This week we have recent Medicare Advantage news, including details from Kaiser Health News on a little known rule called “Seamless Conversion”, and a study on whether Medicare Advantage Plan switching is the exception or the norm.
Some Seniors Surprised To Be Automatically Enrolled In Medicare Advantage Plans | Kaiser Health News, July 27, 2016
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.
Medicare Advantage Plan Switching: Exception or Norm? | Kaiser Family Foundation, September 20, 2016
Each year, Medicare Advantage enrollees have the opportunity to change plans during an annual enrollment period. This opportunity is important because Medicare Advantage plans can make changes in their benefits, cost-sharing, provider networks, and premiums each year, and beneficiaries’ health needs may change from one year to the next. The open enrollment period allows enrollees to compare plans, stick with their current plan, switch to another plan, or shift to traditional Medicare. It is also the time when beneficiaries in traditional Medicare can switch to Medicare Advantage plans.
Little is known about the extent to which Medicare Advantage enrollees change plans during the annual open enrollment period. Prior research shows that roughly the same share of beneficiaries, 5 percent, shift between Medicare Advantage and traditional Medicare each year,1 that most enrollees tend to stay in a Medicare Advantage plan once in Medicare Advantage,2 and that switching rates from Medicare Advantage to traditional Medicare are higher among high-need, high-cost patients.3,4
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