If you have a Medicare question you’d like answered, email it to AskRoger@SeniorMarketSales.com.
This week Roger tackles two questions:
Dick Asks: I am a broker who only sells Medicare supplements. I got a call the other day from a lady looking for a Medicare Supplement because her COBRA Continuation Coverage is about to end. Unfortunately, she never signed up for Medicare Part B. Her only option is to sign up during the General Election Period (January 1 through March 31) with her Part B coverage starting the following July 1. Is there a product out there that will provide her with benefits similar to Part B?
My understanding is that with Part A she could get a Part D PDP but she called me after the AEP was over. Fortunately I was not the broker for her former group coverage. Who dropped the ball here? Is it the broker for the group plan?
You have done your homework and I commend you for researching the issue. Unfortunately COBRA ending does not give your client a Special Enrollment Period for A or B but it does for Part D.
Your first question, is there a policy out there that can replace Part B benefits? I know of one Medicare Supplement carrier that will sell a Medicare Supplement to a person with just Part A. That is Mutual of Omaha. Unfortunately that will just take care of 20% of the problem.
You could try to find a Short Term Major Medical. I don’t think they go beyond age 65 and won’t issue If there is overlapping hospitalization in force which Medicare Part A is. Another is picking up an accident plan or other ancillary products. In trying to find it, you will discover what a great bargain Part B is.
Who dropped the ball? Good question. This is a multiple part answer on playing the blame game.
I assume the broker for the group has no knowledge of Medicare enrollment rules or probably does not care to work that market.
CMS? The problem here is everything automatic for Medicare triggers off of Social Security. With full benefits not being reached until age 66, those that continue to work are not notified of the “Initial Enrollment Period” for Medicare that is initiated at age 65. With this being the law for more than 12 years, CMS has not changed their procedures to offer information to those people. When applying for Part A they could have maybe told them the consequences of not signing up for Part B but then again, these Government offices cannot offer advice just answers to questions. In this case one that was never asked.
How about the individual? As someone who is approaching 65 myself, I get a solicitation almost daily for someone wanting me to know my rights and of course take out a Medicare Supplement. This person should have opened one and read it.
How about the Director of Human Resources in the company that was providing the group coverage? Don’t know when this person retired but it sounds like they might have at the same time they took out for social security because of taking COBRA. If this is the case, the ball could have been dropped twice. The first time when they turned 65 and apparently were only instructed to sign up for Part A. The second when they wanted COBRA coverage was not told of the consequence of not signing up for Part B.
I think the Medicare Supplement agent has a tremendous opportunity to offer consultation services for companies that have group coverage, or seek out the group brokers and offer their services. Again the Medicare Supplement broker has an opportunity for the person turning 65. Remember all that mail I get. Not one of them was from an agent; all were from carriers that have career agents. Needless to say your individual made a mistake that will cost more for Part B the rest of their life. They are not alone; I would think there are thousands out there that are faced with the same situation.
Gale asks: For someone whose plan was automatically chosen for them, paying roughly $300.00 monthly between part B and Medicare Advantage, coming January 1st, 2013 can this individual drop the high premium prescription part and get a more affordable plan since this individual lives on a fixed income and is in good health? No medication in use.
Gale your question has several parts to it. January 1st through February 14th is the Annual Disenrollment Period. This is a time for people who have Medicare Advantage to return to Original Medicare. If the current Medicare Advantage offers prescription coverage they can select a new Part D. The way I interpret the question is this is not what you are looking for. I am not sure I have enough information about your client to give you’re the proper recommendation. Please email me direct at email@example.com.
When you say that the plan was automatically chosen for your client that tells me she is low income and the Part D was selected when the individual did not select their own. Your client should have gotten a “Yellow Notice” instructing them how to proceed and if they did not chose on their own, Medicare chooses for them. (The name of the form is called “Yellow Notice” and it is yellow, our government is so original).
This person would be a Special Needs or Dual Eligible Medicare Advantage with Drug coverage, usually a HMO or PPO. In this case they can choose different coverage throughout the year. For more information about this, please read this link: http://www.medicare.gov/Pubs/pdf/11302.pdf