FAQ: Medicare PDP Termination

An agent from Portage, WI asks…

Q: Does a standalone PDP termination/non-renewal trigger a guaranteed issue right for a Medicare supplement plan? I’ve found various answers, none of which are very conclusive. I have seen some documentation that states that any plan that is under contract with Medicare that is termed/non-renewed triggers a guaranteed issue right for Medigap plans. I have also seen documentation that, in states where Medigap plans are not guaranteed renewable, any loss of Medigap (involuntary) will trigger an SEP for Medicare plans, including PDPs. Is this true?

A: Medicare is perceived to be very confusing, although it really is quite simple when compared to other insurance products. The simple answer to this question is no. PDP plans have absolutely nothing to do with Part D of Medicare. However, the chance to pick up new Medicare supplement clients exists when you assist a Medicare beneficiary with their Part D decision. Part D plans may not pay much commission, but they open the door of trust and will prove your Medicare expertise, earning you new Med supp business and potentially other insurance products in the process of solving the Part D riddle. Do not underestimate the power of the PDP decision!

If the terminating plan is a Medicare Advantage plan with prescription drug coverage (MAPD for short), it certainly will trigger a guarantee issue Med supp provision. Really, the health portion (not the prescription portion) is what triggers the guaranteed issue, which may be one of the following Med supp plans: A, B, C, F, K, or L.