Friday, November 1, 2013

IBM Medicare Extend Health DO NOT try to enroll in the same Part D plan you use in 2013

I wish IBM would hold a public hearing with their stockholders on the transition to Extend Health.  Whomever vetted Extend Health aka Towers Watson should be fired. 
As I have written earlier, I did all my homework and checked THREE times with EH to be sure what I was doing would be acceptable to EH such that I could get my subsidy both before and after my enrollment call.  Everyone I spoke to at EH confirmed my selection would meet the criteria for enrollment such that I could get my subsidy.  And, my profile says I have enrolled and my application is being processed.  My choice, which was confirmed, was to enroll in a part D insurance plan I already am using in 2013.
When does an EH enrollment mean "maybe not"?  You aren't really enrolled in an insurance plan until the insurance company processes and accepts your application.  Better still - EH will say it is not their problem if the insurance company rejects your enrollment EVEN WHEN THEY KNOW IT WILL BE REJECTED.
When a colleague tried, this week, to do a similar enrollment to mine the EH agent he worked with knew enough to stop him from doing it.  My colleague referenced my enrollment and gave the EH agent my name to say ... that person did it ... why can't I?  According to the EH agents he worked with -  my enrollment through EH will be rejected by my part D insurance plan because I already am enrolled in that plan.  Ergo, I will not have enrolled via Extend Health so EH will not show as the agent of record.  Ergo, I will not have access to my subsidy because I did not pick a plan where EH would be the insurance agent of record on my part D plan.
Now, one would think the EH agent would immediately flag my profile and tell someone to call me because he knew my name and that I will have this problem.  Instead - he told my colleague this wasn't an EH problem - they are only the insurance agent. The insurance company will send me a letter and tell me about the duplicate enrollment rejection.  My guess is the letter will say since you are already enrolled you don't need to enroll again.  My further guess is they will say nothing about the fact that EH is therefore not the agent of record for you plan.  And, therefore, had my colleague not tried to do the same thing, I would go on believing I had full access to my subsidy.
Nice - right?  Wait - it gets better.  If the insurance company tells me this after December 7th, I will still be in a stew even if I then realize it impacts my subsidy access. I will not be able to switch to another part D plan because Medicare Fall Enrollment will be close and I have no SEP for my part D plan. Ergo - no subsidy for me!  Wow, this really demonstrates how EH is totally invested in helping us make the right insurance choices.
I decided I will just call EH and just tell them I changed my mind and want to enroll in another part D plan rather than try to fight this battle with them.  I'm the one that has the most to lose. Ugh, another hour on the phone with EH enrollment listening to boilerplate and repeating my name and SS# a thousand times.  It's a good thing I am retired.
Time to write another letter to Dr. Rhee.


  1. According to EH call advisors the reason we cannot keep or reenroll in our current Medicare plan for 2014 is because Medicare does not allow changing the "agent-on-record" for an existing health ins. policy. But checking with Medicare, I was told changing the agent-on-record, particularly during the enrollment period was OK. What Medicare does not want to do is allow agents to steal policies from one another. If the effect of their EH enforcement results is forcing us to buy something else under threat of losing our subsidy is policy driven and not a matter of advisor interpretation, then I think we should bring this up with IBM, Medicare or the even the Justice Dept as a case of unfair market practice or aritficially creating demand for Medicare exhange transactions..

    1. I doubt there is basis for legal action as far as Medicare law is concerned. EH is not tricking us into switching to another policy. IBM made a deal with Extend Health that would require each of us to have a policy through EH so EH could get commissions and IBM likely pays a lower fee to EH to administer the HRA. IBM does not have to give us a subsidy. They can remove it at any time. I'm not saying IBM is doing an ethical thing by having such a contract with EH - I just don't think it is illegal.

  2. Plato - you will have up to 60 days after you lose your IBM group coverage (12/31) to make a plan election with a Medicare Advantage plan. This is called a special election period. you get the special allowance because IBM is terminating a group policy - and you are losing creditable coverage. This does not help you get your own plan back, but at least know that you still have options under the Medicare rules.

    1. Actually, you have until the last day of February 2014 (and it would be effective March 1st) to select a new Medicare Advantage plan or a new prescription drug plan if the plan you had with IBM is ending on 12/31/13. However, if you wait until 2014 to enroll you will not have insurance until the first day of the following month so it is risky to do so. Also, not all IBM plans are ending. Those in Aetna or Kaiser plans had to make a switch by December 7th. However, this has nothing to do with my post. I had a part D plan that was not an IBM plan because I had selected Aetna Integration insurance. Therefore, the part D plan I bought was not "ending". If I was to make a switch I had to do it by 12/07/13. And I had to switch if I wanted to use part D to get my HRA subsidy because it was the only way Extend Health could get commission.