Medicare beneficiaries in Colorado are facing significant changes as several insurance companies have announced the termination of Medicare Advantage plans in the state, including the Denver Metro area. This development has resulted in many patients receiving Service Area Reduction (SAR) letters, notifying them that their current coverage will no longer be available.
“In my 15 years of doing Medicare, this is unprecedented. Insurance companies are reeling and terminating/discontinuing Medicare Advantage plans,” said Mary Jo Heins, a local Medicare advisor.
Medicare Advantage plans are typically tied to specific counties, meaning these terminations directly impact patients based on where they live. As Open Enrollment approaches on October 15, affected individuals will need to evaluate their options for continued coverage.
Heins advised that those who do not frequently visit doctors may still find a Medicare Advantage plan suitable for their needs and finances. “If you don’t go to the doctor often, the best match for your health, lifestyle and finances is still most likely a Medicare Advantage plan. You can use a Medicare agent to help you with this or go to medicare.gov,” she said.
For patients with chronic medical conditions, switching to a Medicare supplement may be more beneficial. “If you have chronic medical problems, your best match may be a supplement. This SAR opens up a guaranteed issue (no medical underwriting required) to move to a supplement. The premium cost per month is around $225 (varies based on age, gender, zip code and smoking status.) This is on top of your Part B premium,” Heins explained.
She outlined several reasons why frequent healthcare users might prefer supplements over Medicare Advantage plans: lower annual out-of-pocket costs ($300 compared to $4,000), fewer prior authorizations needed, and broader provider access nationwide without network restrictions. “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 added.
However, she noted that supplements come with higher monthly premiums compared to some zero-premium Medicare Advantage plans: “Downside, of course, is a $225/month premium vs $0 for Medicare Advantage.”
Patients seeking more information or assistance can contact Mary Jo Heins at 720.484.6946.
