Whether you enrolled in a new Medicare Advantage plan this year, or you didn’t change the plan you had last year, now is the time to review your coverage and be sure it meets your needs.
In 2011, people eligible for Medicare have just six weeks (January 1 through February 14) — last year it was three months — to be sure the coverage fits their needs and maximizes their cost savings.
There are also fewer options for changing coverage during the new Medicare Advantage Disenrollment Period (“MADP”) if you’re unhappy. Here are the changes you can make:
- People with a Medicare Advantage plan or a MA-PD plan (Medicare Advantage with prescription drug coverage) can switch to original Medicare and enroll in a stand-alone Part D prescription drug plan (PDP). If you go without the PDP, you’ll pay a penalty if you ever try to enroll in a PDP during another enrollment period.
- People cannot switch from one Medicare Advantage plan to another. This is new for 2011.
- People with a Medicare Advantage plan and a stand-alone PDP can switch to original Medicare, but they must keep their PDP.
- People already covered by original Medicare and a PDP cannot make any changes.
It’s enough to make anyone’s head spin, but anyone on Medicare who doesn’t take the time to research their options and choose the plan that best fits their needs could leave hundreds of dollars in annual premium savings on the table. In fact, according to a recent study by the Robert Wood Johnson Foundation, only about 10 percent of Medicare participants change plans annually1.
Keep in mind that deductibles, co-pays, and prescription drug coverage can change every year, so even if you didn’t change your plan this year, your plan may have changed on you. Staying put and not investigating your options could impact your yearly health care costs.
Here are a few tips to help you determine whether or not you have the best plan already, or if you should look in to available options:
1) Watch the calendar: In the past, Medicare gave you from Jan. 1 - March 31 to change your Medicare coverage. In 2011, those three months have been cut down to just six weeks, and the deadline to make a change in 2011 is Feb. 14, unless you qualify for a special election period.
2) Check it before you wreck it: Before you drop a Medicare Advantage plan, be sure the coverage you’re considering provides the benefits you need. Medicare Advantage often covers a portion of your doctor visits, as well as eye exams and other services. Also, make sure your doctor will accept the new coverage to which you’re switching.
3) Review your prescriptions: Compare the cost of a Medicare Part D prescription drug plan that covers your medications with the Medicare Advantage plan you’re currently on. It’s critical to make sure your monthly budget can handle the cost of drugs on your new plan versus your old plan. It’s easy and free to compare plans side-by-side on a website like PlanPrescriber.com.
4) Consider Medicare supplemental policies: Original Medicare has cost-sharing requirements and other benefit gaps, so some people who enroll in Original Medicare also purchase Medicare supplemental policies, also called Medigap. Medigap is offered through standardized plans, labeled A-N. Plans offered by different health insurers with the same letters offer the same benefits, but the costs can vary widely depending on age, community, inflation and other factors.
5) Don’t put off filling prescriptions: The drugs that are covered and how much they cost can change each year on a Medicare Advantage plan or Medicare Prescription Drug Plan. If you’re ordering 90-day supplies of medications to save money, or having them sent to you through the mail, be sure you see the bill for a new order placed in 2011 before Feb. 14. Don’t find out too late that one of the drugs you’re taking is no longer covered or that the co-pay has increased.
You may be able to get Extra Help to pay for your prescription drug premiums and costs. To see if you qualify for Extra Help, call: 1-800-MEDICARE (1800-633-4227). TTY users should call 1-877-486-2048, 24 hours a day/ 7 days a week; the Social Security Office at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY users should call, 1-800-325-0778; or Your Medicaid Office (only required for pieces referencing Part D benefits or cost-sharing).
In general, beneficiaries must use network pharmacies to access their prescription drug benefit, except in non-routine circumstances, and quantity limitations and restrictions may apply.
1 RWJF-Funded Study Finds Medicare Part D Too Complex for Many Doctors: Published Jul 29, 2010
Ross Blair is president and CEO of Plan Prescriber, Inc. www.PlanPrescriber.com
Medicare has neither reviewed nor endorsed this information