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I will be eligible and enrolled in Medicare later in the year. I called the NYS marketplace to alert them of the date when Medicare starts and when the ACA plan should end. They told me to call back the month before Medicare starts as they couldn’t enter a plan end date more than a month away. Is that accurate? I would think their computer system could accept a future date when a plan should end but I guess not.
I will be eligible and enrolled in Medicare later in the year. I called the NYS marketplace to alert them of the date when Medicare starts and when the ACA plan should end. They told me to call back the month before Medicare starts as they couldn’t enter a plan end date more than a month away. Is that accurate? I would think their computer system could accept a future date when a plan should end but I guess not.
I am a NYSOH call center agent, since 2019, so I'm the best person here to answer this question.
The way the system is set up is that any cancellation of coverage for Essential Plan, Child Health Plus, or a Qualified Health Plan (QHP) done between the 1st and 15th of the month will end the plan on the last day of the current month. If the cancellation is done between the 16th and the end of the month, the plan will end on the last day of the subsequent month.
Medicaid plans will end on the last day of the current month regardless of what day in the month you call to do the cancellation.
Also, keep in mind that if you have a QHP (full pay or with the tax credit) you are supposed to give your insurance company at least 14 days notice that you are canceling.
Our application system is computerized, and we are unable to manually enter a specific end date. Marketplace plans always on the last day of a month, and that is determined by the 15th of the month rule as stated above. We can backdate an end date for Essential Plan or QHP if the person forgets to call between the 1st and 15th, but ONLY under certain circumstances, like starting another insurance, and that has to be done by a special task team. A regular phone agent wouldn't be able to do that; they would do the cancellation, than file a request for the backdating.
So, in short, you need to call between the 1st and 15th of the month prior to the month your Medicare is going to start to do the cancellation, assuming you have Essential Plan or QHP.
Ex - Medicare stars December 1 - call for cancellation between November 1 and November 15.
Last edited by ContraPagan; 07-09-2022 at 01:28 PM..
Thank you that is very informative. The representative I spoke with just said to call the month before Medicare starts and didn’t mention to call by the 15th (which I would have done anyway). Thanks again!
On another topic related to starting Medicare, what is the deal with mail solicitations from Medicare advisers offering to review various coverage options with you regarding Medicare Advantage and Medigap plans? A few have come from insurance companies but several others came from independent advisers with no apparent affiliation with insurance companies. Who are these people and how do they get compensated? Are they really looking out for your interests or their own? Who is selling lists of names and addresses of people becoming eligible for Medicare? I googled the name of one guy who started a firm that sent me a solicitation. While he introduced himself in his letter as a nice guy from an Ivy League college who wants to help people like he helped his parents in choosing Medicare, his twitter account had a rant about this being the most racist and sexist society in history. I don’t think I will be calling his company.
Advantage plans are huge cash cows for the insurers and their agents which is why the commercials and mailings never end. Agents are highly compensated in some states for Advantage plans, as well as earning commissions on renewals. Agent commissions for Medigap plans is less.
Detailed info on Medicare commissions, here - well worth a read:
On another topic related to starting Medicare, what is the deal with mail solicitations from Medicare advisers offering to review various coverage options with you regarding Medicare Advantage and Medigap plans? A few have come from insurance companies but several others came from independent advisers with no apparent affiliation with insurance companies. Who are these people and how do they get compensated? Are they really looking out for your interests or their own? Who is selling lists of names and addresses of people becoming eligible for Medicare? I googled the name of one guy who started a firm that sent me a solicitation. While he introduced himself in his letter as a nice guy from an Ivy League college who wants to help people like he helped his parents in choosing Medicare, his twitter account had a rant about this being the most racist and sexist society in history. I don’t think I will be calling his company.
My hub just turned 65 a few months ago, I was surprised he did not get much mail. He had AARP/UH both medigap and advantage plan info.
If you google yourself, you'll probably find your age and DOB on public record sites. Someone sold your info at some point.
Have you picked what you're going to do with a medigap or advantage plan?
On another topic related to starting Medicare, what is the deal with mail solicitations from Medicare advisers offering to review various coverage options with you regarding Medicare Advantage and Medigap plans? A few have come from insurance companies but several others came from independent advisers with no apparent affiliation with insurance companies. Who are these people and how do they get compensated? Are they really looking out for your interests or their own? Who is selling lists of names and addresses of people becoming eligible for Medicare? I googled the name of one guy who started a firm that sent me a solicitation. While he introduced himself in his letter as a nice guy from an Ivy League college who wants to help people like he helped his parents in choosing Medicare, his twitter account had a rant about this being the most racist and sexist society in history. I don’t think I will be calling his company.
This is a very common method for scammers to get to you. Don't give anyone your Medicare information over the phone. Medicare will never call you. Your doctor can wait until you get in the office for your information. You can get more information in this topic from AARP. Your state may have a senior's insurance bureau.
Unfortunately these scammers may get information from your DMV. They may ask if you have Part A & Part B Medicare. This is a signal that these people are scammers. If you give them your number & other info they can use it for fraudulent or inflated Medicare claims. They can claim they can send you a test kit in the mail if your doctor approves. They may try to sell you a scooter chair or some other device.
As Medicare open enrollment period begins in the fall you can get mail from all the insurance companies in your state to get you to buy their Advantage plan. You do have an option to switch every year. So competition is fierce between these companies.
There are independent agents with their own Medicare agency. Sometimes they can be helpful for individual applications. They get their money from commissions. They advertise the number of clients they help. Some of them have Youtube channels & videos. As a independent agent they may be able to shop all carriers for the best price, service, etc.
My hub just turned 65 a few months ago, I was surprised he did not get much mail. He had AARP/UH both medigap and advantage plan info.
If you google yourself, you'll probably find your age and DOB on public record sites. Someone sold your info at some point.
Have you picked what you're going to do with a medigap or advantage plan?
I am looking at high deductible Medigap Plan G policies which are about $70 a month. I don’t think I want Advantage plans because you must use the doctors in their network and it seems like they may deny services that Medicare would routinely pay for (that’s my impression when reading for example why retirees don’t like to be forced into an advantage plan).
One thing I am unclear about is if you must answer medical questions or get an exam if you want one of these plans later on if you didn’t take one when you were first eligible. It is my understanding that the first time you are eligible there are no medical screening questions or exams.
I am looking at high deductible Medigap Plan G policies which are about $70 a month. I don’t think I want Advantage plans because you must use the doctors in their network and it seems like they may deny services that Medicare would routinely pay for (that’s my impression when reading for example why retirees don’t like to be forced into an advantage plan).
One thing I am unclear about is if you must answer medical questions or get an exam if you want one of these plans later on if you didn’t take one when you were first eligible. It is my understanding that the first time you are eligible there are no medical screening questions or exams.
You have it all right. You don't want advantage. You may be subject to a physical/underwriting if you don't get the medigap in the first 6 months. It can be a costly mistake because you may not have decent health to pass underwriting.
You have it all right. You don't want advantage. You may be subject to a physical/underwriting if you don't get the medigap in the first 6 months. It can be a costly mistake because you may not have decent health to pass underwriting.
Don't forget the part D drug plan.
So a person can sign up for a Medigap policy up to six months after starting Medicare? There are so many rules about when you can sign up for or change various aspects of Medicare. Also do Medigap plans include Part D?
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