Tuesday, October 15, 2013

IBM Medicare extendhealth.com/ibm Some Retirees just got the EH letter

Yesterday someone told me they just received the information about the transition to Extend Health and what they received was different information.  They had only been using IBM dental and vision insurance in 2013.  Medical was covered by their spouse's insurance plan.
Of course, neither Extend Health nor IBM Service Center explained to a subset of retirees why it took so long for them to receive transition information when the rest of us have been blabbing about this since the end of August. I believe it has to do with Medicare law and the fact that private plans are not allowed to begin their marketing for "open enrollment" until the beginning of October. That is why you are now seeing the flood of mail and ads on TV about Medicare Advantage plans. So, maybe Extend Health didn't send out information to a subset of retirees until the beginning of October because Extend Health did not want to be accused of breaking the law.  I keep saying this - Extend Health is basically an insurance agent.
The IBM retirees who did not use an IBM medical plan (whether it was the IBM supplemental plans, the Aetna Integration plans or most of the Medicare Advantage plans) are not eligible for a "Special Enrollment Period" which occurs when a corporate group plan is ending. The medical plan these people use is NOT ending.   The retirees using the Aetna PPO plan are also NOT eligible for an SEP because the IBM Aetna PPO plan is not ending. 
This SEP (there are many types of SEPs) allows Medicare eligible people to enroll in a new medical plan and begin coverage up to 63 days after the end of their current plan. This SEP started with IBM's announcement to retirees and continues into 2014 for 63 days. There are no marketing limitations for someone in an SEP. (That is why people about to turn 65 are flooded with mail and phone calls from private insurance companies.)  IBM retirees with this SEP are allowed to pick a new medical plan  63 days into 2014 but coverage wouldn't begin until the first of the next month.  To ensure continuous insurance coverage, EH uses the date 12/31/13 as the deadline for enrollment in one of their plans but buried in their literature is the fact that you actually can enroll in the beginning of 2014.
If you are NOT currently using an IBM medical plan that ends on 12/31/13, you do NOT have an SEP.  You are eligible for the normal Medicare Open Enrollment (aka fall enrollment) which begins today, Oct 15, 2013, and ends midnight on Dec 7, 2013. There are other implications that are important.  There is no "guarantee issue" right to get a medigap supplemental plan.  For example, if you were using IBM's Aetna PPO and want to switch to Original Medicare with a medigap - depending on where you live -  your state law may allow insurance companies to DENY to sell you a medigap plan, add riders to exclude pre-existing medical conditions and/or charge higher premiums based on your medical condition or age.
Extend Health is sending out brochures to the retirees without this SEP that describe Medicare Advantage plans.  EH assumes you will not want to switch to Original Medicare if you are using a Medicare Advantage plan. That is misleading because in several states that have continuous enrollment for medigap,  this is the time to switch to Original Medicare and get a medigap.  Also, if 2013 is the first year you tried a Medicare Advantage plan you are allowed to switch back to Original Medicare with a medigap.
Reminder, if you are already using Original Medicare with a medigap the rules for when you can switch to a different medigap plan with "guarantee issue" are state determined and are not tied to Medicare open enrollment.  For example, in California you can only do it on your birthday.
Reminder, these convoluted Medicare rules/laws are brought to you by your federal and state legislators who often times are influenced by insurance company lobbyists.  And retired federal legislators are not required to use Medicare when they turn 65.  They have their own federal plan. 

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