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On July 2, 2009, the
Centers for Medicare & Medicaid Services sent the following email to
State Health Insurance (SHIP) Programs:
WellPoint disclosed that approximately
4600 beneficiaries that enrolled in Wellpoint at the end of last
year were not properly informed that their plan was being terminated
in 2009. As a result, these individuals are eligible for a special
enrollment period (SEP) during July, August, and September 2009
allowing them to enroll in another health plan or prescription drug
plan. Beneficiaries eligible for the SEP will receive the attached
letter shortly after July 6, 2009 and if they are interested in the
SEP, they should contact 1-800 MEDICARE.
With the email came the
template of the letter to be sent to the affected Wellpoint
subscribers, as well as a
spreadsheet showing the number of affected beneficiaries by state.
The SEP begins the month they receive the letter - presumably July -
and runs for two additional months.
The Center for Medicare
Advocacy made a trial call to 1-800 MEDICARE to see how these calls
will be handled. As is the standard procedure, our caller
spoke to a "Level 1" customer service representative who, after
learning about the call's purpose, transferred the caller to a
specialist who provided the following information.
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Beneficiaries should
call 1-800-MEDICARE and be prepared to provide their Medicare
number as well as their name, date of birth, and address. It
really doesn't matter what category (i.e. claims, enrollment)
they select from the menu because the Level 1 CSR with whom they
will initially speak will transfer them to a specialist or
supervisor (Level 2 personnel) in order to assist them with this
SEP issue.
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It would be helpful,
but it is not absolutely necessary, to have the notice letter on
hand when a beneficiary calls; there is no special code or
confirmation number or the like that beneficiaries must provide
over the phone. However, beneficiaries should provide the date
upon which their Wellpoint drug coverage was dropped, the date
of the notice letter, and explain that they received a notice
letter indicating that they are entitled to the SEP.
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Beneficiaries who
want to take advantage of the SEP may enroll for Part D over the
phone. The specialist assured the caller that the CSR will ask
whether the beneficiary would like his or her Part D coverage to
retroactively apply effective January 1, 2009.
The 1-800-MEDICARE
specialist with whom the Center's caller spoke was friendly and
attentive, although she seemed unfamiliar with the SEP for former
Wellpoint prescription drug enrollees whose coverage was dropped.
During the call, she essentially read from the model letter and
consulted a colleague. To the best of her knowledge, she hadn't yet
received any calls regarding this issue.
For
additional assistance, contact your state's SHIP program. Find
your program at www.shiptalk.org. |