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Rubio Works to Protect Seniors from Surprise Health Care Costs
Washington, D.C. – U.S. Senator Marco Rubio (R-FL) is requesting the Centers for Medicare & Medicaid Services (CMS) review its policy of “seamless conversion” to ensure seniors are being properly notified of their automatic enrollment in a Medicare plan when they reach the age of 65.
As the Miami Herald recently reported, “A special Medicare provision that allows private health insurance companies to enroll individuals who become eligible for Medicare into their Medicare Advantage coverage is costing surprised patients lots of money, according to news reports. … Medicare rules require a health insurance company to send a letter explaining the new coverage, which takes effect unless the member opts out within 60 days, according to Kaiser Health News. But many seniors are tossing out these letters. They find out they’ve been auto enrolled only when they get a bill from a physician or a hospital.”
In Rubio’s letter to CMS Acting Administrator Andy Slavitt, he writes, “While it is important to ensure seniors do not have to worry about unnecessary paperwork, efficiency should not come at the expense of transparency. I request you review this practice and ensure CMS and participating insurance companies are being as transparent as possible with patients. Our seniors should understand the issues surrounding any scheduled automatic enrollment, the coverage these new plans will provide, any changes in cost, and their ability to opt out.”
The full text of Rubio’s letter is below.
September 28, 2016
The Honorable Andy Slavitt
Centers for Medicare & Medicaid Services
200 Independence Avenue S.W.
Washington, D.C. 20201
Dear Acting Administrator Slavitt,
I write to express concerns regarding the automatic enrollment of seniors into health insurance companies’ Medicare plans when they reach the age of 65, a practice that is catching many patients off guard and may cost them a significant amount of money.
Companies are approved to use this “seamless conversion” process by the Centers for Medicare & Medicaid Services (CMS) under Section 1851(c)(3)(A)(ii) of the Social Security Act, as long as they inform beneficiaries of the new coverage and allow them 60 days to opt out before their coverage is automatically changed. However, as the Miami Herald recently reported, this information is not being relayed to seniors effectively, and many “find out they’ve been auto enrolled only when they get a bill from a physician or a hospital.”
While it is important to ensure seniors do not have to worry about unnecessary paperwork, efficiency should not come at the expense of transparency. I request you review this practice and ensure CMS and participating insurance companies are being as transparent as possible with patients. Our seniors should understand the issues surrounding any scheduled automatic enrollment, the coverage these new plans will provide, any changes in cost, and their ability to opt out.
I also request CMS provide a detailed breakdown of the steps seniors must take to reverse any erroneous automatic enrollment. If any such process is at the discretion of participating insurance companies, I would ask that you work with these companies to ensure seniors are not only aware of any changes in their care, but are also promptly assisted to correct any errors.
Again, while I acknowledge that seamless conversion provides continuity of care and simplifies the administrative process, it should not come as a surprise to seniors that their health insurance coverage has changed.
Thank you and I look forward to hearing your thoughts on the matter.
United States Senator