Your Weekly Medicare Consumer Advocacy Update
The Health Insurance Marketplaces are Open for Business
As the Marketplaces Open, Things Stay the Same for People with Medicare
This week, millions of people without health insurance were finally able to shop for affordable health coverage thanks to the Affordable Care Act (ACA). On October 1, the U.S. Department of Health and Human Services (HHS) launched the Health Insurance Marketplaces, a new way for people without insurance to purchase coverage for themselves and their families without being denied or charged more because they have a pre-existing condition. People may enroll in insurance plans from the Marketplaces until March 31, 2014. Coverage starts as early as January 1, 2014 for individuals who enroll by December 15, 2013.
States have the option to either set up their own Marketplace or allow the federal government to set up a Marketplace in their state. For example, New York has chosen to set up its own Marketplace, called NY State of Health, which is managed by the New York State Department of Health (NYSDOH). On the NY State of Health website, individuals, families and small businesses can shop for affordable insurance coverage, as well as check their eligibility and sign up for programs like Medicaid.
The Health Insurance Marketplaces created by the ACA are only for people who do not already have insurance. The Marketplaces are not for people with Medicare. People with Medicare should not enroll in the insurance plans offered in the Marketplaces. In addition, Medicare Advantage plans, Medigap supplemental policies and stand-alone Part D plans will not be sold through the Marketplaces. People with Medicare will be able to make changes to their coverage during the Medicare Fall Open Enrollment Period, which runs from October 15 to December 7 of each year. Making changes to Medicare coverage is no different than last year—simply go to www.medicare.gov or call 1-800-Medicare.
What Seniors Need to Know about Scams Related to New Health Insurance Marketplaces
Medicare Rights Center President Joe Baker was quoted in a recent Reuters article on seniors and marketing fraud. With the launch of the Health Insurance Marketplaces on October 1, Medicare beneficiaries are at increased risk of identity theft related to scams targeting seniors with Medicare. According to the Reuters article, consumer protection advocates worry that scammers will falsely tell seniors that they need to renew their Medicare coverage or sign up in the new Marketplaces in order to get them to divulge critical personal information on application forms. Advocates have also received reports of fake websites purporting to offer Affordable Care Act (ACA) insurance policies, also known as Qualified Health Plans.
“Many seniors already think the worst about the law, so they’re ready for some of these false pitches,” said Mr. Baker in the article. “[The scammers] will tell you Obamacare means you need to change your Medicare, or that you need to re-apply for Medicare—or that if you don’t buy a new kind of insurance you’re going to get fined or go to jail.” Mr. Baker adds, “If anyone tells you that you have to do that, they’re lying.”
Seniors are also having to distinguish between two different enrollment periods and marketing messages—one for the Health Insurance Marketplaces, which began enrollment on October 1, and another for Medicare’s Fall Open Enrollment, which runs from October 15 to December 7. According to the Reuters article, the challenge for seniors will be sorting out scams from the massive, legitimate outreach now under way to promote the new law.
Mr. Baker and other advocates have a simple message for seniors—you don’t have to make any changes in your Medicare coverage because of the ACA. Anyone who is already on Medicare has no need to use the Health Insurance Marketplaces; in fact, it is illegal for insurers to sell a Marketplace policy to anyone on Medicare.
Volume 4, Issue 38
The health insurance Marketplaces created by the Affordable Care Act (ACA) allow people who are uninsured or underinsured to shop for coverage online or over the phone. The Marketplaces may also be known as Exchanges. Health insurance plans sold in the Marketplaces are called Qualified Health plans (QHPs).
If you have Medicare or will soon qualify for it, you may wonder how the new Marketplaces will affect you. Visit Medicare Interactive and move through the four scenarios below and see which situation applies to you.
- I already have Medicare and do not have coverage through my own or my spouse’s current employer. Should I make any changes to my Medicare because of the new Marketplaces?
- I have individual QHP coverage that I bought through the Marketplaces. What should I do when I become eligible for Medicare?
- I already have Medicare Part B, and I have coverage from my own or my spouse’s current employer. Do the Marketplaces affect how Medicare works with my employer coverage?
- I have QHP coverage that was purchased by my own or my spouse’s employer through the SHOP. What should I do when I qualify for Medicare?
This week, The Commonwealth Fund released an issue brief detailing their findings from a 2013 survey on the Health Insurance Marketplaces and the expansion of Medicaid, both provided through the Affordable Care Act (ACA). According to the brief, only two out of five adults are aware of the Marketplaces or the financial assistance available to help pay for plans in the Marketplaces, but three out of five individuals said they would take advantage of the coverage options if they are eligible. The survey also shows that there is extensive support for expanding the Medicaid program, both in states that have and those that have not agreed to expand their Medicaid programs.
The survey concludes that education about the Marketplaces and Medicaid expansion is crucial for consumer participations, but those who are eligible will more than likely participate in the new options provided by the ACA as the law continues to roll out.