Seniors Shocked at being Automatically Enrolled Health Plans They Never Chose – Exact Steps to Keep this from Happening to You

Signing up for Medicare is complicated.  As you approach your 65th birthday, you’re bombarded with mail and phone calls from insurers, each touting their own litany of Medicare plan options. Should I sign up for Plan A or F? Do I need Part B? Is there a difference between Plan A and Part A?  Even if you’re an informed consumer who has taken the time to learn the differences between the alphbet soup of Plans and Parts, the process can be exhausting.

Today, Kaiser Health News has a report on something that can make the process even more bewildering.  It seems that some individuals recently eligible for Medicare have been automatically enrolled in a local Medicare advantage plan…and it’s perfectly legal.  Susan Jaffe of Kaiser Health News explains:

With Medicare’s specific approval, a health insurance company can enroll a member of its marketplace or other commercial plan into its Medicare Advantage coverage when that individual becomes eligible for Medicare. Called “seamless conversion,” the process requires the insurer to send a letter explaining the new coverage, which takes effect unless the member opts out within 60 days.

Medicare officials refused recently to name the companies that have sought or received such approval or even to say how long the Centers for Medicare & Medicaid Services has allowed the practice. Numerous insurers, including Cigna, Anthem and other Blue Cross Blue Shield subsidiaries, also declined to discuss whether they are automatically enrolling beneficiaries as they turn 65.

For you as the enrollee, this process has almost nothing but downside. If you are automatically enrolled in a Medicare Advantage plan, you:

  • will be assigned a Primary Care Physician, likely not your current one
  • will not have a hand in choosing the benefits that are right for you
  • will not have access to prescription drug coverage, unless the Medicare Advantage plan is a MAPD plan
  • will lose out on your Initial Enrollment Period exception, allowing you to pick a Medicare Supplement plan without having to answer health questions to prove your insurability

Sounds scary, right? The good news is that this process can be easily avoided by taking an active role in your Medicare plan choice.  Here’s what you need to do to avoid falling into this auto-enrollment trap:

  • Pay attention to mail from your current health plan before you become Medicare eligible. They must inform you they are planning to auto-enroll you and give you the chance to opt out.
  • Make sure to speak with your qualified benefits professional before your 65th birth month (we recommend 4-5 months before) to make your plan selection.
  • Once you have made your plan selection, confirm enrollment in the plan you choose. When confirmed, have your benefits professional call your old insurance carrier to cancel your plan. At that time, make sure they confirm that no auto-enrollment has taken place.
  • Even if you do want a Medicare Advantage plan, don’t accept the auto-enrollment. There may be other plans available that suit you better, both with your current carrier and from other companies.
  • Finally, even if you want the exact plan your insurance company plans to auto-enroll you into, make sure you do it yourself so that you can choose your PCP and not be assigned a random doctor from their list.

If you or someone you know is turning 65 soon and wants to know more about their rights and choices under Medicare, let’s get in touch!  Find us on Twitter, Facebook or request a quote