Series of changes come after reports of Highmark premium notice errors

Dozens of complaints have been registered with the Delaware Department of Insurance after Highmark Blue Cross Blue Shield processed hundreds of customer birthdates incorrectly, leading to notices of higher July 1 premiums for many Medicare Supplement participants, including those in the company’s Medigap Blue Plan. Department staff have taken action to ensure that these errors are corrected, and impacted consumers will be notified. Additionally, the company has agreed to reduce their July 1 rate increase significantly.

“Medicare Supplement customers should continue to feel secure knowing that the Department of Insurance is working to ensure this problem is corrected quickly,” said Insurance Commissioner Trinidad Navarro. “As we worked to resolve this issue with Highmark, the company has also agreed to cut its average premium increase in half due to the reduction in claims activity throughout the coronavirus pandemic.”

Initially pursued prior to the advent of COVID-19, Highmark planned to increase Medicare Supplement premiums an average of 7.2%, the first increase on these plans in several years. The increase was justified for a normal plan year by independent actuaries, but the Department of Insurance and Highmark agree that due to the pandemic, these estimates no longer apply due to low utilization and fewer claims being paid by the company. Highmark has agreed to reduce the premium increase to an average of 3.5%. Consumers can expect to receive additional information in the mail.

The Department of Insurance Market Conduct investigators are monitoring the resolution of this issue, will work with the company to explore the causes of the error as well as any other instances that it may have occurred, and will review measures taken to prevent billing issues in the future.

Medicare Supplement plan premiums are, in part, based on the age of the participant. While the department has not approved a rate increase for Highmark’s plan in several years, participants may have had premium adjustments due to their birthday. These age-based increases are generally very low, are included in the consumer’s policy, and are not reviewed by the department. An error in the birthdate of a consumer can result in an increase, as occurred within the Highmark plan. Plan participants are urged to review the date of birth that is recorded with their insurer.

Contact the Delaware Department of Insurance Consumer Services team to report insurance issues by visiting insurance.delaware.gov, emailing consumer@delaware.gov, or calling (302) 674-7300.

Medicare Part D Open Enrollment Ends December 7

Dover, DE – Insurance Commissioner Karen Weldin Stewart reminds Delawareans that Medicare’s annual open enrollment period continues until December 7. If you’re a Medicare recipient, now is the time to review the options for 2017 Part D prescription drug plans. Medicare recipients can also switch their Medicare Advantage plans during the open enrollment period, or they can return to Original Medicare if they are no longer satisfied with their Medicare Advantage plan. Plans change each year, so even if a plan worked well for an individual in 2016, it doesn’t mean that it will be the most cost-effective plan for 2017. Luckily, the Delaware Medicare Assistance Bureau (DMAB) exists to assist Delaware’s Medicare recipients with their questions related to Medicare, Medicare Advantage and prescription drug plans.

According to the Kaiser Family Foundation (KFF), only about 10 percent of Medicare recipients switch Medicare Advantage plans each year and approximately 13 percent change their Part D plans. The KFF found that the average Medicare Advantage enrollee saved $190 annually on their premiums and lowered their out-of-pocket expenses by about $400 when they switched plans during the 2014 open enrollment period, the most recent data available.

Just as with any insurance policy, consumers should consider more than premiums alone when making a decision about a drug plan or Medicare Advantage policy. It may be short sighted to select a plan based on the lowest premium alone; it’s especially important to consider the plan’s deductible, co-pays and co-insurance. By now, Medicare recipients with a Part D plan should have received an Annual Notice of Change from their insurer. This document will list upcoming changes to your existing coverage, such as the cost of premiums and co-pays, and show a comparison of the plan between this year and next.

It is common for Medicare Part D plans to change their formularies and the rules under which they are covered from year to year. A formulary is the list of medications that a plan covers. For example, a plan might decide to limit the quantity of a medication or require a prior authorization before they will cover the drug. That likely means additional steps and paperwork are required before you can get a medication that your physician ordered. Changes in plans may require you try a less expensive alternative to the drug prescribed by your doctor. The plan might also drop coverage of a medication altogether; that’s why reviewing your options each year is so important.

Most Medicare Advantage plans include prescription drug coverage, which should be checked in the same way that you would review a stand-alone drug plan. Medicare Advantage plans also can make changes to the list of healthcare providers considered in-network at any time of the year. The annual enrollment period provides the opportunity for enrollees to review the list of included providers, to make sure they will continue to meet your needs.

DMAB’s staff and trained volunteers are available to meet with Medicare recipients at various locations throughout each county to review residents’ current prescriptions and options in-person. Please call 1-800-336-9500 to make an appointment to review your drug plan options; don’t wait until the final week to call. If you have an appointment for a drug plan review be sure to bring a complete list of the medications (and all of the specific details about the drugs, such as dosage and how often you take them)

If you’re satisfied that your current coverage will continue to meet your needs for next year, you don’t need to do anything. For more information about the Delaware Medicare Assistance Bureau and the services it provides, visit www.delawareinsurance.gov/DMAB or call 1-800-336-9500. DMAB is a free public service of the Delaware Department of Insurance that provides unbiased Medicare counseling to Medicare recipients of all ages.

DMAB is Delaware’s State Health Insurance Assistance Program (SHIP) and is funded in part by a grant from the U.S. Department of Health & Human Services’ Administration for Community Living.

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Delaware Department of Insurance: “Protecting Delawareans through regulation and education while providing oversight of the insurance industry to best serve the public.”

DMAB Releases 2015 Medicare Supplement Insurance Guide for Delaware Medicare Recipients

​Dover, DE-The Delaware Medicare Assistance Bureau (DMAB) is pleased to announce that the 2015 Delaware Medicare Supplement Insurance Shopper’s Guide is now available in print. This popular guide is updated annually and includes price comparisons and toll-free telephone numbers for all Medigap policies sold in Delaware. Medicare supplement insurance, also called Medigap, is private insurance designed to supplement your Medicare coverage. The guide is also available at any time on the DMAB website, www.delawareinsurance.gov/DMAB.

While reviewing the rates on the Medigap plans in the 2015 guide, keep in mind that your gender and status as a smoker/non-smoker will directly affect your premiums. Please also be aware that listed rates may change during the year. It is recommended that you contact at least two or three companies directly and seek quotes to find the plan that provides you with the best value. It is important to note that the best time to purchase a Medigap policy is during your 6-month Medigap open enrollment.  This period automatically starts the month you’re 65 or older and enrolled in Medicare Part B, and once it’s over, you can’t get it again.  After six months have passed, companies selling these plans are not required to sell you a policy and may underwrite you.

DMAB was formerly known as ELDERinfo and still provides the same helpful services to Delaware’s Medicare recipients. While Medicare is a federal program, DMAB can help Delawareans with Medicare make sense of the complex health insurance system. All DMAB services are completely free. DMAB staff can assist with questions related to Medicare, Medigap, long-term care, and related financial assistance programs. Call DMAB at 1-800-336-9500 to receive a guide or to get help with your Medicare questions. Additional resources related to Medicare are available at  www.delawareinsurance.gov/dmab.

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Contact:  Jerry Grant

(302) 674-7303

DOVER, DE-Insurance Commissioner Karen Weldin Stewart recommends that all Medicare recipients under age 65 in Delaware review their Medigap (Medicare supplement insurance) coverage options before the first deadline to purchase a policy occurs on June 30, 2014. With the passage of Senate Bill 42 (SB 42) in 2013 there are new Medigap options available to disabled Medicare recipients under 65 but time to purchase the plans is limited. SB 42 became effective on January 1, 2014, and requires insurance companies that offer Medigap policies to people 65 and older to also offer the same policies to anyone under the age of 65 who qualifies for Medicare due to a disability.

Commissioner Stewart noted, “Existing Medicare beneficiaries under the age of 65 who were receiving Medicare benefits prior to January 1, 2014, only have until June 30, 2014 to purchase a Medigap plan under SB42. Going forward, newly enrolled Medicare recipients under age 65 have six months to purchase one of these plans, from the time benefits begin. It’s very important that these individuals not wait until the last minute to compare plans or sign up, if they are interested. That’s why I encourage anyone with Medicare due to a disability under age 65 to call the Delaware Medicare Assistance Bureau at 1-800-336-9500 today to get more information before their time to act expires.”

The Delaware Medicare Assistance Bureau, DMAB, website, www.delawareinsurance.gov/DMAB, also has information about Medigap plans, including the 2014 Delaware Medicare Supplement Insurance Shopper’s Guide, which was released in late May.

As of September 2013, Delaware was home to 167,538 Medicare recipients which includes almost 28,000 individuals who are under the age of 65 and on Medicare due to disability.

What is Medigap (also known as ‘Medicare supplement insurance’)? According to Medicare.gov, “A Medicare supplement (Medigap) insurance, sold by private companies, can help pay some of the health care costs that Original Medicare doesn’t cover, like copayments, coinsurance, and deductibles.

Some Medigap policies also offer coverage for services that Original Medicare doesn’t cover, like medical care when you travel outside the U.S. If you have Original Medicare and you buy a Medigap policy, Medicare will pay its share of the Medicare-approved amount for covered health care costs. Then your Medigap policy pays its share.”

Lakia Turner, Director of the Delaware Medicare Assistance Bureau said, “DMAB is a free resource for Medicare recipients who have questions about Medigap plans, prescription drug coverage, Medicare Advantage, financial assistance programs and anything else related to Medicare. Our staff and volunteers are available to help over the phone or in-person at numerous locations throughout the state. We encourage disabled Medicare recipients to call DMAB today to get more information about Medigap policies before time runs out.”

The Delaware Medicare Assistance Bureau (DMAB) is Delaware’s State Health Insurance Assistance Program (SHIP) and is funded in part by a grant from the federal Administration for Community Living. DMAB accepts walk-ins only at their office in Dover from 8:30 am to 4:00 pm. The DMAB office is located at the Delaware Department of Insurance at 841 Silver Lake Blvd., Dover, DE 19904. Please call 1-800-336-9500 to get help over the phone or to make an appointment with a DMAB volunteer at a counseling site near you. Visit www.delawareinsurance.gov/DMAB for more info.

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Delaware Department of Insurance: “Protecting Delawareans through regulation and education while providing oversight of the insurance industry to best serve the public.”

DMAB Medigap SB 42 Poster