CCRCs need to check residents' health insurance plans twice a year, expert urges

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Continuing care retirement communities should ask residents about their health plans twice a year, to keep tabs on the increasing number of seniors being shifted into Medicare Advantage, an expert told an audience of long-term care professionals in Chicago Wednesday.

There's a trend of employers requiring workers to utilize Medicare Advantage rather than fee-for-service Medicare in order to activate all their retirement benefits, said Betsy Rust, CPA, a partner with public accounting and business advisory firm Plante Moran. Even workers who have been retired for years and are living in a CCRC could be transitioned into Medicare Advantage, she noted. This becomes problematic if the CCRC does not have a contract in place with the private insurer administering the Medicare Advantage plan.

“I'm finding this to be a very big problem with my clients,” Rust told an audience at the annual LeadingAge Illinois (formerly Life Services Network) conference.

She recommended that CCRC operators ask residents what health plans they are on twice a year, saying that once a year is not often enough.

Another strategy is for the CCRC to determine which local health plans offer the most favorable reimbursement, and invite them into the facility at enrollment time, Rust told McKnight's. Beneficiaries being transitioned into Medicare Advantage are offered at least two choices of insurer, she said, so it could behoove an operator to make it easy for residents to get information about the preferred option.

The conference is scheduled to conclude Friday.

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