Insurer seeks payments from seniors after Medicare error

Thousands of Massachusetts senior citizens with Medicare drug benefits have received automated phone calls from Blue Cross Blue Shield of Massachusetts in recent days asking them to repay up to $1,400 because Medicare failed to automatically deduct monthly premiums from their Social Security checks.

Elizabeth Holmes, 71, of Plymouth said she first noticed in April that premiums for Medicare drug coverage were not being deducted from the Social Security payments she and her husband receive monthly. Holmes said she repeatedly contacted Blue Cross and the Centers for Medicare and Medicaid Services , which oversees the plan, but was unable to find out why the deductions were stopped. She said she received a call from Blue Cross on Wednesday explaining what had happened.

"It's not a big deal for me to pay the $720 that is due," said Holmes. "But what aggravates me is most people don't put money aside, and it could create a serious problem for some of them."

In March, The Tampa Tribune reported that hundreds of thousands of seniors were receiving inaccurate Social Security payments because of problems with Medicare Part D drug coverage premiums. Most were overpaid because the premiums were not being deducted. Others received accidental refunds that averaged $215 and were asked to return the money. The problems still haven't been fully resolved.

A spokesman for Blue Cross Blue Shield of Massachusetts said 5,200 members in the state are affected by the glitch. They are being contacted by Wellpoint Inc., a national healthcare company that recently merged with Anthem Inc. Wellpoint administers the Blue Cross stand-alone Medicare drug plan in Massachusetts called Blue MedicareRx.

"It's conceivable that members could owe 12 months of premiums," said Chris Murphy , a Blue Cross spokesman. "If anybody wants to pay the amount due immediately, that's fine, but we'll also let people pay monthly increments through the first quarter of 2007."

The billing problems also affect some seniors who have drug coverage through other insurers. Tufts Health Plan said that as many as 1,000 members of its Medicare Preferred plan, which combines medical and drug coverage, could also have been affected by the Medicare error. Catherine Grant, a Tufts spokeswoman, said it is still waiting for a list of names from the agency. Tufts' Medicare Preferred plan has 55,000 members in Massachusetts.

A spokeswoman for Harvard Pilgrim Health Care said it noticed in July that premiums were not being properly deducted for members in its First Seniority Medicare Advantage plan, which combines medical and drug coverage. The problem affected as many as 500 out of 34,000 members, the insurer said.

The Harvard Pilgrim billing problems have been resolved for members who enrolled prior to Aug. 1, and the plan is now checking to ensure that those who enrolled later are now receiving Social Security checks with the proper deductions.

"We're double-checking to make sure that later enrollees don't have billing problems," said Sharon Torgerson of Harvard Pilgrim.

The Centers for Medicare and Medicaid Services, or CMS, said it sent letters Oct. 31 to seniors who will see changes in their November Social Security payments. The agency calls them "premium withhold issues."

"The vast majority of these issues have been resolved," said Roseanne Pawelec , a spokeswoman for CMS. "At no time was anybody's drug coverage compromised by these billing glitches."

But Pawelec said as many as 50,000 people nationwide may still have a problem, according to the government's latest accounting.

Bill Dillon of Randolph said he received a call this week from Wellpoint about his Blue Cross drug plan. "We didn't know the bill was due," he said. "Our assumption was the payments had been taken out."

Fortunately, Dillon said, he and his wife can afford to pay the $1,200 they owe. "We can probably manage it," he said.

Jeffrey Krasner can be reached at krasner@globe.com.