Many Medicare patients in Colorado are receiving Service Area Reduction (SAR) letters as three insurance companies have announced they will terminate certain Medicare Advantage plans, including those in 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 operate within specific service areas based on the patient’s county of residence. The recent SAR notifications mean that affected patients must consider new coverage options during the upcoming Open Enrollment period starting October 15.
Heins advised that individuals who do not frequently visit doctors may still find a Medicare Advantage plan to be the best fit for their health needs and finances. She suggested using a Medicare agent or visiting medicare.gov for assistance.
For those with chronic medical conditions, Heins recommended considering a supplement plan. “This SAR opens up a guaranteed issue (no medical underwriting required) to move to a supplement,” she said. The average monthly premium for such supplements is about $225 but varies depending on 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 medical needs might benefit from switching to 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.” She also noted that supplements require fewer prior authorizations and allow access to any provider nationwide who accepts Medicare A&B—eliminating concerns about network disputes between insurers and doctors.
“This window to get a supplement without medical underwriting really is a ‘once in a lifetime’ opportunity for someone with ongoing, expensive medical concerns,” Heins emphasized.
However, she cautioned that there is an increased monthly premium compared to some zero-premium Medicare Advantage plans: “Downside, of course, is a $225/month premium vs $0 for Medicare Advantage.”
For further information or questions regarding these changes and enrollment options, Mary Jo Heins can be reached at 720.484.6946 (voice only).
