Current Medicare Developments Updated 10/23/17

MORE CURRENT MEDICARE DEVELOPMENTS 10/23/17: (1) Medicare’s Annual “Open Enrollment” Period is Underway, and Help With Choices Is Available; (2) Equitable Relief extended for Beneficiaries Who Had Medicare and Marketplace Coverage.

October 15 marked the beginning of Medicare’s annual Open Enrollment period — the time when all beneficiaries can choose to join, switch, or drop Medicare health plans (a/k/a “Medicare Advantage” and “Part C” plans) and prescription drug-only plans. The Open Enrollment period ends on December 7, and choices take effect January 1st. If beneficiaries take no action, they will automatically keep the plan in which they are currently enrolled. And while most beneficiaries don’t make new choices, exploring options can often be financially advantageous, and can reveal whether their plan provider networks and drug coverage has changed. To help individuals make these choices, the “Resource Center” of the state Aging & Long-Term Services Department is holding Enrollment Days around the state. A schedule of the dates and times of these sessions – which are on a walk-in basis – can be found at http://www.nmaging.state.nm.us (click on “Special Events.” Assistance is also available by phone from the Resource Center; 1-800-432-2080.

In a news alert dated April 7, 2017, we reported new Equitable Relief that the federal Medicare agency was offering to beneficiaries who had gotten Medicare and “Marketplace” private insurance coverage at the same time. As discussed there, the agency acknowledged that many individuals had received insufficient information about the negative effects of such dual coverage. As a result the agency created the Equitable Relief to help beneficiaries who had failed to enroll with Part B in timely fashion, or had incurred Part B premium late enrollment penalties. The time within which affected beneficiaries had to seek such relief was scheduled to expire on September 30th; the agency has now extended the time limit a full year, to September 30, 2018.

Current Medicare Developments—How Future Medicare Cards Will Look; and New MSN Notices for “Qualified Medicare Beneficiaries.”

The look and layout of all Medicare cards will be changing, though not starting until next April.
The changes are intended to fight against fraud and identity theft. While beneficiaries’
numbers on their cards have long been based on 9-digit Social Security Numbers, the new cards, which will replace all existing ones, will have a random mix of 11 (eleven) numbers and letters. The Medicare agency (CMS) will begin issuing the new cards – which are officially called “MBI”s (for “Medicare Beneficiary Identifiers”) — next April. Eventually all beneficiaries will receive the new cards. On September 14, 2017, CMS issued a press release showing how the new cards will look, https//www.cms.gov/medicare/new-medicare-card/nmc-home.html.  A rendering is also included in the 2018 Medicare & You booklet being mailed to most beneficiaries (a copy is also available on CMS’ web site).

Many lower income Medicare beneficiaries qualify for one of three “Medicare Savings Programs.” These are state Medicaid eligibility programs, which cover their Medicare Part B premiums; and, in the case of one of them, “QMB, Part A premiums (if needed) and Part A and B coinsurance and co-pay charges. “QMB” stands for “Qualified Medicare Beneficiary.” Providers who serve Medicare patients are generally prohibited from charging beneficiaries for more than they get from Medicare (this is called ‘balance billing’), however many beneficiaries and providers are unaware of, or overlook this requirement. Effective October 2, 2017, the “Medicare Summary Notices” QMB beneficiaries receive will include a written notice of this requirement, and will highlight the beneficiaries’ zero liability. Although only beneficiaries who use Medicare on a fee-for-service basis receive MSN’s, the balance billing prohibition applies to Medicare health plans as well.

 

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