Medicare bars insurers from ‘seamless conversion’ of seniors’ health plans

Medicare bars insurers from ‘seamless conversion’ of seniors’ health plans

The Obama administration has temporarily blocked some health insurers from automatically moving eligible Medicare customers to Medicare Advantage plans as the controversial practice is being reviewed by federal officials.

A memo issued by Michael Crochunis, the acting director of the Medicare Enrollment & Appeals Group at the Centers for Medicare & Medicaid Services (CMS), also revealed that new rules will be issued for the so-called “seamless conversion” plans.

David Lipschutz, a senior attorney at Washington-based Center for Medicare Advocacy, said, “We think this is an important first step in addressing the issues surrounding seamless enrollment. But ultimately, we want it to go away.”

Under current rules, a health insurer can transfer an eligible customer who has bought a plan through an Affordable Care Act (ACA) insurance exchange or other private insurer when he or she becomes eligible for Medicare, usually at age 65 years.

An insurer has to give an individual a 60 days’ notice before the switch; but if the individual does not opt out, the switching takes effect automatically. But, many seniors argued that such notices can easily be missed in the flood of mailings from other insurers.

Meanwhile, the annual open Medicare enrollment period is providing eligible customers with a chance to choose a new health plan, either switching between Medicare and a private Medicare Advantage plan or by switching from one Medicare Advantage plan to another. The ongoing open enrollment period started on Oct. 15 and will last until Dec. 7, 2016.


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