Q: My parents were quoted $48 a month for Simplete 3 as their 2019 Medicare plan from Health Alliance. A week later, they were contacted because the insurance rep mistakenly thought they were in Champaign County, and therefore quoted the wrong plan.
Because they live in Douglas County, they have to go with the Health Alliance Medicare POS 10 RX to get the same benefits as the aforementioned plan, but at a monthly rate of $155.
This is a significant difference for a mere 10 miles south of the county line. It's not easy for a couple living on Social Security, and that $214 difference (for both) is significant.
What are the reasons for plans to be so different by an adjoining county? And can my parents appeal this?
A: Health Alliance spokeswoman LAURA MABRY said Medicare Advantage carriers often offer different plans in different areas, though most Health Alliance Medicare Advantage plans and premiums are the same in Champaign County and adjacent counties.
In this case, the 2019 "Simplete" plans — with lower premiums connected to seeing health care providers at Carle, Christie Clinic and Kirby Medical Center — are only available in Champaign, Piatt and Vermilion counties, she said.
"These plans are unique to the health care providers that partner with Health Alliance to offer them, so they are offered where those providers have services available," she said.
Mabry advised working with a Health Alliance service representative to find the best plan available for your parents. You can still make a change over the upcoming three months, even though the annual election period for 2019 Medicare Advantage plans has ended.
Starting this year, Medicare is offering a new open enrollment period from Jan. 1 to March 31 to allow people to change from one Medicare Advantage plan to another.
According to the Centers for Medicare and Medicaid Services:
"The 21st Century Cures Act eliminates the existing MA (Medicare Advantage) disenrollment period that currently takes place from Jan. 1st through Feb. 14th of every year and, effective for 2019, replaces it with a new Medicare Advantage open enrollment period (OEP) that will take place from Jan. 1 through March 31 annually.
"The new OEP allows individuals enrolled in an MA plan, including newly MA-eligible individuals, to make a one-time election to go to another MA plan or original Medicare. Individuals using the OEP to make a change may make a coordinating change to add or drop Part D coverage."