Free one-on-one counseling saved Delawareans $1.5M in 2022

As Medicare Open Enrollment approaches, the Delaware Department of Insurance and its Medicare Assistance Bureau (DMAB) are sharing their annual consumer information update. From October 15 to December 7, consumers can join, switch, or drop a Medicare Prescription Drug Plan (Part D) or Medicare Advantage Plan. DMAB’s free, confidential, unbiased one-on-one assistance can help residents determine if making a coverage change is the right choice. In 2022, the team completed 5,123 counseling sessions, saving beneficiaries a combined $1.5 million.

When selecting 2024 coverage, there are important changes to keep in mind. Extra Help is expanding to offer full subsidy benefits to those up to 150% of the federal poverty level, allowing more people access to $0 premiums for coverage and fixed prescription copays. Additionally, those with Medicare Part D who fall into the catastrophic phase of their benefits will no longer have to pay 5% coinsurance for covered drugs during that period of coverage. And, on July 1, 2024, CMS will institute a new cap on Part B payment amounts for new biosimilars when average sales price data is not available.

2023 Medicare changes will continue into the new plan year. As of July 1, people with Traditional Medicare who take insulin through a traditional pump pay no more than $35 a month for their supply, and deductibles do not apply. Free vaccine coverage has expanded, and as of April 1 persons with Part B have lower coinsurance for drugs whose price increased faster than the rate of inflation.

“Delaware’s Medicare Assistance Bureau provides consumers with the education and empowerment they need to find the coverage they need at a cost they can afford,” said Insurance Commissioner Trinidad Navarro, who reminded residents to be smart shoppers this enrollment season.

“Part of being a smart shopper is knowing what to ask, and where to find trustworthy answers,” shared DMAB Director Lakia Turner. “There is no shortage of marketing during Open Enrollment, and bad actors may disguise themselves by offering information about changes for 2024. Our team can help you cut through the noise by answering your questions and identifying the best plan for your needs.”
In addition to scheduled phone and virtual appointments, DMAB is offering weekly appointments at all three Department of Insurance offices from October 17 to November 30:

• Tuesdays from 9:30AM-3:00PM at 503 Carr Road, Suite 303, Wilmington DE 19809
• Wednesdays from 9:30AM-3:00PM at 28 The Circle, Suite 1, Georgetown, DE 19947
• Thursdays from 9:00AM-3:30PM at 1351 West North St., Suite 101, Dover, DE 19904

Top Tips for a Successful Medicare Open Enrollment

1. Know that enrolling in a Medicare Advantage plan means it becomes your primary coverage. Original Medicare will no longer pay for services. You will receive a new ID card from the new plan, and should store your Original Medicare card in a safe place.
2. When moving from Original Medicare to a Medicare Advantage plan, be prepared to pay both a monthly Medicare Advantage premium and a monthly Medicare Part B premium.
3. Medicare Advantage plans do not automatically give you “more money in your Social Security check every month.” To qualify, you must be eligible for the Medicare Savings Program by having an income below Medicaid limits.
4. Check that additional benefits, like dental, vision, hearing, fitness, or over-the-counter medications are actually accessible if offered. Some network providers of these services may be farther away than anticipated, including in neighboring states, so only factor them into your decision if you feel they are usable.
5. Know that premium costs aren’t the only out-of-pocket costs you may face. Medicare Advantage plans may have co-pays or cost-sharing that differ from Original Medicare.
6. Call your preferred healthcare providers and facilities to understand if your prospective plan contracts with them. You may experience additional out-of-pocket expenses, service denial, or referral requirements if providers are considered out of network.
7. Check if a prospective plan is a Health Maintenance Organization (HMO) or Preferred Provider Organization (PPO). HMO plans require healthcare to be completed by a provider contracted with the plan’s network, otherwise the consumer will need a referral. PPO plans have both in-network and out of network providers and facilities, with consumer costs differing based on the network. HMO and PPO plans are not Medicare Supplement Plans, and may have out-of-pocket costs each visit.
8. Check if the plan provides Prescription Drug (Part D) coverage that meets your needs.
9. Be aware that in many cases, enrollment locks a person into a plan for the full upcoming calendar year.
10. Scrutinize any contact carefully during Medicare Open Enrollment to ensure it is from a known, credible source. Commercials, cold calls, and other contact may be scams or can provide deliberately misleading information about a plan.

About the Delaware Medicare Assistance Bureau

The Delaware Medicare Assistance Bureau provides free one-on-one health insurance counseling for people eligible for Medicare. Residents can call DMAB at 1 (800) 336-9500 or (302) 674-7364 to set up a free, confidential session or visit the DMAB website for important educational resources. Counselors can assist with Medicare, Medicare Advantage, Medigap (Medicare Supplement Insurance), long-term care insurance, billing issues, prescription savings, and much more. DMAB has a Virtual Welcome to Medicare Seminar helpful for new and soon-to-be Medicare beneficiaries and those exploring enrollment changes.

The department does not manage benefits offered to state employees, pensioners, or spouses. While DMAB can counsel Medicare-eligible state plan members, questions about the state’s proposed Medicare Advantage plan or transition, they should first contact the Office of Pensions at 1 (800) 722-7300 and explore their online guide.

Medicare Advantage plans are regulated at the federal level, though the Insurance Commissioner and his peers are advocating for increased state regulatory authority.

Be aware of non-compliant alternative health plans

More than 37,500 Delaware agents, policyholders, beneficiaries impacted

Following the receipt of additional data breach reports from insurers, including those related to the breach of the MOVEit file transfer services system used by third-party vendors, the Delaware Department of Insurance is updating this consumer alert and will be updating the online posting as information is received.

Residents who may be agents, policyholders, or beneficiaries of the following insurers should be aware that their personal data may have been compromised, and should watch for contact:

As shared during a June 26 consumer alert, the MOVEit data breach and other data security events trigger Delaware’s Insurance Data Security Act, which in addition to proactive data security measures and other requirements, mandates the following occur:

• Investigation of a cybersecurity event and correction of compromised information systems
• Detailed reporting to the Insurance Commissioner
• Notification to consumers within 60 days, except in cases where federal law or law enforcement agencies require or request modified timelines
  Consumers must be provided credit monitoring services at no cost for a period of at least one year in addition to receiving information regarding freezing one’s credit

Insurance Commissioner Trinidad Navarro encouraged consumers to protect their identities and reassured residents that the breach will be investigated thoroughly. “I take any breach of personal information very seriously, and encourage consumers affected to utilize the identity and credit protection services offered. Our Market Conduct staff, likely alongside investigators across the country, will work to investigate the situation and assess if appropriate safeguards were in place for the handling of data.”

The department worked with the General Assembly in 2019 to pass the Insurance Data Security Act and was one of the first states to implement the National Association of Insurance Commissioner’s model law. The law is an effort to fortify security measures and protect consumer data. It requires insurance companies and their vendors to follow certain data protection and breach protocols, including notification. The department may investigate violations of the Act and levy penalties accordingly.

Consumers should consider freezing their credit report due to the incident.

[Last Update: August 16, 2023 – Insurer and Producer added; Impact counts amended]

Insureds, agents, and beneficiaries should watch for notification

On June 16, PBI Research Services, a third-party vendor for Genworth Financial, disclosed a data breach that impacted the personal information of an estimated 2.5-2.7 million individuals, including about 8,000 Delaware residents. At this time, the company has indicated that the potentially compromised information may include agents, policyholders, and beneficiaries’ data including names, contact information, dates of birth, social security numbers, and policy numbers. Consumers are urged to be vigilant in protecting their data, as beneficiaries may not be aware of policies that contain their information, particularly in regard to life insurance benefits.

This event triggers Delaware’s Insurance Data Security Act, which in addition to proactive data security measures and other requirements, mandates the following now occur:

• Investigation of a cybersecurity event and correction of compromised information systems
• Detailed reporting to the Insurance Commissioner
• Notification to consumers within 60 days, except in cases where federal law or law enforcement agencies require or request modified timelines
• Consumers must be provided credit monitoring services at no cost for a period of at least one year in addition to receiving information regarding freezing one’s credit

Insurance Commissioner Trinidad Navarro encouraged consumers to protect their identities and reassured residents that the breach will be investigated thoroughly.

“I take any breach of personal information very seriously, and encourage consumers affected to utilize the identity and credit protection services offered. Our Market Conduct staff, likely alongside investigators across the country, will work to investigate the situation and assess if appropriate safeguards were in place for the handling of data.”

The department has received a relevant policyholder list, including consumers of long-term care, life insurance, and annuities lines, which investigators may use to check company compliance with the Act. Consumer service representatives may also use this information to help concerned agents, policyholders, and beneficiaries who contact the office.

This incident was a part of a significant cybersecurity attack involving the MOVEit file transfer system, with the breach likely occurring May 29-30 before a corrective action was implemented on June 2. The department has not at this time been notified of additional insurer or insured information being accessed as part of this breach.

The department worked with the General Assembly in 2019 to pass the Insurance Data Security Act and was one of the first states to implement the National Association of Insurance Commissioner’s model law. The law is an effort to fortify security measures and protect consumer data. It requires insurance companies and their vendors to follow certain data protection and breach protocols, including notification. The department may investigate violations of the Act and levy penalties accordingly.

Consumers can visit Genworth.com/MOVEit for updates and should consider freezing their credit report due to the incident.

Free one-on-one counseling saved consumers more than a half million dollars in 2021

As the October 15 to December 7 Medicare Open Enrollment quickly approaches, the Delaware Department of Insurance and its Medicare Assistance Bureau (DMAB) are sharing their annual consumer information announcement.

During Medicare Open Enrollment, consumers can join, switch, or drop a Medicare Prescription Drug Plan (Part D) or Medicare Advantage Plan. DMAB’s free, confidential, unbiased one-on-one assistance can help residents determine if making a coverage change is the right choice. In 2021, DMAB provided more than 5,500 counseling sessions, saving beneficiaries a combined $521,000.

The department does not manage benefits offered to state employees, pensioners, or spouses. While DMAB can counsel Medicare-eligible state plan members, questions about the state’s Medicare Advantage plan or transition should first contact the Office of Pensions at 1 (800) 722-7300 and explore their online guide. Medicare Advantage plans themselves are regulated at the federal level, though the Insurance Commissioner and his peers are advocating for increased state regulatory authority.

“Our Medicare Assistance Bureau is an important resource for residents. Many Delawareans face confusion when it comes to Medicare Advantage plans, and as Open Enrollment approaches, they will begin to see an influx of television commercials and be targeted by a lot of other enrollment marketing,” said Insurance Commissioner Trinidad Navarro.

DMAB Director Lakia Turner agreed. “Many beneficiaries enroll in plans based on marketing, without fully assessing the plan’s total costs or asking key questions about their coverage, and ultimately that means they then experience unexpected issues. We work hard to inform consumers on the front-end to help ensure they get the right plan from the start.” Commissioner Navarro and Director Turner recently shared enrollment advice on Delmarva Life.

Ten Tips for a Successful Medicare Open Enrollment

1. Know that enrolling in a Medicare Advantage plan means it becomes your primary coverage. Original Medicare will no longer pay for services. You will receive a new ID card from the new plan, and should store your Original Medicare card in a safe place.
2. When moving from Original Medicare to a Medicare Advantage plan, be prepared to pay both a monthly Medicare Advantage premium and a monthly Medicare Part B premium.
3. Medicare Advantage plans do not automatically give you “more money in your Social Security check every month.” To qualify, you must be eligible for the Medicare Savings Program by having an income below Medicaid limits.
4. Check that additional benefits, like dental, vision, hearing, fitness, or over-the-counter medications are actually accessible if offered. Some network providers of these services may be farther away than anticipated, including in neighboring states, so only factor them into your decision if you feel they are usable.
5. Know that premium costs aren’t the only out-of-pocket costs you may face. Medicare Advantage plans may have co-pays or cost-sharing that differ from Original Medicare.
6. Call your preferred healthcare providers and facilities to understand if your prospective plan contracts with them. You may experience additional out-of-pocket expenses, service denial, or referral requirements if providers are considered out of network.
7. Check if a prospective plan is a Health Maintenance Organization (HMO) or Preferred Provider Organization (PPO). HMO plans require healthcare to be completed by a provider contracted with the plan’s network, otherwise the consumer will need a referral. PPO plans have both in-network and out of network providers and facilities, with consumer costs differing based on the network. HMO and PPO plans are not Medicare Supplement Plans, and may have out-of-pocket costs each visit.
8. Check if the plan provides Prescription Drug (Part D) coverage that meets your needs.
9. Be aware that in many cases, enrollment locks a person into a plan for the full upcoming calendar year.
10. Scrutinize any contact carefully during Medicare Open Enrollment to ensure it is from a known, credible source. Commercials, cold calls, and other contact may be scams or can provide deliberately misleading information about a plan.

About the Delaware Medicare Assistance Bureau

The Delaware Medicare Assistance Bureau provides free one-on-one health insurance counseling for people eligible for Medicare. Residents can call DMAB at 1 (800) 336-9500 or (302) 674-7364 to set up a free, confidential session or visit the DMAB website for important educational resources. Counselors can assist with Medicare, Medicare Advantage, Medigap (Medicare Supplement Insurance), long term care insurance, billing issues, prescription savings, and much more. DMAB has a Virtual Welcome to Medicare Seminar helpful for new and soon-to-be Medicare beneficiaries and those exploring enrollment changes.

Be aware of non-compliant alternative health plans

Devices being used to treat chronic conditions, COVID-19

Delaware Insurance Commissioner Trinidad Navarro has released a consumer alert for users of respiratory devices manufactured by Philips. An estimated 4 million Philips Continuous Positive Airway Pressure (CPAP) and Bi-Level Positive Airway Pressure (BiPAP or BiLevel PAP) devices, as well as mechanical ventilators manufactured before April 26, 2021 are being recalled due to potential health risks associated with the sound abatement foam in the devices that may degrade and be inhaled, and could contain cancer-causing chemicals.

The Delaware Department of Insurance is issuing this notice after the company’s recall notification and lack of communication to consumers and facilities has caused concern, particularly due to the necessity of devices in the treatment of both chronic conditions as well as facility-based usage. Recalled devices include those listed as providing respiratory treatment or support for COVID-19 patients.

While the recall notice urges immediate discontinuation of device use if possible, some individuals require the use of CPAP, BiPAP, and ventilator devices and may face serious medical issues, including the possibility of death, if they do not have access to a machine. Residents using these medically necessary devices should contact their physician to discuss the best path forward for their individual needs and register in the Philips recall system online or call 1-877-907-7508 to begin a claim for replacement or financial restitution. Users should not make any changes to their equipment or treatment plan without discussing with a physician. Doctors are encouraged to proactively communicate with their patients, and facilities should check all machines.

At this time, the company has not provided a replacement or repair timeline after issuing notice in June that the sound abatement foam in these devices may degrade, be ingested, and create additional respiratory problems, and could be releasing carcinogenic or otherwise hazardous chemicals into the air pathway. The Department of Insurance encourages insurers to assist policyholders in any way possible during this situation.