Just when you think you have this Medicare enrollment down pat, along comes another twist.
And the most hated kind of twist – one that hides inside the avalanche of Medicare sales pitches.
What is this latest Medicare enrollment twist?
Seamless conversion, which is a laughable contradiction in terms.
What is Seamless Conversion in Medicare Enrollment?
Sanctioned by the federal government, this little-known enrollment process has confused more than one senior citizen. Imagine that.
Seamless conversion hits individuals who are newly eligible for Medicare.
- Individuals turning age 65
- Those eligible for Medicare due to disability
- And those who are enrolled in other plans offered by the Medicare Advantage organization
I’ll use my own coverage as an example.
- I purchased individual health insurance coverage through SelectHealth
- The plan purchased is a qualified health plan under health reform’s Affordable Care Act
- SelectHealth also offers a Medicare Advantage plan for qualified Medicare beneficiaries
If approved by Medicare, SelectHealth could automatically enroll me in its Medicare Advantage plan when I become eligible for Medicare.
Sure, SelectHealth must send me a letter telling me they did that. And I have 60 days to opt out of that plan. But, do you know what it’s like the year you turn 65?
Picture AARP mailings on steroids.
- Medicare sales representatives bombard your snail mail with more information about Medicare than you will ever need (or understand)
- Your phone and voicemails groan under the weight of calls from across the country
- EVERY broker, sales professional, and consultant can’t wait to help you choose the best Medicare plan
If you followed my Medicare Basics series, you know the selection is beyond confusing. You may also know I am a licensed life/health agent, although I no longer sell or service insurance. I do think it’s smart to consult with a qualified Medicare sales agent. So, this is no slam on eager sales agents (well, maybe not all of them).
But what seamless conversion does is ~
- Automatically enroll you in a Medicare Advantage plan, regardless if you want it or not
- Puts the onus on you to “opt out” within 60 days if you don’t want the plan
- Assumes you actually find and read the seamless letter among the billions burying you alive
That’s just what happened in this story shared by Kaiser Health News.
The unsuspecting woman enrolled in Original Medicare, with no plans to enroll in Medicare Advantage. Because she had already enrolled, she ignored her current insurer’s seamless letter as the junk mail Medicare sales pitches become.
And life being what it is, the poor woman ended up in the hospital after her Medicare effective date. Well, imagine her surprise when she discovered she was not enrolled in Original Medicare. Instead, her former insurer enrolled her in their Medicare Advantage plan.
Wait. It gets better.
Her doctor and hospital were not in the plan’s network. KA-CHING! Major out-of-pocket dollars.
All because Medicare decided to put a twist on enrollment.
Open That Letter
In Medicare’s defense, they did eventually restore the woman’s Original Medicare. They also covered her medical bills.
But, as is often the case, the process is part of the problem. According to the Kaiser Health News article, Medicare refused to make public which insurers applied for the automatic enrollment process of seamless conversion. Why?
Wouldn’t you like to know if your insurer has that process? If you did know, you may pay closer attention to their correspondence.
But, here’s a better idea. Make it an opt-in process, rather than opt-out.
Medicare enrollment is complex enough. Why twist us into more knots?
Notice of Disclaimer –Cathy Miller is not an attorney or health care provider and cannot provide legal or health care advice. The information provided is for your general background only, and is not intended to constitute legal or health care advice as to your specific circumstances. We recommend you review legislation with legal counsel and visit your physician for health care issues.