Aetna Medicare Solutions - Heads up: Action required by members who use SSA/RRB premium withhold opt

May 11, 2019

  1. Northeast Agent
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    Northeast Agent Guru

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    State:
    Pennsylvania
    We want to notify you about an issue affecting all Medicare members who elected to pay plan premiums from their Social Security Administration (SSA) or Railroad Retirement Board (RRB) check.

    BACKGROUND
    Normally, when members select this premium payment option, the SSA/RRB withholds funds from members’ SSA/RRB checks to cover their plan premiums.
    Unfortunately, due to a system issue, this did not occur for two or more months starting February 1, 2019. This issue affected all carriers, not just Aetna. Although the system issue is now fixed, the SSA/RRB cannot retroactively deduct premium payments from members’ checks.
    WHAT DO MEMBERS NEED TO DO?
    Because these members now have past-due accounts, their premium payment method has changed to direct billing, effective February 1, 2019. This means they now need to pay any past-due premium amounts to Aetna directly.

    MEMBER COMMUNICATION
    Members will receive a letter explaining what happened and what they need to do later this month. Letters are being mailed in waves, between May 10-24, so members will receive them over several weeks. View the member letter.

    WHAT HAPPENS NEXT?
    • We’ve already submitted a new request to restart SSA premium deduction for the affected members, effective June 1, 2019. If the request is accepted by SSA, they will send members a letter of approval. Please be aware this can take up to 90 days.
    • Please explain to your clients that SSA will only deduct future premiums from their Social Security check as of the effective date noted in their approval letter, so any balances owed up until that effective date must be paid to Aetna directly. Members need to pay premiums directly to us for any months the SSA or RRB doesn’t cover.
    • While these members are not currently at-risk for termination due to nonpayment, they do need to begin making payments to ensure their plan does not face termination for nonpayment in the future.
    ENCOURAGE MEMBERS TO CALL US WITH ANY QUESTIONS
    Although this issue was out of our control, we realize it will be an inconvenience for our members. If they have any questions, please encourage them to call Member Services by dialing the number on their member ID card. The Member Services team is available 7 days a week, from 8 a.m. to 8 p.m.
    As always, thank you for your dedication to our members and for your help educating them on this matter. If you have any questions, please contact the Aetna Medicare Broker Services Department at 1-866-714-9301 or [email protected].
     

    Attached Files:

  2. WCMason
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    WCMason Guru

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    This is a CMS-created template letter. All carriers will be sending them. The inability to deduct the missed payments will make this a mess for awhile.
     
    WCMason, May 12, 2019
    #2
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