New Medicare Advantage Rules Proposed to Protect Seniors

Law Firm Newswire



Waxahachie, TX (Law Firm Newswire) April 4, 2014 – In the autumn of 2013, UnitedHealthcare dropped thousands of doctors across the country from its Medicare Advantage plans. At least ten states were affected. Nearly 16 million people are enrolled in Medicare Advantage, and many struggled to make the adjustments needed before the December enrollment deadline. These struggles sparked a national concern: how does Medicare Advantage protect seniors when private insurance companies make changes?

Under Medicare Advantage, the federal government reimburses insurance carriers for their care of beneficiaries. UnitedHealthcare is one of the leading providers. When an insurance company makes a major change, the results can affect huge numbers of those involved in the program.

Now, federal officials have proposed safeguards to ensure that elder citizens will receive the time they need to make their own changes in response to a carrier’s. “The importance of these proposed measures cannot be overstated,” commented elder care law attorney John D. Hale.

The Texan lawyer explained the protection that the proposed measures offer. “When the most recent cuts were made, seniors had very little time to change their plans before being locked into them. The UnitedHealthcare drop took place just a few weeks before the December 7 Medicare enrollment deadline. If the government proposals go through, Medicare Advantage beneficiaries will receive more than 30 days to make any coverage changes they need because of cuts. Providers will receive at least 60. It’s a step toward proper, supportive consideration for beneficiaries.”

Additionally, if network providers left a network outside of the normal enrollment period, specified language concerning patients’ rights would now be required within the announcement.

The changes to Medicare Advantage may necessitate many health care changes for affected seniors. If a beneficiary’s provider was dropped, he or she will need time to find a new one. Some may wish to choose a different healthcare plan or enroll in traditional Medicare, which does not restrict beneficiaries to a limited network of providers in the same way.

In the past year, Medicare funding and policies have undergone enormous change. Considerations for seniors are just one part of the government’s proposals to respond to those changes. The full announcement spanned 148 pages. A final decision on the senior protection measures is expected as early as April 7, and the announcement’s full components will be debated in the months to come.