Sunday, February 7, 2016  
Health Insurance for Individuals

Sanctions Blocking Medicare Sales Lifted

Sanctions blocking health insurance providers from marketing Medicare plans and taking steps to enroll new beneficiaries has been lifted by federal regulators, this according to Aetna Inc.

Removal of these restrictions are crucial because Aetna, as well as a number of other health insurance carriers, are looking to build up presence in the field of Medicare. Sanctions were imposed by the Centers for Medicare and Medicaid Services last April.

Currently, Aetna Inc. has about 1 million Medicare Advantage as well as drug-plan beneficiaries. Now, the company will be able to compete for new beneficiaries throughout the open enrollment period for Medicare in the fall.

Atena Inc Is Purchasing Genworth Financial Inc

Aetna Inc. has admitted interest in acquisitions that would increase the presence of Medicare. Recently, the company announced the purchase of Genworth Financial Inc., which is a Medicare supplement company, for just under $300 million. Unaffected by the restrictive sanctions, Medicare supplement plans were bought by individuals that held coverage under traditional Medicare. Medicare supplement plans offer beneficiaries with protection against paying any out-of-pocket expenses that may not be covered by Medicare. According to Aetna Inc., the Genworth unit featured almost 150,000 members.

Atena Inc Is Purchasing Genworth Financial Inc

The penalty was imposed by the regulator in April 2010, claiming that the company had not complied with regulations related to changes in drug-plan designs. According to CMS then, Aetna Inc. did not meet the necessary requirements, ensuring senior citizens would be able to continue receiving their medications throughout changes to the company’s plans–last years as well as the year before in 2009.

The issue grew as Aetna Inc. progressed from an open formulary for prescription medications in 2009 to a closed formulary in 2010, according to the company. With an open formulary, patients are able to receive prescriptions for just about any drug; in a closed formulary, the choices of medications available are somewhat restricted.

Creative Commons License photo credit: TR Photographics

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