Pdp lep who gets the money???

[asher]

Does anyone know who benefits from the LEP?
The comapnies collect it-but where does it go?
And what happens if you pay your monthly pdp premium but don't pay the penalty?

Will the member get terminated from pdp coverage?

If they change plans the following year does the unpaid LEP follow them?

Hope someone has answers!

 

[bluediamond]

The government gets the money (CMS) late penalty will stay with them for life. If memory serves me correct yes their pdp will be dropped sooner or later w/o paying the penalty.

 

[somarco]

Pretty sure the LEP is deducted from their SS and goes right to the Treasury

 

[bluediamond]

I've seen it both ways, if one has their premium deducted from social then yes the penalty is also, I have also seen it included on a monthly premium bill. But the gooberment is going to get it and if they don't send troops to your house, put your head in a vice and squeeze it out of you.

 

[kstein]

Having an out standing lep can cause a delay in enrolling into another plan. Had it happen this year and a client got screwed.

 

[goillini52]

I just ran wrote an 85 year old man his 1st Med Supp. Never had anything but Medicare. I know he'll have a big penalty if he takes a PDP during AEP.

His wife is 83 and never had anything but Medicare until she took a Humana MAPD effective 01/01/2022. I'll be replacing it with a Med Supp during AEP. When I write her a PDP, will she have to pay the penalty for all those years before this year, or will they not catch it coming off a MAPD?

I think she will, but I'm not sure.

 

[LostDollar]

I just ran wrote an 85 year old man his 1st Med Supp. Never had anything but Medicare. I know he'll have a big penalty if he takes a PDP during AEP.

His wife is 83 and never had anything but Medicare until she took a Humana MAPD effective 01/01/2022. I'll be replacing it with a Med Supp during AEP. When I write her a PDP, will she have to pay the penalty for all those years before this year, or will they not catch it coming off a MAPD?

I think she will, but I'm not sure.

Caveat, not an agent

I would expect the PDP carrier to be asking for proof of previous drug coverage and assessing the penalty if it is not provided.

 

[somarco]

I just ran wrote an 85 year old man his 1st Med Supp. Never had anything but Medicare. I know he'll have a big penalty if he takes a PDP during AEP.

His wife is 83 and never had anything but Medicare until she took a Humana MAPD effective 01/01/2022. I'll be replacing it with a Med Supp during AEP. When I write her a PDP, will she have to pay the penalty for all those years before this year, or will they not catch it coming off a MAPD?

I think she will, but I'm not sure.

MAPD, including $0 premium, are supposed to collect the LEP from the carrier. Even though the PDP premium is not segregated and identified to the consumer, it is still baked into the plan.

 

[BibH]

Samarco’s correct . The carrier will collect it .The penalty is about 33 cents a month x total # of months you’ve not had .. I believe the max penalty goes back to 2006 .

 

[goillini52]

Samarco’s correct . The carrier will collect it .The penalty is about 33 cents a month x total # of months you’ve not had .. I believe the max penalty goes back to 2006 .

I understand how the penalty works. I just didn't know if coming off of a MAPD might allow her to sneak through without getting the penalty, which will be about $60 a month.