We think it is important to keep you informed of these activities so you are aware and can help lobby your local Congress People regarding these key topics.
NAHU has a list of 8 key legislation priorities that are the focus for 2016. At Senior Advisors, all of these issues are important, but we further prioritized the list to summarize the top two issues that we are pressing from a Medicare perspective.
COBRA as Credible Coverage – This is an issue we see too frequently and falls into our #1 Biggest Mistake People Make on Medicare. If someone is Medicare eligible (65+) and takes Cobra Coverage from a former employer, this coverage is not considered “Credible” Coverage. Thus, the individual will pay a 10% penalty on Part B Premiums, if they do not sign up for Part B within 8 months of the Cobra start date. Additionally, Medicare is the primary payer when someone is on Cobra so the individual needs to have Medicare Part B since Medicare will pay first on claims. This is not fully understood by the Cobra participant, or by HR departments around the country. This results in claims not being paid, people getting penalized when they go to sign up for Part B, and delays in Part B coverage up to 15 months. Unfortunately the bill is not yet drafted to address this issue, but it should be drafted in the coming months.
- Allow COBRA coverage to count as credible coverage for Medicare beneficiaries just as employer-sponsored coverage does.
Medicare Advantage Open-Enrollment – Years ago, individuals on Medicare Advantage plans were given a one-time opportunity to make a plan switch 90 days after the beginning of each calendar year. This allowed for individuals who selected the wrong plan, or found out their doctor or prescription weren’t covered by the plan – to have an opportunity to get into a different Medicare Advantage Plan.This rule was changed a few years ago, based on a concern that brokers would switch client’s policies to game the system in the first 90 days of the year. This logic is faulty since there is only a one-time switch option available and advance commissions already paid on the prior policy would be charged back to the broker. We would like to restore the rule that provided more flexibility for people who want to change their plan in the first 90 days of the year.
- H.R. 588/2581 would restore the open-enrollment period for Medicare beneficiaries to make a one-time plan switch to another Medicare Advantage plan or return to traditional Medicare for 90 days after the beginning of each calendar year.
If you have any questions about the pending legislation or getting involved to help support these key issues, let us know.
Doug & Justin