Enrollment period question

[sshafran]

Not true.

Ok, now you are just trolling. You can't be serious.

 

[LostDollar]

That is the the law in most every state. It's clearly laid out in the "Choosing a Medigap Policy" guide. She has a GI to enroll in Plans A, B, C, F, K or L.

Not according to federal law.

Page 22 of the guide you quoted:

You have Original Medicare and an employer group health plan (including retiree or COBRA coverage) or union coverage that pays after Medicare pays and that plan is ending. Note: In this situation, you may have additional rights under state law.

Shows federal law referring only to small group plans. As I stated above, op found the note in the very last sentence to be an applicable exception for his state.

 

[LostDollar]

Ok, now you are just trolling. You can't be serious.

I am/was serious. I was working out an explanation post to go with that when op posted he had resolution for the issue. In addition, I had already twice posted the link to CMS data that underlaid my statement.

Rick has accused me of trolling a lot. I really had no clue what that is. So I decided recently to just assume for a moment he was right and see what it is/was I was being accused of doing. I did some searching-and still don't understand it well but I have tried to be much more careful with my posts since doing that. I can see why you would make the statement you made, but trolling was the furthest thing from my mind.

I have/can only work from the federal rules as expressed in the reference CMS page. According to those rules, op's client does not have GI eligibility. Newby and op's posts have indicated that state rules can expand what the federal rules allow. In addition, discussion in the other thread I linked, indicates that some insurance carriers will also allow a broader interpretation. That's where the knowledge and skill of an agent come in to bring the best possible range of outcomes to the client.

I didn't say it very well and Rick really exploded as a result, but I tried to indicate to op that some practical agent experience is at variance with what CMS said and he should follow agent advice rather than mine.

Not wanting/trying to get crossways with you on this.

 

[jdeasy]

I know what the federal law says. And it does not allow GI for the situation described. Op indicated he has worked out state laws for his state and they are more liberal.

Are you saying the Choosing a Medigap booklet, the Medicare and You booklet, the companies in the med sup business and the med sup agents are all wrong?

Where are you getting that info?

I’ve dealt with this exact situation dozens of tines.

They have all been GI for a med sup. And I’ve never once had to involve the state for clarification.

What makes you think that you have info that no one else has?

 

[sman]

Not according to federal law.

Page 22 of the guide you quoted:

You have Original Medicare and an employer group health plan (including retiree or COBRA coverage) or union coverage that pays after Medicare pays and that plan is ending. Note: In this situation, you may have additional rights under state law.

Shows federal law referring only to small group plans. As I stated above, op found the note in the very last sentence to be an applicable exception for his state.

You're hopeless. Time to put you on ignore.

 

[insuranceguy088]

State and carrier can impact what will be considered GI. I would take an application and move forward with it as if it is a Guarantee Issue situation. You will know soon enough as to whether it is, in fact, a Guarantee Issue situation. Trial an error. Nothing wrong with that.

 

[sman]

State and carrier can impact what will be considered GI. I would take an application and move forward with it as if it is a Guarantee Issue situation. You will know soon enough as to whether it is, in fact, a Guarantee Issue situation. Trial an error. Nothing wrong with that.

It's real simple to know BEFORE you take an app whether or not it's a GI. And based on the original post which started all of this, this person has a GI to one of 6 Medicare Supplement plans. This situation is a mandated GI to those 6 plans. There are three states where the plan is different from the 6 I mentioned.

The only thing states can do is ADD additional rights. They can't take away or lessen the GI rates as mandated by federal law. Regardless of what a non-agent who participates on this forum tries to tell others, the FACT is the person referenced in the original post on this topic has a GI to a Med Supp based on the loss of employer sponsored health insurance. Many Medicare Supplement applications even reference this situation as a GI situation. I wouldn't expect a non-agent to know this as they likely haven't seen many (or any) Medicare Supplement applications nor seen the Underwriting Guidelines issued by insurance carriers.

 

[DS4]

I'm beginning to think the only interaction LD has with human beings is this Forum? Has he absolutely nothing else to do?? LD, here is the Forum you need to be a member of, A Lonely Life Forums

 

[insuranceguy088]

It's real simple to know BEFORE you take an app whether or not it's a GI. And based on the original post which started all of this, this person has a GI to one of 6 Medicare Supplement plans. This situation is a mandated GI to those 6 plans. There are three states where the plan is different from the 6 I mentioned.

The only thing states can do is ADD additional rights. They can't take away or lessen the GI rates as mandated by federal law. Regardless of what a non-agent who participates on this forum tries to tell others, the FACT is the person referenced in the original post on this topic has a GI to a Med Supp based on the loss of employer sponsored health insurance. Many Medicare Supplement applications even reference this situation as a GI situation. I wouldn't expect a non-agent to know this as they likely haven't seen many (or any) Medicare Supplement applications nor seen the Underwriting Guidelines issued by insurance carriers.

Perfect, so my recommendation would have worked. He would take the application, submit it and it would be approved.

 

[sman]

Perfect, so my recommendation would have worked. He would take the application, submit it and it would be approved.

Sure, as long as you provided the right documentation. Personally, I'd rather know ahead of time so as to not waste mine or my potential clients time.