Reply
Esteemed Contributor
Posts: 6,852
Registered: ‎03-09-2010

Getting switched with little warning into Medicare Advantage

[ Edited ]

THIS COULD BE VERY IMPORTANT INFORMATION FOR STANDARD MEDICARE BENEFICIARIES.  PLEASE READ FULL ARTICLE.

 

Only days after Judy Hanttula came home from the hospital after surgery last November, her doctor’s office called with bad news: Records showed that instead of traditional Medicare, she had a private Medicare Advantage plan, and her doctor and hospital were not in its network.

Neither the plan nor Medicare now would cover her medical costs. She owed $16,622.

“I was panicking,” said Hanttula, who lived in Carlsbad, N.M., at the time. After more than five hours making phone calls, she learned that because she’d had individual coverage through Blue Cross Blue Shield when she became eligible for Medicare, the company automatically signed her up for its own Medicare Advantage plan after notifying her in a letter. Hanttula said she ignored all mail from insurers because she had chosen traditional Medicare.

“I felt like I had insured myself properly with Medicare,” she said. “So I quit paying attention to the mail.”

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.

 

Important information:  https://www.washingtonpost.com/national/health-science/senior-surprise-getting-switched-with-little-...

 

 

The more I learn the more I realize how little I know.
Are you setting an example or being an example?
Honored Contributor
Posts: 8,034
Registered: ‎10-01-2013

Re: Getting switched with little warning into Medicare Advantage

If you are approaching age 65, you had better pay attention to your mail. A letter was sent and she chose to ignore it. Lesson learned, hopefully.  

Honored Contributor
Posts: 19,977
Registered: ‎08-08-2010

Re: Getting switched with little warning into Medicare Advantage

Wow. I certainly am no expert on the field of health insurance, but it seems like quite a racket probably designed 'to keep people insured' without loss of coverage as the excuse, but actually another instance where the government messing in the insurance creates havoc for the insured.

 

There have been a couple of time where we were 'automatically' signed up for something, and shocked when it happened. I think it should be illegal to do, and a signature required before something can be 'automatic' like this. A simple letter informing is not enough.

Valued Contributor
Posts: 860
Registered: ‎01-03-2011

Re: Getting switched with little warning into Medicare Advantage

Thank you for posting this.  I had no idea.  As an aside -- several of my doctors have had signs up in their offices for years saying that they accept Medicare but do not accept Medicare Advantage plans.  It is important to check about acceptance as well before choosing an Advantage plan.

Honored Contributor
Posts: 25,929
Registered: ‎03-09-2010

Re: Getting switched with little warning into Medicare Advantage

Clearly , this was Blue cross using an excuse of wanting to keep her covered but honestly, anyone who has just started on medicare receives a ton of mail and certainly a person of normal intelligence should be able to recognize that she has gone from regular insurance to medicare and she now needs to look into what she wants to do for supplemental coverage. IMO - the blame for this lies right in this woman's lap. She was irresponsible.

Esteemed Contributor
Posts: 6,075
Registered: ‎03-09-2010

Re: Getting switched with little warning into Medicare Advantage

[ Edited ]

Insurance companies are ripping people off and a letter that is not sent certified and explaining what they have done should not be acceptable.  There is so much fraud out in the public with older people it is frightening.  

Honored Contributor
Posts: 14,522
Registered: ‎03-09-2010

Re: Getting switched with little warning into Medicare Advantage

I don't like that we can be switched as that article explains, BUT BUT BUT -  in the 50+ years I've been taking care of my financial life, I've learned there arer almost no notices I should cavalierly ignore.  And were there no uses once that change was made?  Seems like I get reports to check on every few weeks.  PITA -  and I'm basically healthy for someone 10 years on Medicare!

 

It's fine to worry about $3 and other small amounts, but our lives are most impacted by recurring bills and big messes like the one in that article.  I once heard a financial advisor say that most people spend more time choosing a pair of pants than they do working on theirr healthcare choices.  I laughed, but it might be true.  Thousands of dollars scary.

Respected Contributor
Posts: 3,533
Registered: ‎04-04-2015

Re: Getting switched with little warning into Medicare Advantage

I guess I am not understanding this.

 

Having just enrolled in Medicare - and keeping my supplement - I am paying two fees - one to Medicare and one to the supplement.

 

Doesn't Medicare Advantage just have the one fee?

 

Wouldn't someone notice this?

 

What am I missing here?

Respected Contributor
Posts: 2,735
Registered: ‎03-10-2010

Re: Getting switched with little warning into Medicare Advantage

Yet another reason why I will never select an "advantage" plan when the time comes.

Respected Contributor
Posts: 4,627
Registered: ‎03-10-2010

Re: Getting switched with little warning into Medicare Advantage


@hopi wrote:

Insurance companies are ripping people off and a letter that is not sent certified and explaining what they have done should not be acceptable.  There is so much fraud out in the public with older people it is frightening.  


 

You might not like what the insurance company did and debate can be had whether the practice is acceptable, but equating it to fraud is inaccurate.  The insurance company did not engage in fraudulent behavior. The insured party was notified.