OKLAHOMA CITY – The Oklahoma Insurance Department’s Medicare Assistance Program (MAP) can help beneficiaries whose current Medicare Advantage plans won’t be available in 2018. Thousands of Oklahomans on Medicare received the cancellation notices this week. The Centers for Medicare and Medicaid Services (CMS) determined their existing plans could not be offered in some counties because those plans were unable to meet the network adequacy standards established by CMS for provider access in those areas. These standards were established to assure that Medicare Advantage plan enrollees have adequate access to critical providers within an established distance from their locations.

 

“It is important that beneficiaries take action before Dec. 31, 2017 to ensure they have coverage beginning Jan. 1, 2018,” said Oklahoma Insurance Commissioner John D. Doak. “We want affected consumers to carefully read the letter received from their carrier and take action to ensure there is no lapse in health and prescription drug benefits.”

 

Affected beneficiaries must choose a new plan before Dec. 31 to ensure they have health and/or prescription drug coverage on Jan. 1, 2018. Those who do not choose a new plan will be placed on original Medicare and lose prescription drug coverage. Affected consumers have two options:

  1. Choose one of the other Medicare Advantage plans available in their county that provides both health and prescription drug coverage.
  2. Switch to original Medicare and add a Part D prescription drug plan. The consumer may also want to consider a Medicare supplement plan to fill in the gaps in original Medicare. Because these beneficiaries are being terminated against their wishes, this creates a special enrollment period during which they can purchase a Medicare supplement policy without the risk of being denied or charged a higher premium due to a current or pre-existing condition. This opportunity lasts 63 days from the date of plan termination.

Also, if the beneficiary was enrolled in CommunityCare as part of their health coverage provided to retirees through their former employers, those individuals should contact their respective employers to find out what arrangements are being made for replacement coverage.

While those affected by the loss of their existing policy have until Feb. 28 to choose a new one, open enrollment for all Medicare beneficiaries runs Oct. 15-Dec. 7. During this time, Medicare beneficiaries can review their current medical and prescription drug coverage, as well as exploring new options that could provide them with better coverage at a reduced cost. Oklahomans on Medicare are encouraged to call MAP counselors to review their options.

“Our goal is to help Medicare beneficiaries get the right coverage at the right price for their specific medical needs,” Doak said. “This is a personalized approach that arms each person with the knowledge they need to make the right choice about their Medicare coverage.”

Trained counselors can help beneficiaries understand Medicare benefits and the enrollment process. Last year, they saved clients an average of $2,000 by reviewing their current medications and identifying drug plans that provided the best coverage at the lowest cost.

Any changes made during Medicare Open Enrollment will go into effect on Jan. 1. Consumers can call MAP at 800-763-2828 to ask questions or schedule an appointment to review their coverage. MAP partners with other agencies to offer this assistance throughout the state. A list of partner agencies is available at oid.ok.gov.

About the Oklahoma Insurance Department
The Oklahoma Insurance Department, an agency of the State of Oklahoma, is responsible for the education and protection of the insurance-buying public and for oversight of the insurance industry in the state.

For more information contact:

Jeremy Bush, Phoenix Insurance (918) 336-5460

Kelly Dexter, OID (405) 522-0683