If you have become eligible for Medicare, you may think that many of your worries and concerns over the cost of healthcare are over. You may trust that the program will cover most of your potential or actual medical costs. But you may want to check to see if you actually have the coverage you believe you have
Some insurance companies are using a little-publicized procedure that permits them to auto-enroll customers who have had an individual health policy through the company prior to turning age 65. Instead of being covered by traditional Medicare, their coverage is through a private Medicare Advantage plan.
One woman found out the hard way that there may be little “advantage” in such a plan and was left facing a staggering $16,000 medical bill. She had been auto-enrolled in such a plan and underwent surgery from a physician that was an out-of-network provider. She did not know this at the time, because she thought she was covered by Medicare.
Massive medical bills are a frequent trigger for bankruptcy filings, when individuals are hit with medical expenses that are not covered by insurance.
The current law allows insurers to auto-enroll customers after sending notice via a letter, which supposedly explains the new policy and requires that they opt-out. If they fail to understand the implications of the letter and do not to respond to the note and opt-out, they can later find they do not have traditional Medicare coverage.
One lawmaker would like to change the process and make it one where the consumer would receive information explaining the plan from the insurer and they would then have to affirmatively “opt-in” to the plan. This would ensure that individual would fully understand that they were going outside of traditional Medicare for their coverage and would avoid unpleasant surprises with shockingly large medical bills.