Opportunity is a knocking.
Sorry for the feeble attempt at humor. Believe me there is nothing funny about this time of year for many people.
A.N.O.C. is an acronym for the Annual Notice Of Change, that the Medicare Part D and Medicare Advantage plans have to mail to each and every one of their subscribers at this time of year.
If an insurance company is choosing to leave a marketplace, by law they have to give subscribers 90 days notice in writing. A few large insurance companies are choosing to exit the Medicare Advantage marketplace in 2010 and so their subscribers will have received a notice in the past few days outlining this to them.
One of the largest that we have here on the Peninsula is Coventry Healthcare, they have decided that the Medicare Advantage plans are no longer a good fit for their business model. In addition plans from Aetna and a few smaller companies have likewise decided to leave the Peninsula.
Is this because of reduced Federal reimbursement rates, higher than anticipated claims, a lack of provider networks ? The answer is probably a combination of all three as well as others we may not be aware of.
So, what are your options?. Here I can share some good news.
The Federal government mandates that if you lose your coverage involuntarily you have a “guaranteed” right to purchase any plan you choose. This can be a plan similar to the plan you had, or a plan that is different from what you had.
For example if a person had a Coventry Advantra Freedom plan and they have received notice that their plan will be terminated at the end of the year their options are as follows.
They could purchase a similar Private Fee For Service (PFFS) plan from companies like Secure Horizons for a relatively low premium. However these plans will probably go away at the end of 2010, and then you are back at square one.
You could purchase a Preferred Provider Organization (PPO) plan from Regence Med-Advantage. These plans should still be available in both 2010 and also 2011, however beware of the costs of these plans as they appear to be rising very rapidly. If you want drug coverage with a PPO plan you must purchase it from the same company.
Or, you go back to traditional Medicare and purchase a Medicare Supplement plan or Medigap plan from anyone of a number of plans available in Washington State. These are the plans most people are familiar with from companies like AARP, Mutual of Omaha, Regence & Premera, and go by letters “A” through “J”.
Plans K & L are available, but I have never seen one yet. With a Medicare Supplement plan you can choose any Part D drug plan.
Many people I have spoken to who have tried the PFFS plans are quite happy to go back to traditional Medicare and a supplement. They may not have liked the uncertainty of the co-pays when they needed treatment, or even finding out some hospitals in the Seattle area did not accept the plans at all.
However, many people either can’t afford or don’t want to pay the much higher premiums of Medicare Supplement policies. In addition people who are under age 65 may find they have very few options as the number of companies offering Medicare Supplement plans for persons under age 65 is relatively low.
So, the bottom line is, if you get an “Annual Notice Of Change” letter please make sure you read it very carefully as it may contain very important information about the plan benefits in 2010.
Oh yes, please do not forget you can always review your options at www. Medicare.gov or 1-800-medicare (1-800-633-4227), the local Statewide Health Insurance Benefits Advisors (SHIBA) 452-3221, and your local health insurance agent. By the way, no one can ever charge you a fee for assisting you review your options, so please seek help if needed.