Turning 65 soon? Your mailbox probably is stuffed with ads from health care companies eager to sign you up for Medicare coverage.
Be aware, though: buried in there may be a notice that you are about to be automatically enrolled in an HMO-style, private Medicare Advantage plan by your current insurance company. If you never see that letter, or if you ignore it, you could find yourself locked into coverage that doesn’t cover your doctors or costs you more.
Some insurance companies serving South Florida seniors are considering, or have started, a little-known policy called seamless conversion. Insurers granted approval by the federal Centers for Medicare and Medicaid Services can automatically shift existing members into their Advantage plans when those members become eligible for Medicare.
While CMS requires that beneficiaries be notified in writing at least 60 days in advance, insurers do not need confirmation that the member wants the new coverage before making the switch. Medicare advocates say that blocks seniors from making informed choices.
Seamless conversion was created by Congress almost 20 years ago, as part of the Social Security Act of 1997, but rarely used over the years, said Stacy Sanders, federal policy director for the Medicare Rights Center in New York City. That changed in the 2016 plan year, she said, when CMS sent Medicare Advantage providers letters suggesting conversion was a good option for transitioning low-income seniors and nursing home residents into new state Medicaid managed care programs once their members were eligible for Medicare.
Sanders is concerned that seniors usually will receive seamless conversion notices when they’re most likely to be flooded with Medicare Advantage pitches: during annual open enrollment in October and right before their 65th birthdays.
HENRY KOTULA 