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Social Security Error Jeopardizes Medicare Coverage For 250,000 Seniors

At least 1 / 4 of one million Medicare beneficiaries could obtain payments for as many as 5 months of premiums they thought they already paid.

But they shouldn’t toss the letter within the rubbish. It’s not a rip-off or a mistake.

Because of what the Social Security Administration calls “a processing error” that occurred in January, it didn’t deduct premiums from some seniors’ Social Security checks and it didn’t pay the insurance policy, in response to the company’s “frequently asked questions” page on its web site. The downside applies to non-public drug insurance policies and Medicare Advantage plans that present each medical and drug protection and substitute for conventional government-run Medicare.

Some individuals will uncover they have to discover the cash to pay the plans. Others might get cancellation notices. Medicare officers say roughly 250,000 persons are affected.

Medicare and Social Security stated they count on that correct deductions and funds to insurers will resume this month or subsequent. Insurers are required to ship payments on to their members for the unpaid premiums, in response to Medicare.

But neither company would clarify how the error occurred or present a extra precise quantity or the names of the plans that have been shortchanged. The quantity the plans are owed additionally wasn’t disclosed. A notice to beneficiaries on Medicare’s web site lacks key particulars.

Rep. Richard Neal (D-Mass.), who chairs the Ways and Means Committee, and two colleagues wrote to both agencies about the issue on May 22 however haven’t acquired a response from Medicare. Social Security’s response referred most inquiries to Medicare officers.

Organizations that assist seniors say they’re getting some questions from Medicare beneficiaries. Two seniors in Louisiana misplaced drug protection after their insurance policies have been canceled because of the SSA error, stated the state’s Senior Health Insurance Information Program (SHIIP) director, Vicki Dufrene. One lady had the identical drug plan since 2013, which dropped her on the finish of April. She was with out protection for all the month of May till earlier this week, when Dufrene was in a position to get her retroactively re-enrolled.

Dufrene stated some individuals won’t discover that their checks didn’t embrace a deduction for his or her Medicare Advantage or drug plan premiums. If their test was just a little greater than anticipated, they might have assumed that additional quantity was the anticipated cost-of-living enhance, amongst different issues.

In Ohio, a Medicare Advantage plan reinstated a member on account of unpaid premiums lower than 48 hours after the state’s SHIIP received concerned, stated director Christina Reeg.

Medicare beneficiaries have had the choice of paying their premiums by a deduction from their Social Security checks for greater than a decade, she stated. However, they will additionally cost funds on to a bank card or checking account as an alternative of counting on Social Security.

Humana spokesman Mark Mathis stated about 33,000 members have been affected — or fewer than 1% of its whole Medicare membership. None of these members misplaced protection. The firm blamed Medicare’s almost 15-year-old IT programs for the failure and urged the company to spend money on new gear.

A UnitedHealthcare consultant stated none of its 32,000 Medicare Advantage or Part D members affected by the SSA downside misplaced protection. The firm has the very best Medicare enrollment within the U.S.

Aetna has not acquired funds for Medicare Advantage and drug plans for the months of February by May for 43,000 affected members, stated spokesman Ethan Slavin. Customers will obtain payments for the unpaid premiums and might arrange fee plans if they will’t pay all the quantity.

These and different affected insurers should enable their members at the very least two months from the billing date to pay. And they have to supply a fee plan for individuals who can’t pay a number of months of premiums directly, Medicare stated. With each steps, “plans can avoid invoking their policy of disenrollment for failure to pay premiums while the member is adhering to the payment plan,” Jennifer Shapiro, the performing director for the Medicare Plan Payment Group, warned the businesses in a May 22 memo.

Lindsey Copeland, federal coverage director for the Medicare Rights Center, an advocacy group, stated she is anxious that older adults will view the invoice with suspicion.

“If you think your premiums are being paid automatically and then your plan tells you six months later that wasn’t the case,  you may be confused,” she stated.

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