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Payment Glitch Interrupts Automatic Medicare Advantage and Part D Premium Withdrawals

Earlier this year, a federal government systems issue prevented Medicare Advantage and Part D premiums from being automatically deducted from the Social Security payments of some people with Medicare. Normally, if a beneficiary elects, Social Security deducts the premiums and sends them directly to the plan. In this instance, the payments were not sent to the plans, and beneficiaries did not know that their plans were not receiving them.

While the issue has since been resolved and premium payments should be processed correctly moving forward, Medicare Rights remains concerned about the scope of the processing error and the potential impacts on beneficiaries—including confusion, financial hardship, and coverage losses.

According to the Centers for Medicare & Medicaid Services (CMS), affected individuals include those who were “enrolled either in a Medicare Advantage Plan or in a Medicare Prescription Drug Plan for coverage starting January 1, 2019” and chose to have their premiums automatically deducted from their monthly Social Security benefit, rather than pay the plan directly.

However, it’s not yet clear how many of these enrollees were affected, if those who were have been made aware, or how much they might owe. The Social Security Administration (SSA) notes that “Plans will be sending premium bills to those affected. If you are affected and haven’t already received a bill in the mail, you will soon. The first bill will likely be for a larger amount than usual to make up for the unpaid premiums.”

Importantly, plans must offer enrollees a “grace period” to repay the missed premium payments, which must last at least as long as the delay in billing. Plans also have the option not to pursue these outstanding payments.

CMS advises beneficiaries to call their plan directly with any questions or concerns. Medicare Rights’ Helpline counselors are also available at 800-333-4114, and enrollees may want to contact their local SHIP or 1-800-Medicare for assistance.

Medicare Rights appreciates federal agency and plan efforts to educate affected enrollees and we encourage them to continue to work together to hold beneficiaries harmless.

Read the CMS notice.

Read more from SSA.

Read coverage of this issue on Kaiser Health News.

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