Medicare deadline looming for those losing Blue Cross

By: 
JENNY GESSAMAN
Reporter

Fergus County Council on Aging Personal Services Director Kerri Scheeler helps clients understand Medicare free-of-charge, and recommended those losing Blue Cross Advantage Plan coverage reevaluate the different Medicare options.

Photo by Jenny Gessaman

It’s a busy season, but some Central Montanans may be a bit busier than the rest, at least if they’re enrolled in a Medicare Advantage Plan. Blue Cross Blue Shield isn’t offering an Advantage plan in 2018, and its current customers have are facing deadlines.

Enrollees technically have until Feb. 28 to choose a new plan. However, if they don’t take action in the next month, they will be auto-enrolled in original Medicare on Jan. 1. For most, that enrollment will not include Part D, so while people are still covered for healthcare, there could potentially be a gap in their Part D prescription drug coverage.

Dennis DelPizzo recommended tackling the change sooner rather than later. As a health insurance specialist with a CMS External Affairs Team out of Denver, he explained why waiting could create a gap.

He said new coverage plans start the on first day of the month after you select them. For example, if you enroll Jan. 2, the coverage will begin on Feb. 1.

 DelPizzo said this meant if those losing coverage enrolled before Dec. 31, their new plan will take effect the first day of 2018. If they wait until after that date, the coverage will kick in later and leave at least a month without prescription drug coverage.

The rare exception, DelPizzo added, is those who have access to other credible coverage, such as retirees with coverage through former employers.

While people are losing coverage through no fault of their own, DelPizzo said the protection is the auto-enrollment in original Medicare, which maintains their health coverage.

“They’d be protected, but the problem, and our concern, is if they don’t act by the open enrollment cutoff,” he said. “They could have a gap in their [prescription drug] coverage if something happens in the first of the month.”

This fall, Blue Cross sent notification letters to both clients and providers such as Central Montana Medical Center. CMMC Business Office Manager Andrea Martin said the change leaves those losing coverage with a single Advantage Plan choice.

“The only [Medicare Advantage] plan that’s available in Lewistown is Humana,” she said.

Hospitals, physicians and other providers can’t recommend or choose insurance plans for patients, so Blue Cross’ exit doesn’t require immediate action from CMMC. Martin is making an effort to minimize any potential effect on patients, though.

“A large population of our clientele is Medicare-aged,” she said. “I’m making a very heavy effort to make sure the hospital and its employed providers are all preferred providers, and are within that platform of Humana.”

While CMMC providers are already in Humana’s network, and serving clients with Humana insurance, Martin explained the hospital gained several new providers in the last year. She has been pushing paperwork to double check all of them are in-network before Jan. 1.

If patients losing Blue Cross coverage switch to Humana, Martin wants the transition to be easy.

“They are asking if we are a Humana provider or not,” she said. “We’re assuring them we are, that all our t’s are crossed and our i’s are dotted.”

Fergus County Council on Aging Personal Services Director Kerri Scheeler helps clients understand Medicare as a free service, and she recommended everyone on Medicare, not just those losing Blue Cross coverage, should check their own t’s and i’s.

“This is open enrollment,” she said. “This is the time of year people can make changes if they’re not happy.”

 

The what and the when

Medicare Advantage Plans

According to the Centers for Medicaid and Medicare Services, an Advantage Plan is one of several kinds of coverage under the Medicare umbrella.

A Medicare Advantage Plan is an alternative to original Medicare. The name is a label for a kind of plan, so several private providers can all offer an Advantage Plan. The plans are still regulated by the federal government, and must provide at least the same services as Medicare, if not more.

An Advantage Plan includes Medicare parts A and B, and is known as Medicare Part C. It may or may not require Part D, prescription drug coverage.

 

Deadlines

• Open enrollment (when eligible people can sign up for Medicare, or when those already enrolled can change their coverage): Oct. 15-Dec 7.

• Enrollment period for those losing Blue Cross Advantage Plan coverage: Oct. 15-Feb. 28

• Deadline before original-Medicare auto-enrollment (for those losing coverage): Dec. 31

Category:

Poll

When do you think the snow will finally be melted in Lewistown?