Q&A with Taryn Mott
Taryn Mott, Director of Provider Referral Operations and Training and long-time licensed insurance agent, answers your questions about all things Medicare.
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Taryn’s corner
Dear Taryn,
Have you heard about any CMS updates for AEP? (2024)
Nancy
Dear Nancy,
CMS will require that agents, brokers, or web-brokers document the receipt of consent from the consumer or the consumer’s authorized representative prior to providing assistance. This requirement will help with enforcement and help resolve disputes between enrolling entities and consumers, or between multiple enrolling entities. We are also finalizing the requirement that this documentation be retained by the agent, broker, or web-broker for a minimum of 10 years and be produced upon request in response to monitoring, audit, and enforcement activities. From cms.gov.
Taryn
Dear Taryn,
If a client changes plans in the middle of the year, does the TrOOP follow them?
David
Dear David,
Yes! Mid-year changes do not change TrOOP or whatever stage they are in with their MAPD or PDP. It follows them.
Taryn
Dear Taryn,
Two questions: 1) Can somebody under 65 and on disability enroll into a supplement plan? 2) If someone under 65 does enroll into a med-supp, does it automatically continue?
Jim F.
Dear Jim,
1) Yes they can. Two problems! The premium is expensive, and the coverage is less. What I mean is this! Federal law does not require states to sell Medicare Supplement (Medigap) insurance plans for the disabled under 65. But in many states, insurance companies must sell Medigap plans to disabled beneficiaries under 65. These states do not have to offer the full range of plans. Therefore, you may be limited to certain Medigap plan options. In Texas, insurance companies are only required by law to offer Medigap Plan A to people under 65 — which is the least comprehensive set of benefits available.
2) Yes, it does. If I were the agent and somebody is on Social Security, I would suggest looking into MAPD for ease of premium and richer benefits. Medigap plans are not required to offer a full array of benefits to those under 65. This can lead to less protection and a large out-of-pocket due to high premiums.
Taryn