Confusion is in the air as Medicare Advantage cards and calls are arriving this week.

Seniors who have changed Medicare Advantage plans  may be in for some confusion when they receive an ID card from their current plan before they receive a card from their new plan (for 2010).  The Advantage plans assumed (and hoped) that people enrolled in their plans would stay put for 2010, so they’ve sent ID cards for 2010.  However, quite a few people put in applications to change plans and they haven’t yet received their new plan ID cards.  I’ve had two calls and an email this week from confused clients.

A bit more confusion is being added to the mix as Medicare is requiring Advantage plan companies to call everyone who enrolls in their plans to quiz them on how much they understand about what they signed up for. These are called “verification calls”.  Part D enrollees are getting calls as well.

I was talking with an agent who told me about her client who got a call from Health Net to verify her enrollment in one of their plans. This lady was already a bit confused because she had just received an ID card from Secure Horizons (the plan she wanted to leave).  Then she got the call from Health Net  quizzing her about the plan for which she had filled out an application a month earlier.  After a few questions this lady got very anxious and told the caller she had NOT enrolled in Heath Net and would not answer any more questions.  Yikes! 

I have written about how confusing Part D plans and Medicare Advantage plans can be for seniors when they are face-to-face with an insurance agent.  Now they are getting quizzed about the details of meetings they had a month previously.  

Once again, Medicare coverage has become even more complicated, causing lots of confusion. What a great system!

A reader responded to my last post and accused me of misleading seniors about the timeframe for changing their Medicare coverage.  Here is some clarification.

If a person is enrolled in a Medicare Advantage plan which includes a drug plan (Part D), that person can change their plan during the Open Enrollment Period of January 1 – March 31st.  Most of the Advantage plans in Tucson include Part D, and people enrolled in these plans can make one plan change during the first three months of 2010.  They can only move to another plan that has a Part D drug plan.

If a person does not have a Part D drug plan before December 31st, (as part of a Medicare Advantage plan or as a stand-alone plan), they cannot enroll in a Part D plan until next November’s Annual Election Period.  So if a person wants to enroll in a Humana Medicare Advantage plan in January (all of which include Part D) , they will be refused by Medicare – because they cannot pick up a Part D plan after December 31st.

Some examples :

Mrs. Jones is enrolled in Health Net’s Ruby plan.  She has not paid attention to mailings from the company.  In January she realizes she must pay a monthly premium and she decides to shop around for another plan.  She can change to another Medicare Advantage plan that has Part D (as her Ruby plan does).

Mr. Smith has Medicare and a stand-alone Part D plan.  He decides he’d like to enroll in a Medicare Advantage plan in February.  He can enroll in a Medicare Advantage plan which includes a Part D plan – because he has Part D already.

Mr. Rivera is a veteran who gets his prescriptions filled at the VA, so he never enrolled in Part D.  In February he decides to enroll in a Medicare Advantage plan.  He cannot enroll in a Medicare Advantage plan that includes a drug plan.  This is because Medicare will not allow him to get a Part D plan at that time of year.  Medicare recognizes VA pharmacy coverage as “creditable” coverage, so Mr. Rivera won’t face a late-enrollment penalty for Part D if/when he enrolls in a Part D plan.  But for some reason, Medicare doesn’t recognize VA pharmacy coverage during the Open Enrollment period (January-March).  He can only enroll in a Medicare Advantage plan with Part D during the Annual Election Period which is November 15 – December 31st.

If you can’t make up your mind about changing your Medicare Advantage plan or staying put, December 31st is not your deadline.  You still have January – March (Open Enrollment) to make one change.

The December 31st deadline applies only to people with a stand-alone prescription drug plan, or those who are signing up for a Part D plan for the first time – alone or with a Medicare Advantage plan. But the 40% or so Tucsonans enrolled in Medicare Advantage still have a few months to make a change.

It seems like lots of insurance agents (and insurance company advertising) have left seniors with the misconception that they must “ACT NOW!” or they’ll be locked into their Advantage plan until 2011. Don’t let anybody push you to make a decision – you still have plenty of time.

Submitting paperwork this week or next will likely mean you won’t get your new Advantage plan card by January 1st. And if you have prescriptions that need refills in early January, you might find your old plan coverage cancelled but your new plan not yet in the system. I tell everyone to refill prescriptions before the end of the month, if at all possible.

The best time to submit an application to change your Medicare Advantage plan is early in the month.  If your paperwork goes in before the tenth of the month, everything will be processed and you’ll have your card – and your info will be in the system for the first of February. 

I have a feeling there will be many folks who did not look at the materials sent by their Medicare Advantage company at the end of October. These materials provided information on changes to their Advantage plan for 2010.  When they realize their plan has changed substantially (and they’re being asked to pay a premium), lots of folks will start shopping for a new plan in January, February, or March.

The key piece of information is that people enrolled in Medicare Advantage plans can still make one change during the Open Enrollment Period of January through March.