A House Republican wants to let Medicare program managers put people who age into Medicare in the cheapest available Medicare Advantage plan automatically, rather than letting those people stick solely with "original Medicare."
People who ended up in the default Medicare Advantage plans and missed their chance to opt out might have to wait three years to change their coverage.
Rep. David Schweikert, R-Ariz., has included the Medicare Advantage plan automatic enrollment proposal in H.R. 3467.
The bill is under the jurisdiction of the House Ways and Means Committee and the House Energy and Commerce Committee. It has no co-sponsors.
What it means: The Schweikert proposal could protect some consumers from huge bills for their share of the cost of care for strokes, heart attacks or cancer.
But the proposal could also keep clients who are bad with Medicare paperwork from being able to choose their supplemental coverage.
Because Medicare Advantage plans often use limited provider networks to hold costs down, the Schweikert proposal could also end up making some of the people automatically enrolled into plans change their doctors.
Medicare basics: Original Medicare — the Medicare Part A hospitalization insurance program and the Medicare Part B physician and outpatient hospital services insurance program — exposes enrollees to many deductibles, co-payments and coinsurance bills.
Some people who turn 65 fail to take any active steps at all. They usually have "free" Medicare Part A coverage. They will be able to sign up for Part B later, during an annual enrollment period, but likely will have to pay more for their Part B premiums.
Low-income people with complete original Medicare coverage may also get help with out-of-pocket costs from special government programs.
About 35 million of the 69 million Medicare enrollees buy Medicare Advantage plans. Medicare Advantage plans are regulated by the federal government, look like soup-to-nuts replacements for original Medicare, and often take an active approach to managing enrollees' care.
Roughly 14 million enrollees, including many affluent people who work with financial professionals, buy Medicare supplement insurance policies, or Medigap policies. Medigap policies are regulated by the states, tend to have higher premiums and let the insureds see all health care providers who take Medicare.
Schweikert's bill: Schweikert is calling for Medicare program managers to put an individual who turns 65 into the cheapest Medicare Advantage plan in the individual's community for three years.
Officials would have to give the individual a chance to opt out.
The bill does not say what would happen if an enrollee who was auto-enrolled in a Medicare Advantage plan failed to pay the plan premiums.
The bill also does not talk about the impact of the program on Medicare Advantage plan providers with premiums higher than the premiums of the highest cost plans.
Today, many Medicare Advantage plans in some markets have premiums. The Schweikert bill calls for program managers to develop a process for deciding how to handle situations in which the lowest available Medicare Advantage plan price in a market is offered by two or more plans.
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