You are turning 65 and have decided you don’t want a Medicare Advantage plan, but you get one anyway via automatic enrollment. To make it worse, your automatic enrollment was done by your current health insurance carrier by implied consent. Also known as SEAMLESS CONVERSION.
Imagine finding a thick package in the mail, opening it and learning that you’ve been enrolled in a health insurance plan you never signed up for. Worse, the process is legal.
That’s what happened to Pam Ludlow of Georgetown. She’s about to turn 65 and enroll in Medicare. But she wants to buy an alternate Medicare Advantage plan from Humana.
What if she didn’t want ANY Medicare Advantage plan with all the hoops, network hassles and high out of pocket?
My clients like the ability to use any doctor, lab or hospital anywhere in the U.S. and never have to worry about out of network penalties.Once they find out how AFFORDABLE Medigap plans can be they never want an advantage plan.
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Automatic Enrollment – Seamless Conversion
This happens with some frequency and Blue Cross isn’t the only “villain” in this game.
Three months ago, BCBS sent her a one-page letter offering her “a unique service: automatic enrollment” in its new Advantage plan. If Ludlow did nothing, the letter explained, she would be automatically enrolled.
Ludlow was told by a friend to ignore the letter. Bad advice.
Just like some of the offers from credit card companies, utilities or your cable provider, unless you specifically OPT OUT you have OPTED IN by implied consent.
The Medicare Managed Care guide labels it a “seamless automatic enrollment”, or “seamless conversion”. Someone already enrolled in a health plan with Company A can be switched without direct consent by that company to a Medicare Advantage plan as part of a do-nothing opt-out procedure.
Enrolled in Medicare Advantage Plan Automatically
Medicare Advantage carriers and prescription drug plans do this all the time. Unless you specifically non-renew your plan either by declaration or enrolling in a new Advantage or drug plan, your current carrier just assumes you want to continue coverage for another year.
I had a client that wanted out of his Advantage plan so he could return to original Medicare and a Medicare supplement plan. We made the switch in November of 2011 but he failed to notify his Advantage carrier and did not enroll in a stand alone drug plan (which would have automatically disenrolled him from his existing Advantage plan).
He promptly paid his Medigap premiums for almost 2 years never realizing he was still covered under the Advantage plan. He finally called me one day to ask if I had cancelled his Advantage plan.
No, I told him. I am not allowed to cancel any existing coverage, even if I was the writing agent on the old plan.
I reminded him how we talked about cancelling his old plan and he even contemplated going without a drug plan since he did not take any medications.
All his claims for the past two years had been paid by his Advantage carrier and promptly denied (rightly so) by his Medigap carrier.
Automatic Enrollment Disaster
In this case his Advantage automatic enrollment kicked in because he never told them to cancel the plan.
automatic enrollment “is a commonly used industry practice to avoid disruption of coverage.” Plan members can always get out of a plan before the effective date of a policy, she says.
BCBS has unenrolled Ludlow. She can go where she pleases. But Ludlow is still upset, especially since changing her Medicare records is a hassle. Her enrollment, she fumes, “is totally bogus. It never happened.”
Never assume anything and read every piece of mail you get. Never throw anything away until you are sure you don’t need it.
Need less hassle?
Forget Medicare Advantage plans. Go with original Medicare and an affordable Medicare supplement plan.