Help! Losing Medicare Advantage or Employer Coverage

This time of year, every day there is a new Medicare Advantage plan termination or employer-sponsored group health plan termination announced. This can be intimidating and scary for someone who is losing Medicare Advantage or employer/group coverage. We field hundreds of questions about this annually, with some of the common questions being why is my plan ending, what can I do about it, or what are my options. This article should answer those questions clearly and concisely. If you prefer to speak to an adviser directly about your specific situation, you can call us at 877.506.3378 or email us at garrett@securemedicaresolutions.com.

First and foremost, you should understand what type of plan you have now that is ending. If you have a Medicare Advantage plan, this type of coverage is a privatized version of Medicare offered through private companies but run on a year-by-year (calendar year) basis with the Federal Government’s Medicare program. So each year, some of these plans will be renewed by the companies that sell them, and other plans will be dropped or changed.

If you are losing Medicare Advantage coverage, you will be notified by October 1 of that change and your entitlement to a special election period to choose another Medicare Advantage plan or an actual Medicare supplement (Medigap) plan on a ‘guaranteed issue’ basis. If you take no action, you will be returned to Medicare Parts A and B and you will have that for the calendar year 2015. It is important to understand that, just because you you are losing Medicare Advantage coverage, it does not mean you are going to have ‘no coverage’ for the following year. First of all, you will be reverted back to Medicare (at the worst). Best case scenario, you can get a much more comprehensive coverage plan (Medicare Supplement/Medigap) on a one-time ‘guaranteed issue’ basis. Normally, you have to ‘qualify medically’ for this type of coverage, but you do not have to do that when you are losing Medicare Advantage coverage because the company is terminating it.

If you want to compare the other Advantage plans in your area or look at Medigap as a more stable alternative, you can contact us at 877.506.3378 or at garrett@securemedicaresolutions.com.

If you are losing an employer-sponsored group plan, as many large employers are doing over the past few years, your situation is very similar but does have some unique aspects. For example, if you are a General Electric retiree (GE) or AT&T retiree that is losing coverage this year, there are better options besides what are presented with from your company.

The trend now for many of the large companies that are ‘cutting off’ insurance benefits for their retirees is to hire these ‘middlemen’ companies like AON, Extend Health, etc. These third-party companies are financially incentivized to place you in certain plans, and their stake in this is often tied (financially) to your former employer. If that seems like a conflict of interest, that’s because it is.

If this is your situation and you have the option of using an actual independent broker to compare/choose a plan, we would highly advise doing so, regardless of whether that is us or someone else. Besides the aforementioned conflict of interest, you would also be dealing with a more qualified, informed agent when using an independent brokerage (business owners vs. hourly call room employees). Moreover, an independent brokerage is equipped and able to offer support, answer questions, etc. after you are enrolled in a plan.

In working with retirees from these two companies already this year, we have seen some of the plans being presented/recommended and would strongly recommend that you explore your other options rather than get stuck with a $150+/month Plan F.

If you are losing employer-sponsored group coverage, you are entitled to a ‘guaranteed issue’ situation, during which you can choose a Medigap plan without medical underwriting. It is important that you choose wisely during this time, as you would have to ‘qualify’ medically to choose a plan or change plans later.

If you have questions about any of this information or if we can help alleviate your concerns about this transition, please call us at 877.506.3378 or contact me at garrett@securemedicaresolutions.com.