There’s a major marketing campaign under way for Access Health CT, the new insurance marketplace opening Oct. 1 as part of the federal health reform law.
But some officials and others who work with seniors are trying to get out a separate message: If you’re on Medicare, the new marketplace is not for you.
“There is a lot of confusion,” said Andrea Callow, a policy attorney at Center for Medicare Advocacy.
Her message to Medicare beneficiaries: “Stay away from the marketplace.”
Lt. Gov. Nancy Wyman, who heads the board that oversees Access Health, said she often gets questions from people on Medicare, wondering what they should do.
“We have to make sure that people understand that if you’re on Medicare, your health care is not being touched,” she said during a meeting of the Access Health board last week.
A recent survey suggests there’s room for education. One in five seniors said they think they can enroll in medical and prescription drug plans through the new marketplaces, known as exchanges, according to the survey, commissioned by pharmacy benefits management company Express Scripts.
And 17 percent of those surveyed said they believe the exchanges could replace their Medicare plans.
Both beliefs are incorrect.
Part of the confusion might reflect timing. The exchanges open Oct. 1 to sell private insurance plans to small employers and people who buy coverage on their own.
Two weeks later, on Oct. 15, the open enrollment period will begin for Medicare Advantage plans and Medicare Part D prescription drug plans.
Like Wyman, U.S. Rep. Joe Courtney, D-2nd District, said he’s been getting questions about the exchange from constituents with Medicare. A recent email newsletter he sent to seniors included what he called “our flashing, highlighted message”: For people with Medicare, “the exchange is a nonevent.”
“We just want to keep people in separate lanes of traffic, and make sure they’re not getting misdirected,” he said.
Access Health will sell insurance policies referred to as “qualified health plans.” It won’t sell Medicare Part D coverage, Medicare Advantage plans or supplemental policies for people with Medicare.
Many exchange customers are expected to qualify for federal tax credits to discount their premium costs. But those subsidies are not available to people with Medicare — with two exceptions: People who qualify for Medicare because of end-stage renal failure and people who don’t have enough work history to qualify for premium-free Medicare Part A.
“Otherwise, people with Medicare can never get tax credits, and in general, a qualified health plan through the exchange is really not going to be as good for them as, say, a standard Medigap policy,” Callow said.
In some states, Callow said, people with Medicare who need help paying for their coverage could access Medicare savings programs through the exchanges. But in Connecticut, people with Medicare who are seeking those programs would apply through the state Department of Social Services.
Whether the new marketplace will affect how they buy insurance is a major question among seniors, said Claudio Gualtieri, associate state director for advocacy at AARP Connecticut, which has been hosting events and telephone town halls to talk about Medicare.
People with Medicare “should be confident that if they shopped for a Medicare Advantage plan in the past, a Part D plan, those traditional processes are still in place, and they should proceed as normal,” he said.
The federal Centers for Medicare and Medicaid Services issued a fact sheet last month that notes that it’s illegal to sell someone an exchange insurance plan to a person he or she knows has Medicare.
Referring to exchanges as “the Marketplace,” it noted that, “The Marketplace won’t have any effect on your Medicare coverage.”
People with questions can call CHOICES at 1-800-994-9422 to speak with a trained counselor. The program offers information for people 60 and older and those with disabilities.
Connecticut residents can also call the Center for Medicare Advocacy at 860-456-7790.
Medicare fact sheet (back to story)