Seniors Shocked to Discover Automatic Medicare Advantage Enrollment through Medicare Approved “Seamless Conversion”

seamless conversion medicare medicare advantageSome seniors are learning in a not-so-seamless way that they have been enrolled in a Medicare Advantage plan through a Medicare-approved process called “seamless conversion”.

Seamless conversion is a process provided to insurers that allows them to automatically enroll those who are plan members with a marketplace or other commercial plan into one of their own Medicare Advantage plans when they turn 65.  The only form of notification the companies are required to give seniors is a letter 60 days before they turn 65 informing them that they will be automatically enrolled unless they opt out.

Several seniors have discovered they were automatically enrolled after they received a bill from a hospital or provider showing their care was out of their Medicare Advantage plan’s network- except they thought they were enrolled in Original Medicare.

These bills have been petitioned and some waived, with seniors explaining they either did not receive the letter through the mail or did not understand what it meant and disregarded it as unnecessary communication from their marketplace or commercial policy.  While some plan members may appreciate being automatically rolled over into a Medicare Advantage plan, it has been communicated that an “opt-in” policy may be a better approach instead of the current “opt-out”.

Blue Cross Blue Shield is currently using the seamless conversion process, with Aetna, UnitedHealthcare, and Humana planning to follow within the next few months.  Aetna plans to send out a postcard 90 days in advance to plan members instead of the 60 day requirement.

Posted in Industry News, Medicare Advantage/Part D Prescription, Medicare Information