The Seamless Conversion plan, part of the 1997 Balance Budget Act, allows insurers to transfer customers enrolled in the Affordable Care Act or other commercial plans to Medicare when they eligible. In 2005 the Centers for Medicare and Medicaid Services established guidance and as of October 6, 2016 Medicare Advantage Programs submitted proposals and have been approved to use this seamless enrollment. Shortly after the federal government blocked more insurance companies from partaking in this practice.
These beneficiaries, typically 65 and over are sent notification with 60 days do opt-out of this automatic enrollment and often misses the notice or misinterprets it’s meaning. The issue is usually caught when the beneficiary goes to an out of network provider causing a large bill or received a new card with a new unknown physician. Mostly this comes as a shock to customers because they are not being properly informed or prepared. One solution put forward is that insurers should be required to obtain the customers signature before proceeding.
Read the full article at Kaiser Health News, a national health policy news service that is part of the nonpartisan Henry J. Kaiser Family Foundation.