Helping your clients with Medicare Part D coverage understand the mechanics of the Medicare Part D coverage gap can be a daunting task. We are going to cover a couple of the more difficult questions raised regarding the coverage gap in this segment.
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One of the more common questions agents get asked from their Medicare clients is "what is the Medicare Part D late enrollment penalty?" It is fairly easy to explain that if a Medicare member spends more than 63 consecutive days without having Part D or creditable drug coverage, they will be required to pay a late enrollment penalty should they choose to enroll in a Part D plan in the future. The typical follow-up question is "will I have a late enrollment penalty?" This is also usually pretty easy to answer, assuming the agent asks the proper questions of the client and the client responds with accurate answers about prior coverage.
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Do you have clients whose Medicare Advantage Plans did not renew for 2013 and have yet to elect a new plan? They can still pick a new plan, and you can help them do it. Here are a few things to know in order to make sure your client has a smooth transition to their new Medicare Advantage Plan:
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Here’s the scoop on Dual Eligibles:
Dual Eligibles are defined as those having both Medicare and either partial or full Medicaid benefits. Here are some qualification items you can ask to verify their status: Medicaid Card, Medicaid Award Letter, Medicaid #, or Member Attestation Form.
As long as they are eligible for dual status they have a continuous open enrollment period. For those who have recently lost their status (which can be verified by member attestation or state notice showing loss of status), then the SEP begins the month of lost dual eligibility and runs for two consecutive months following the first month.