Tucson Citizen.com
Medicare and More -

Posts Tagged ‘medicare advantage problems’

Medicare Advantage Cancellation: Your Options

Monday, September 27th, 2010

If your Medicare Advantage plan is cancelled, you have two options:  Change to another Advantage plan or return to Medicare and get a Medicare Supplement – with no questions asked. This is called “guaranteed issue”, and it is an option that should be seriously considered.

Guaranteed issue means a person who is 70 years old (or 90) with health problems can get a Medicare Supplement plan with no questions asked.  A person in this situation will pay the premium rate for his age, but will have no penalty because of his health condition.  This is a great opportunity to get the full coverage offered by a Plan C or F Medicare Supplement - and people in this situation are encouraged to look seriously at this option.

A copy of the cancellation letter from the Medicare Advantage plan must be submitted with the  Medicare Supplement application.  The Medicare Advantage cancellation letter will say clearly that  the person has “guaranteed issue”  for a Medicare Supplement with any company.  There are also boxes on the Medicare Supplement application to indicate that the applicant has guaranteed issue.

A number of Medicare Advantage plans will be cancelled for 2011 and letters have been sent to more than 2,000 people in southern Arizona informing them that they will have to change their Medicare plan by the end of December.  Details of 2011 Medicare Advantage plans are not publicly available until October 3rd, so plan options cannot be discussed until that time.

For more information go to the Medicare Choices of Arizona.

New Health Insurance Rules: Free Preventive Care

Thursday, July 15th, 2010

The Department of Health and Human Services has issued new regulations requiring private health insurance plans, beginning on or after September 23, 2010, to cover evidence-based preventive services and eliminate cost sharing requirements for such services.  This means that health insurance plans beginning on or after September 23, 2010 must cover preventive services and may no longer charge the patient a copayment, coinsurance, or deductible for preventive services when they are delivered by a network provider.

Under these new rules, people who enroll in health insurance plans after September 23rd will be able to get a variety of preventive and screening tests fully paid for by their insurance company.  Services covered will include screening tests for blood pressure, Diabetes, and cholesterol; many cancer screenings; routine vaccinations; pre-natal care; and regular wellness visits for infants and children.

Most legitimate health insurance plans, even individual plans, have already been modified to cover preventive services. And even high-deductible plans offered by companies such as Blue Cross Blue Shield of Arizona, Health Net, and Humana already allow enrollees to get preventive care that is not subject to their deductible.  This means they pay a co-pay to see their doctor for preventive screenings, or they may not even have a co-pay for certain tests.  I have called these insurance plans “legitimate” because people who pay premiums actually get some benefits for staying healthy and before they get really sick and have to use the “major medical” part of their insurance.

Companies that have offered “catastrophic coverage” health insurance are now dropping their plans.  I got an email just yesterday from Assurant announcing their lowest priced plans (with very high deductibles) will take no more enrollments after August.  In these plans a person pays premiums but must pay all of their medical expenses (doctor visits, lab tests, etc) until they hit the deductible amount, which is usually $5,000 or even $10,000. Then the plan becomes an 80/20 plan or a 70/30 plan, meaning the patient pays 20% or 30% of the medical bills.

The new rules for health insurance plans are part of the Affordable Care Act that was signed into law earlier this year. The health care reform law also applied these same rules on preventive care and screenings to Medicare and Medicaid.  Medicare beneficiaries will now be able to get an annual physical and the screening tests mentioned above at no cost.

Rating Medicare Advantage Plans

Saturday, June 26th, 2010

Back in April I asked the question “How good are Arizona Medicare Advantage plans?”  My post described the process for rating Advantage plans and noted how our plans stack up against the rest of the country.  The Washington Post recently wrote about the same topic and reported that the Medicare Advantage ratings will be more important in 2011 in determining how much money plans will be paid by Medicare.

Here is the link to that article. “Rating System for Medicare Advantage Plans Slated for Upgrade”

And here is the link to my April post on ratings for Arizona Medicare Advantage plans.