Medicare Advantage insurance changes
LMH Health will no longer accept Aetna and Humana Medicare Advantage insurance effective January 1, 2025. We do understand the inconvenience this causes. Our goal is to ensure you have plenty of time to learn about options and select new coverage.
Open enrollment for Medicare and Medicare Advantage begins October 15.
You will have until December 7 to enroll in traditional Medicare (with or without a supplemental plan), or one of the Medicare Advantage plans we accept. Those are:
• Traditional Medicare plans or plans with supplemental coverage
• Blue Cross Blue Shield Medicare Advantage
• United Health Care Medicare Advantage
• AllWell Medicare Advantage
If you don’t see a company listed, please contact us.
Questions
The October 3rd Seminar demonstrated that most questions were related to specific individual circumstances. That is why we direct people to the Senior Resource Center or to a private insurance broker.
Why are we making this change?
While navigating the complexity and variations in health insurance is never easy, LMH Health and hospitals across the country have witnessed an alarming increase in the delay of prior authorization for care and denial of payment for care among Medicare Advantage plans. Two Medicare Advantage plans—Aetna MA and Humana MA—will no longer be accepted by LMH Health effective January 1, 2025, due to their consistently high rates of delaying, denial and low reimbursement for care provided.
The announcement was made prior to Medicare Open Enrollment (October 15 to December 7) in order to allow patients impacted to research alternative coverage. The LMH patient accounts team is working with patients on an individual basis to review options and to create the best experience possible in the difficult transition to other plans.
Can I switch from Medicare Advantage to Medicare and Medicare Gap without being denied or charged more?
There are no additional charges as this is already a Medicare plan.
There is a risk of denial when it comes to the Medigap Plans as they require medical underwriting.
Is there a penalty payment for rejoining regular Medicare after being on a Medicare Advantage plan for years?
There is no penalty payment.
When can I join, switch, or drop a Medicare Advantage Plan?
You can only join, switch, or drop a Medicare Advantage Plan during these enrollment periods:
Open Enrollment Period—Between October 15 and December 7 each year, anyone with Medicare can join, switch, or drop a Medicare Advantage Plan. Your coverage will begin on January 1 (as long as the plan gets your request by December 7).
If you join a Medicare Advantage Plan during your Initial Enrollment Period, you can change to another Medicare Advantage Plan (with or without drug coverage) or go back to Original Medicare (with or without a separate Medicare drug plan) within the first 3 months you have Medicare.
How can I save money on my prescription drugs?
A new prescription drug law that went into effect January 1, 2023, will help save money for people with Medicare. This law improves access to affordable treatments and strengthens the Medicare program.
Download more information (pdf)Where can I get help making a decision about Medicare?
We are aware of several area businesses who specialize in answering questions and educating people about Medicare options. The following list is not comprehensive and it does not indicate our endorsement or recommendation of any listed business. The list is for general information purposes only.
Senior Resource Center for Douglas County
785-727-7872
CEK Insurance, Scott Souther
785-843-2772
H+W Advisors
913-730-7730
Medicare-Planning.com, Pat Brown
785-979-9796
The Capital Concierge, Emily Abbott
785-251-0999
If you have, or know of, a business that should be added, please submit information online.
Source: https://www.medicare.gov/publications/12026-Understanding-Medicare-Advantage-Plans.pdf
Still have questions?
Reach out to Medicare at 1-800-633-4227. 24 hours a day, seven days a week.
Reach out to Mary Goodlett at LMH Health, 785-505-5788 or fill out the form below.
