The Affordable Care Act (ACA) requires Marketplace plans to keep people unless they ask to disenroll or stop paying their premiums under a consumer protection called “guaranteed renewability.” This means that people have a right to keep a plan that they are in and their plan cannot drop them because they become older or sicker.
In a recently proposed rule, the Centers for Medicare & Medicaid Services (CMS) asks whether this protection conflicts with a longstanding Medicare law that prohibits a health plan from selling a policy to a person who already has Medicare. Medicare Rights responded that guaranteed renewability should be maintained, based on both the simple reading of the law and on fundamental fairness.
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At the Medicare Rights Center, we know that your healthcare needs don’t take a summer vacation, and neither do we. Over the summer, our national Consumer Helpline staff was hard at work answering thousands of questions for people with Medicare and their families. From Monday-Friday year-round, our dedicated staff and volunteers are available to assist with needs ranging from help with low-income benefit enrollments to submitting complex Medicare coverage appeals.
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Last week, the Medicare Rights Center and partner organizations, including Justice in Aging, the Center for Medicare Advocacy, and the National Council on Aging, wrote to the Acting Administrator of the Centers for Medicare and Medicaid Services (CMS), to urge the agency to revisit the policy that allows certain private insurance companies to automatically enroll certain people into Medicare Advantage plans.
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The Centers for Medicare and Medicaid Services (CMS) recently announced Part D plan participants for a new demonstration, the Enhanced Medication Therapy Management Model, that seeks to strengthen Medication Therapy Management (MTM) services in Part D. In 2003, the Medicare Modernization Act was enacted, creating the Part D program and requiring every Part D plan to offer an MTM program. MTM programs are meant to improve quality of care by ensuring people are taking their medications safely and as prescribed, addressing any barriers to their doing so, and bringing any medication issues to the attention of the treating physician. CMS claims that these activities can also create cost savings.
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Dear Marci,
My mother is going to be eligible for Medicare soon. I want to help her choose a prescription drug plan, but I’m not sure where to start. What are some questions she should consider before signing up for a Part D plan?
– Erin (Clark, NJ)
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