff without at least a basic knowledge of how Medicare works.

[Nwit]

I am not soliciting clients as yet. This came up in conversation with a neighbor. I did not know the answer to his question and thought I would post it here.

Thanks for the information and the "lesson."

[Frank Stastny]

Originally Posted by Nwit

I am not soliciting clients as yet. This came up in conversation with a neighbor. I did not know the answer to his question and thought I would post it here.

Thanks for the information and the "lesson."

I assumed you were an agent since you said you have a "prospect". I don't sell cars and if I'm talking to a neighbor about cars I would not call that person a prospect.

It would have made things a lot more clear if you had said you were having a conversation with a neighbor and this question came up.

If I can ever be of help in your quest to learn about Medicare and Medicare Supplements please contact me, I will be more than happy to help you.

[Nwit]

Thank you.

I am an agent. Just got my license and am waiting for appointment paperwork to clear.

I do consider my neighbor as a prospect. Everyone I talk to or meet I consider a prospect or at least a potential prospect.

I'm also looking at your product. When I have something to put in it I'll contact you.

[jdeasy]

Originally Posted by Frank Stastny

His Open Enrollment runs for 6 months from the effective date of Medicare Part B.

Are you sure about that? The reason I ask is because i just had this situation, the husband turned 65 in Jan., '08 abd the wife in Feb. '08. The husband had a good job with benefits, so neither took B. The husband was called into the headquarters where he worked on May 12 and unexpectedly laid off and his benefits for he and his wife were stopped that day as well.

They contacted SS and enrolled in B with an effective date for B of June 1, 2008. They were referred to me by a current client for a med sup or an MA.

They didn't want to pay for a med sup and were really interested in an MA and a partD or a combo MAPD.

They finally decided on an MAPD. I enrolled them with an effective date of July !, 2008. They were both declined by the carrier because CMS said that they had only from May 12 to May 31 to enroll. I had several discussions with Medicare and SS and the carrier. What the final decision from SS was that they had 63 days from the day they lost credible coverave, {May 12}, to enroll. The decline was over ruled by CMS and the folks are active as of July 1.

Thay may be the rule because of the part D. I didn't pursue enrolling them in a med sup because they had decided they didn't want one, {actually they did want one, they didn't want to pay for it with his being unemployed}.

If what you say is correct, they could still pick up a med sup with GI thru Nov. Is that right?

[Frank Stastny]

Originally Posted by jdeasy

Are you sure about that? The reason I ask is because i just had this situation, the husband turned 65 in Jan., '08 abd the wife in Feb. '08. The husband had a good job with benefits, so neither took B. The husband was called into the headquarters where he worked on May 12 and unexpectedly laid off and his benefits for he and his wife were stopped that day as well.

They contacted SS and enrolled in B with an effective date for B of June 1, 2008. They were referred to me by a current client for a med sup or an MA.

They didn't want to pay for a med sup and were really interested in an MA and a partD or a combo MAPD.

They finally decided on an MAPD. I enrolled them with an effective date of July !, 2008. They were both declined by the carrier because CMS said that they had only from May 12 to May 31 to enroll. I had several discussions with Medicare and SS and the carrier. What the final decision from SS was that they had 63 days from the day they lost credible coverave, {May 12}, to enroll. The decline was over ruled by CMS and the folks are active as of July 1.

Thay may be the rule because of the part D. I didn't pursue enrolling them in a med sup because they had decided they didn't want one, {actually they did want one, they didn't want to pay for it with his being unemployed}.

If what you say is correct, they could still pick up a med sup with GI thru Nov. Is that right?

Yes, I am positive about that because the original question was asked about a Medicare Supplement policy. Not an HMO, PPO or PFFS plan.

The prospect already had one of those, apparently didn't like it (I don't either and don't sell them) and wanted a Medicare Supplement policy.

[senior-advisor-indiana]

Since he enrolled in the
Ma plan during his OE period he now has 12 months from 6/1 to go to a med supp on a GI basis. I am king.