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Anthem Blue Cross Terminates 6 PPO California Medicare Plans

Anthem Terminates 6 PPO California Medicare Plans

My goodness have we been receiving a ton of phone calls on this.  Many of you are currently enrolled in the Anthem Blue local PPO plan called the Medicare Preferred Standard and previously known as the Freedom Blue Plan. You should have received a letter in late October letting you know that your plan is terminating as of December 31; Anthem is not renewing their contract with Medicare for 2013. And yes, the letter arrived 3 weeks past the October 2 deadline for Anthem to notify their enrollees of any non-renewal for 2013. What makes this situation so confusing for beneficiaries is that Anthem is offering a “new” local PPO plan in 2013 with the exact same name just a different ID number. The difference? Higher monthly premiums and a higher MOOP  (Max Out Of Pocket).

The affected counties are: Sacramento, San Diego, San Francisco, San Mateo, Sonoma and Ventura. Unfortunately those of you on this plan need to actively choose  new coverage for the coming year. Since Anthem’s 2012 local PPO is not renewing, members have a Special Election Period (SEP) to join a different Medicare Advantage plan (between December 8 and February 28).

Does this cloud have a silver lining? Yes, if you have ever wanted to switch to Original Medicare with a Medigap Supplement NOW is the time. You have  a guaranteed issue right to by a Medigap policy, which means no medical underwriting.

Your option:

Choose a different California Medicare Advantage plan. This change can be made during the Annual Election Period (October 15 – December 7), or during their SEP (December 8 – February 28). So the window is actually October 15 through February 28th. However the plan does end on December 31st so if someone waited to make a decision until after January 1st there would be a gap in coverage. Enrollment in the 2013 PPO will not be automatic.

Original Medicare with a Supplement. Beneficiaries can go back to Original Medicare by enrolling in a stand-alone Part D plan during the Annual Election Period (AEP) or SEP. They also have the opportunity to use their guaranteed issue status to purchase a Medicare Supplement.

 The chart below lists the 6 affected counties.

Please feel free to call us with any questions at 1-888-806-3299

County 2012 plan no. 2013 plan no. 2012 premium 2013 premium 2012 MOOP 2013 MOOP
Sacramento H8552-005 H8552-011 $131 $203 $3,400 $4,000
San Diego H8552-001 H8552-006 $0 $70 $3,400 $4,500
San Francisco H8552-002 H8552-008 $40 $85 $3,400 $3,800
San Mateo H8552-003 H8552-011 $106 $203 $3,400 $4,000
Sonoma H8552-002 H8552-009 $40 $105 $3,400 $4,400
Ventura H8552-001 H8552-007 $0 $41 $3,400 $4,500

By Dave Wilson

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