Automatic enrollment of consumers in Medicare Advantage plans is commonplace among insurers, but it’s a practice that could face more regulatory scrutiny in the wake of complaints, according to Kaiser Health News.
Using a process known as “seamless conversion,” insurers automatically enroll existing members in MA plans when they turn 65, even if they opt for traditional Medicare coverage instead. Insurers typically send a notification letter to the member that includes a 60-day opt-out period. Members who fail to take action have been stuck with high medical bills after discovering they were enrolled in an MA plan that did not cover the doctor or hospital where they received treatment.
Seamless conversion, which requires approval from Medicare, has become a routine practice among insurers. Although Medicare officials did not tell KHN how many insurers have gained approval, several of the nation’s largest carriers--including Aetna, Humana and UnitedHealth--have an auto-enroll process, arguing it allows members to remain with the same carrier.
But that could change as lawmakers have taken notice. Rep. Jan Schakowsky (D-Ill.) tells KHN that she is looking at new regulations that would require members to opt-in to MA plans.
MA enrollment has surged over the last five years, reaching 17.6 million in 2016 and accounting for nearly one-third of all Medicare beneficiaries. The MA market has been a source of consistent profitability for many insurers struggling with marketplace losses, and seniors have been overwhelmingly satisfied with the plans.
- read the KHN article