BURLINGTON, Vt. (WCAX) – Tens of thousands of Vermont seniors are scrambling to find new health insurance coverage after their privately-run Medicare Advantage plans are no longer being offered next year.
You’ve likely seen the advertisements on TV. Those 65 and older can enter into the federal Medicare program and buy supplemental plans for prescription drug coverage. Or, seniors can get Medicare Advantage plans which are similar to Medicare but offer other benefits like vision, dental, prescription drugs, and even gym memberships.
“That, for many people, becomes the reason to join them,” said Meg Burmeister with the Northeast Kingdom Council on Aging. She says those plans have limitations on which providers are in-network.
But big changes are coming. About 6,000 Vermonters lost care when MVP Health Care last month said they would no longer insure in the state. Then, 1,500 more lost coverage, when Wellcare followed suit a few days later. WCAX has also learned another plan through United Health Care will also end their plans next year, but officials won’t tell us how many people are impacted.
Medicare Advantage plans are facing headwinds in several states. Legislation that caps what consumers pay out of pocket is shifting the cost onto insurance companies, and Vermont’s aging demographic is becoming more expensive for the companies to cover.
“That overarching goal of trying to solve the drivers in health care costs is going to front of mind for the state for some time because they do have these market implications,” said Vt Financial Regulation Commissioner Kevin Gaffney.
As Vermont’s open enrollment period begins, officials estimate up to 25,000 seniors will need to buy new plans or switch back to Medicare. “It’s really important, there’s a lot of decisions to be made, and when those decisions have to be made depends on what you choose,” Gaffney said.
For those losing coverage, there are a number of resources to help make the right decision. State health coordinators will help explain the different plans depending on age, health condition, prescription drug needs, and whether your provider is in-network.
“We take a look with them at the medications, the kinds of services they’re using in the health care realm, what their needs are. And the next layer out is looking at some of the geographic issues,” Burmeister said.
Open enrollment for Medicare is underway right now and runs through December 1.
The Senior Help Line phone number is: 800-642-5119