Did I Handle this Med Supp Issue the Wrong Way?

[wehotex]

I was trying to help a family friend to get into a Med Supp product during the MADP period, which ended Feb 14. I enrolled her into a PDP app, which of course will cancel out her current Humana Gold Plus MAPD on Feb 29. I know that she can still cancel the PDP and stay with Humana Gold. The plan was to get her into Continental Life Plan G, but I just found out right now that she was DECLINED. So now, I have to find her a Med Supp that will accept her in time before she can't get back on her MAPD by the end of the month (if she has to). Med Supp is really not my focus and have been successful in putting the others in the same Continental Life Med Supp product when the occasion presented itself. As far as I know, she is healthy. She takes generic metformin for diabetes, has controlled high blood pressure, citalopram for anxiety. This is my "typical" customer. She did tell me that she went to a sleep study recently, but did not know the results. That's it. Should I have submitted MULTIPLE med supps with different carriers when I met with her?
Is there a foolproof Med Supp co that will ACCEPT her?
Her husband has had Physicians Mutual Plan F for many years, but he used his T65 Open Enroll. I feel bad that she was not accepted into Aetna Continental Life. Is United/ AARP "foolproof?"

 

[craig_ritter]

I was trying to help a family friend to get into a Med Supp product during the MADP period, which ended Feb 14. I enrolled her into a PDP app, which of course will cancel out her current Humana Gold Plus MAPD on Feb 29. I know that she can still cancel the PDP and stay with Humana Gold. The plan was to get her into Continental Life Plan G, but I just found out right now that she was DECLINED. So now, I have to find her a Med Supp that will accept her in time before she can't get back on her MAPD by the end of the month (if she has to). Med Supp is really not my focus and have been successful in putting the others in a Med Supp product when the occasion presented itself. As far as I know, she is healthy. She takes generic metformin for diabetes, has controlled high blood pressure, citalopram for anxiety. This is my "typical" customer. She did tell me that she went to a sleep study recently, but did not know the results. That's it. Should I have submitted MULTIPLE med supps with different carriers when I met with her?
Is there a foolproof Med Supp co that will ACCEPT her?
Her husband has had Physicians Mutual Plan F for many years. I feel bad that she was not accepted into Aetna Continental Life. Is United/ AARP "foolproof?"

When did she get her Part A/B? How long did she have the Humana Gold plan? Also, I believe there is a way that she can "cancel" the ADP enrollment which would put her back on the Humana Gold plan, but I think she needs to call 800-MEDICARE by 2/29, at the latest. Maybe someone else can confirm that enrollments can be cancelled before they are effective. . .

 

[Chazm]

I was trying to help a family friend to get into a Med Supp product during the MADP period, which ended Feb 14. I enrolled her into a PDP app, which of course will cancel out her current Humana Gold Plus MAPD on Feb 29. I know that she can still cancel the PDP and stay with Humana Gold. The plan was to get her into Continental Life Plan G, but I just found out right now that she was DECLINED. So now, I have to find her a Med Supp that will accept her in time before she can't get back on her MAPD by the end of the month (if she has to). Med Supp is really not my focus and have been successful in putting the others in a Med Supp product when the occasion presented itself. As far as I know, she is healthy. She takes generic metformin for diabetes, has controlled high blood pressure, citalopram for anxiety. This is my "typical" customer. She did tell me that she went to a sleep study recently, but did not know the results. That's it. Should I have submitted MULTIPLE med supps with different carriers when I met with her? Is there a foolproof Med Supp co that will ACCEPT her? Her husband has had Physicians Mutual Plan F for many years. I feel bad that she was not accepted into Aetna Continental Life. Is United/ AARP "foolproof?"

Sounds like she waited too long to get this done. The best action would of been to apply for the med supp but not enroll into a pdp until the supp was approved.

The state will help to know what plan to choose. UHC will easily take her but most likely over priced. What was she declined for?

 

[DS4]

Step 1. Get Med Supp approval
Step 2. Apply for Part D.

AARP/UHC would probably take her

 

[wehotex]

Sounds like she waited too long to get this done. The best action would of been to apply for the med supp but not enroll into a pdp until the supp was approved.

The state will help to know what plan to choose. UHC will easily take her but most likely over priced. What was she declined for?

Continental would not tell me why she was declined. She and I would have done it sooner, but her husband was in the hospital for 2 weeks and then my Dad (family friend of hers) passed away. So, we didn't get to it until Feb 13 or so.

She's been on Humana Gold in San Antonio since 1-1-14 and T65 in 2007, previously on an MAPD.

YIKES!! I just went on the AARP website and found that a Plan F for a 73 year old is Level 1- $235.67/mo and Level 2- $321.37/mo. I'm sure that these rates would be more than she can afford. :(
Her rate on Continental Life Plan G was ONLY $134.03/mo!!!!!

 

[craig_ritter]

Continental would not tell me why she was declined. She and I would have done it sooner, but her husband was in the hospital for 2 weeks and then my Dad (family friend of hers) passed away. So, we didn't get to it until Feb 13 or so.

She's been on Humana Gold in San Antonio since 1-1-14 and T65 in 2007, previously on an MAPD.

For AARP, since she's past the 6 years of A/B eligibility, she would have to answer 2 medical eligibity questions for TX. This is section 5 on the app. She would be declined for a yes answer here. Her underwriting class will be either Level 1 or Level 2 (depending on the answers to the questions right after the eligibility in section 6).

Obviously, the rate is going to be significantly different and that might influence her decision, even is she COULD qualify. I don't think you handled it badly. The system doesn't make it easy since the approval of a Med Supp is pretty fundamental to the decision to use the ADP (and you can't be 100% sure unless there's a GI right).

 

[vic120]

There is no way she is declined just for what you had mentioned, Sleep study should not decline either, There has to be something going one,

I just went through similar situation couldn't figure out what the problem was declined from Aetna, Lady said she was healthy besides similar normal stuff,
We then Applied her to equitable and equitable was a little easier to talk to and found out she was going through physical therapy for broken wrist, I was able to confirm that was only issue and spoke with her and found out that ends in a weeks and I get the supp

Happened 2 x before once it turned out the guy was told he needed cataract surgery at some point and he told that to mutual.The other time a lady was waiting on results from a polyps test

So for the 2 times it has happened I would say check for anything not completed surgery tests or whatever, These are the things the prospects tend to forget to tell agents but tell underwriters

 

[somarco]

Did you pre-screen her (BEFORE submitting the app) by going over the medical questions and Rx histories? Based on your post it seems you did not review the questions and med's but just asked "Are you healthy" and left it at that.

 

[JimmyUt]

There is no way she is declined just for what you had mentioned, Sleep study should not decline either, There has to be something going one,

I just went through similar situation couldn't figure out what the problem was declined from Aetna, Lady said she was healthy besides similar normal stuff,
We then Applied her to equitable and equitable was a little easier to talk to and found out she was going through physical therapy for broken wrist, I was able to confirm that was only issue and spoke with her and found out that ends in a weeks and I get the supp

Happened 2 x before once it turned out the guy was told he needed cataract surgery at some point and he told that to mutual.The other time a lady was waiting on results from a polyps test

So for the 2 times it has happened I would say check for anything not completed surgery tests or whatever, These are the things the prospects tend to forget to tell agents but tell underwriters

A sleep study without results would be a decline with most. ie pending tests

 

[TDFnCali]

A sleep study without results would be a decline with most. ie pending tests

Are u sure? Thats not a medical professional!