Be Sure to Tell Your Patients to Fully Research Any New Plan Prior to Enrolling!
MAC Members: Click here for a handout you can give to your Medicare patients before the upcoming Open Enrollment Period!
Last year, Humana and UnitedHealthcare imposed prior authorization requirements for chiropractic services under their Medicare Advantage (MA) plans. At the time, thanks to intense pressure from the MAC, ChiroCongress, and other key stakeholders, Humana announced their policy did not apply to the state of Michigan. However, UnitedHealthcare’s prior authorization requirements remain in effect for Michigan chiropractic Medicare Advantage patients.
Requirements such as these prior authorization plans drastically affect patient care and chiropractic practices, and we firmly believe that such unjustified burdens create barriers for seniors to access a conservative, cost-effective care option. No justification exists to require additional pre-conditions for care for those seniors who have chosen an MA plan over those who are covered under traditional Medicare.
These prior authorization requirements underscore the importance of your Medicare patients thoroughly researching any Medicare Advantage they may be considering during the upcoming Medicare Open Enrollment Period (October 15th – December 7th).
What Is the Medicare Open Enrollment Period (OEP)?
Each year, Medicare plans change what they cost and what they will cover. Medicare’s Open Enrollment Period (OEP) – also known as the Medicare annual election period – is the time when Medicare beneficiaries who want to make changes to their prescription drug plans or Medicare Advantage coverage can do so. This period runs from October 15th through December 7th and will be the only chance most Medicare beneficiaries have to make a change to their health and prescription drug coverage for 2026.
During the OEP, Medicare beneficiaries may:
- Switch from Original Medicare (Medicare Parts A and B) to Medicare Advantage (Medicare Part C)*
- Switch from a Medicare Advantage plan back to Original Medicare
- Switch from one Medicare Advantage plan to another, which may involve switching from a plan without Medicare Part D prescription drug coverage to one that has it, or vice-versa
- Make changes to their Medicare Part D prescription drug plan, like joining a Part D plan, switching from one Part D plan to another, or dropping a Part D plan altogether
* It is critical that patients considering such a change know that it’s possible that their chiropractic coverage could drastically change under a new, Medicare Advantage plan, which could require prior authorization for chiropractic care, higher co-pays, referrals or other restrictions, costs for seeing an out-of-network chiropractor, hidden costs/fees, etc.
Once your patient selects a plan, they are committed to that plan for one year and are only able to change plans (or return to Medicare Part A & B) during the next OEP.
MAC Members: For a patient handout you can give to your Medicare patients that includes all the questions they need to ask themselves before changing their coverage, click here.
