Special Enrollment Period for Pennsylvania Medicare Beneficiaries

A special enrollment period has been established for Pennsylvanians affected by a contract dispute between Lehigh Valley Health Network and UnitedHealthcare regarding Medicare Advantage plans. The Pennsylvania Insurance Department, collaborating with the Department of Aging and the Centers for Medicare & Medicaid Services, initiated this period to provide affected individuals the opportunity to explore alternative coverage options until April 30.

Pennsylvania Insurance Commissioner Michael Humphreys emphasized the importance of this initiative for those impacted by the loss of in-network access to healthcare providers. Policyholders are encouraged to consult with licensed insurance agents or PA MEDI counselors to determine the most suitable coverage options, whether that involves remaining with a Medicare Advantage plan or switching to Original Medicare with a Medigap policy.

This special enrollment period differs from the usual Medicare Advantage open enrollment, which is currently ongoing until March 31. More than 5,400 UnitedHealthcare Medicare Advantage members were affected when their contract with Lehigh Valley Health Network ended, losing in-network provider access as of January 2023. PA MEDI counselors, available through Pennsylvania's Area Agencies on Aging, offer unbiased and cost-free guidance to assist older adults in navigating their health insurance choices.

Jason Kavulich, Secretary of Aging, highlighted the experience of PA MEDI counselors, many of whom are familiar with Medicare themselves, in aiding beneficiaries with their health plan selections. The Pennsylvania Insurance Department advises policyholders to leverage this enrollment period, which allows selection from a wider range of options, including the potential shift to traditional Medicare with a Medigap policy, free from medical underwriting restrictions.

For assistance or inquiries, affected individuals can contact the consumer helpline at 1-866-PA-COMPLAINT or visit the Pennsylvania Insurance Department's website for further information. The PA MEDI program receives financial support from the Administration for Community Living under the U.S. Department of Health and Human Services, ensuring continued assistance for Medicare beneficiaries across Pennsylvania.