Senior lady outside
September 29, 2016 | by The Polyclinic

Don’t throw away your mail just yet. Learn more about a special Medicare provision allowing private health insurance companies to automatically enroll eligible Medicare members into Medicare Advantage. Stay informed and utilize Medicare resources to choose a plan best for you. Below is information from Connexion Insurance Solutions to help you understand this provision.

What is seamless conversion?

Medicare rules allow Medicare Advantage [MA] plan sponsors to “develop processes to provide seamless enrollment in an MA plan for newly Medicare Advantage eligible individuals who are currently enrolled in other health plans offered by the MA organization (such as commercial or Medicaid plans) at the time of their conversion to Medicare.”

How can I avoid being automatically enrolled in a Medicare Advantage plan that I didn’t sign up for?

Be attentive. If you are enrolled in a health plan offered by an MA organization at the time you become eligible for Medicare, be aware of any changes.

MA organizations are required to send you a notice within 60 days of the conversion if you are auto-enrolled into a MA plan. The notice must contain instructions on how to opt-out or decline the seamless conversion.

Be on the lookout for written notice regarding conversion and carefully consider whether to opt-out of the MA plan.

Content contributed by Lance Ghiorso, senior account executive, Connexion Insurance Solutions.
Connexion Insurance Solutions is an independent broker agency that provides Polyclinic patients with resources and support.

[1] Medicare Managed Care Manual (MMCM) (CMS Pub. 100-16), Chapter 2, section 40.1.4; Kaiser Health News and