First open enrollment period for Pathways for Aging program begins October 15

Medicaid members in the Pathways for Aging program will have the opportunity to change plans during the first open enrollment period since the new program launched in July. Open enrollment starts on October 15.

Pathways for Aging is Indiana’s new long-term care program for Medicaid members 60 years or older. One of the goals of the program is to make it easier for dual-enrolled members to align their Medicaid coverage with their Medicare coverage.

Holly Cunningham Piggott, the director of care programs for the Family and Social Services Administration’s Office of Medicaid Policy and Planning, said this open enrollment period will give members an opportunity to choose the same managed care entity to be in charge of their coverage for both Medicaid and Medicare.

“Because 80 percent of the Pathways population is also receiving Medicare benefits, they can change their MCE during the open enrollment period — annual enrollment period for Medicare,” Cunningham Piggott said.

Members can align their plans by selecting the same MCE or insurer for both types of coverage.

“A letter will be sent to the member informing them that they can make this change and they would just need to call the enrollment broker to meet to let them know that they want to make this change,” Cunningham Piggott said.

Cunningham Piggott said members should start receiving those letters in the next couple of weeks. The open enrollment period starts on October 15 and ends on December 7.

READ MORE: Medicaid officials say they will monitor Pathways for Aging program services for a full year
 

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Members also have other opportunities to change plans.

When a member first transitions to the program, they have 90 days to make changes to their plans.

For members already in the program, they have the opportunity to make changes once per calendar year during their Medicaid redetermination and during the Medicare annual open enrollment period. If a member’s Medicare and Medicaid plans become unaligned, they will also be able to make changes if needed.

Members can also make changes for “just cause,” such as poor quality of care, and significant language or cultural barriers.

Abigail is our health reporter. Contact them at aruhman@wboi.org.