HARRISBURG, PA — Thousands of Pennsylvania seniors who lost access to certain doctors can now switch or update their health coverage through a special enrollment period approved by federal officials.
What This Means for You
- You may have until April 30 to change Medicare coverage
- You can switch plans or return to traditional Medicare
- Free counseling is available to help you compare options
The Shapiro Administration announced the special enrollment period after a contract dispute between Lehigh Valley Health Network and UnitedHealthcare left more than 5,400 Medicare Advantage members without in-network access to LVHN providers.
A Medicare Advantage plan is a private insurance alternative to traditional Medicare that typically uses a network of doctors and hospitals. When a provider leaves that network, patients may face higher costs or lose access to their doctors.
Why Coverage Was Disrupted
State officials said the issue stems from a contract dispute between UnitedHealthcare and Lehigh Valley Health Network, which ended their agreement as of January 26.
As a result, affected patients with UnitedHealthcare Medicare Advantage plans could no longer see LVHN providers at in-network rates.
Officials said the state worked with the Centers for Medicare & Medicaid Services to reopen enrollment options, allowing impacted residents to make changes outside the normal enrollment window.
What Options Are Available
During the special enrollment period, which runs through April 30, eligible residents can switch to another Medicare Advantage plan or move to Original Medicare.
Original Medicare is the federal government’s traditional health coverage program, which allows patients to see any provider that accepts Medicare. Patients can also add a Medicare Supplement, or Medigap plan, to help cover out-of-pocket costs.
State officials said affected residents can enroll in Medigap coverage without medical underwriting, meaning insurers cannot deny coverage based on pre-existing conditions.
“Impacted UHC Medicare Advantage policyholders that see LVHN providers should shop their coverage during this Special Enrollment Period,” said Insurance Commissioner Michael Humphreys.
Help for Seniors
Pennsylvania officials are directing residents to PA MEDI, the state’s Medicare counseling program, which provides free, unbiased assistance through local Area Agencies on Aging.
“It can be challenging choosing the right health care coverage, especially when older adults have maintained the same benefits for years,” said Aging Secretary Jason Kavulich.
Counselors can help residents compare plans and determine whether switching coverage better meets their needs.
What to Do Before the Deadline
Officials recommend affected residents take several steps before April 30:
- Check whether their doctors are still in-network
- Compare available Medicare Advantage plans
- Consider whether Original Medicare with a Medigap plan is a better fit
Residents with questions or complaints can visit pa.gov/consumer or call 1-866-PA-COMPLAINT (1-866-722-6675).
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