Everyone enrolled in a Medicare Advantage plan or Part D drug plan should have received a package of information that includes the “Annual Notice of Change”.  Somewhere in this material is a comparison of the plan’s premium and co-pays for 2010 and 2011.   My neighbor is enrolled in Health Net’s Amber plan and she showed me what she received.  It is a “book” about half an inch thick.  Most of the information in this “book” is the evidence of coverage for her 2011 plan.  Also included, near the front of “the book”, is the Annual Notice of Change which is extremely important for people enrolled in the Amber plan.

AMBER PLAN CHANGES ARE BIG

I was curious to see if the changes to the Amber plan are highlighted in a way to alert many Amber enrollees that YOU MAY HAVE TO DROP THIS PLAN!! I’m sorry to say there is no major notification or explanation of what the changes mean for many Amber Plan members.  For 2010,  a visit to a specialist has a $20 co-pay.  In 2011, the co-pay will be 20% of the fee.  If an Amber member goes to the hospital in 2011, there is an $1100 deductible.  The charge for an emergency room visit has been $50 for Amber enrollees, but it will be 20% of the total bill in 2011.

What these changes mean is that the Amber plan will be only for “dual eligibles” in 2011. These are people who have Medicare and AHCCCS/Medicaid. This is actually a big change and will require people with limited incomes to find a new plan.

Amber Plan members who make less than $930 per month can remain on the plan because AHCCCS (Arizona Health Care Cost Containment System) will pay their co-pays.  But Amber members whose incomes are between $930 and $1,260 per month will have to find a new plan because they will pay a 20% co-pay for all services.  People who are “full duals” will have their co-pays paid by their AHCCCS plan. People in the higher low-income bracket mentioned above will have to find another plan to avoid 20% co-pays.

The information sent by Health Net leaves it up to the Amber enrollee to figure all this out on their own.  That is scary.

MEDICARE.GOV STILL NOT WORKING PROPERLY

I went on to Medicare.gov to look at Advantage plans in Pima county (where I know every plan). Health Net Ruby 1 is not appearing on the Medicare.gov Plan Finder list.  When I tried to email a comparison of two plans to a client, the link to the plan comparisons did not work in the email that was received.

In summary, the Medicare.gov Plan Finder is very broken. It has been broken for a while and has not been fixed.  Very odd.

INSURANCE AGENTS ARE VERY PUSHY THIS YEAR.

I have heard from my own clients and other insurance agents that some agents are being very pushy and don’t want to take “no” for an answer.   Agents are appearing at peoples’ doors and calling them on the phone – things that are totally against Medicare rules.  The reason for this aggressive behavior is a shortened selling season for Medicare Advantage.  Changes can only be made between November 15th and December 31st this year.  In the past, Medicare beneficiaries also had January through March to choose or change a Medicare Advantage plan.

I know an insurance agent who follows the Medicare rules, and she called Health Net to complain about an agent who did break Medicare rules with her client. Health Net said there is nothing they can do.  The senior called Medicare to complain about the rule-breaking agent and was told there is nothing Medicare can do.  Very odd to have rules that nobody seems to enforce.

This entry was posted on Tuesday, November 2nd, 2010 at 10:53 am and is filed under Health. Tags for this post: amber plan arizona, Amber plan tucson, Arizona Medicare, arizona medicare advantage, change medicare advantage plans, health net advantage, medicare 85711, medicare advantage tucson, medicare annual enrollment period, medicare arizona, medicare blog, medicare changes, part d help. You can follow any responses to this entry through the RSS 2.0 feed. Both comments and pings are currently closed.