In Colorado, Medicare patients are facing significant changes as several insurance companies discontinue Medicare Advantage plans in the state, including the Denver Metro area. According to Mary Jo Heins, who has worked with Medicare for 15 years, “In my 15 years of doing Medicare, this is unprecedented. Insurance companies are reeling and terminating/discontinuing Medicare Advantage plans.”
Medicare Advantage plans have service areas determined by county of residence. Recently, patients have begun receiving Service Area Reductions (SAR) letters from three insurers notifying them that their plans will be terminated in Colorado. Heins described the situation as “unprecedented.”
With Open Enrollment beginning on October 15, Heins advises patients to carefully consider their options. For those who do not visit doctors frequently, a Medicare Advantage plan may still be suitable. She suggests using a Medicare agent or visiting medicare.gov for assistance.
For individuals with chronic medical conditions, switching to a supplement plan may be beneficial due to SAR-triggered guaranteed issue rights—meaning no medical underwriting is required for enrollment. The monthly premium for such supplements averages around $225 but varies based on factors like age, gender, zip code, and smoking status; this cost is in addition to the standard Part B premium.
Heins outlined several reasons why patients with ongoing health needs might prefer a supplement: “Super low medical out of pocket. ($300/year vs $4000/year on Med Adv). If you are maxxing out your Med Adv out of pocket, the total costs (premium + copays) are likely to be lower on a supplement.” Additional benefits include fewer prior authorizations and access to any provider nationwide who accepts Medicare A&B without network restrictions.
She emphasized that “this window to get a supplement without medical underwriting really is a ‘once in a lifetime’ opportunity for someone with ongoing, expensive medical concerns.” However, she also noted the downside: “Downside, of course, is a $225/month premium vs $0 for Medicare Advantage.”
Patients affected by these changes can contact Mary Jo Heins at 720.484.6946 (voice only – no text) for more information.
