Medicare Advantage (MA) plans, offered by private insurance companies, as an alternative to the traditional Medicare program, are improperly denying many medical claims, according to a New York Times article. Based on a new report by the U.S. Dept. of Health and Human Services, the “plans, which now cover more than 20 million people – more than one-third of Medicare beneficiaries – have an incentive to deny claims ‘in an attempt to increase their profits.'” Read the full article here.
According to the Center for Medicare Advocacy, “Enrollment in a private MA plan, rather than traditional Medicare, is often a disadvantage for people when they get sick or injured and really need coverage and care. They then find their health care options limited by plan networks, prior authorization requirements and restrictive interpretations of coverage rules.” Nonetheless, the Administration is working to steer beneficiaries into MA plans during the 2018 annual enrollment period which ends December 7, 2018. Soon, however, you will have another opportunity to change from a private MA plan to traditional Medicare, according to the Medicare Handbook.
You Can Still Make Changes to Your Coverage after December 7. Here’s how:
Starting in 2019, between January 1–March 31 each year, during the Medicare Advantage Open Enrollment Period:
• In addition to changing Medicare Advantage plans, you can disenroll from your Medicare Advantage Plan and return to Original Medicare. If you choose to do so, you’ll be able to join a Medicare Prescription Drug Plan.
During this period, you can’t:
• Switch from Original Medicare to a Medicare Advantage Plan.
You can only make one change during this period, and any changes you make will be effective the first of the month after enrollment.
https://www.medicare.gov/sites/default/files/2018-09/10050-medicare-and-you.pdf, downloaded December 7, 2018