Medicare Annual Open Enrollment is right around the corner. In 2017, between October 15 and December 7, you will have the option to review and make changes to your Medicare supplemental coverages. These changes will take effect January 1, 2018. During Annual Open Enrollment, you may switch or drop a Medicare Advantage or Part D Standalone Drug Plan.
A few definitions to help you understand Annual Open Enrollment (AEP):
Original Medicare – includes Part A (Hospital Insurance) and Part B (Medical Insurance) it covers care received by any qualified provider in the United States that is enrolled in Medicare and accepting Medicare patients. Original Medicare usually pays 80% of covered medical services.
Medicare Advantage Plan also known as Part C – a private insurance plan that provides Medicare Part A and B benefits. Additional coverage plans are offered by Medicare approved companies as an alternative to original Medicare.
Part D – the part of Medicare that helps pay for the cost of prescription drugs. You can get Medicare Part D coverage as a Stand-Alone Prescription Drug Plan or as part of a Medicare Advantage Plan.
Reasons why you should review your Medicare coverage each year:
- You may be paying more than you should be for your Medicare Advantage or Stand- Alone Part D coverage and you might be getting less.
- Plan premiums can change each year.
- Plan coverages are reviewed annually and can be changed.
- Both Medicare Advantage and Stand-Alone Part D plans can make changes in their formulary (list of covered drugs) annually.
- You should double check that all your prescriptions are still covered by your plan.
- Have your co-pays changed?
- Is your pharmacy still in the covered network?
- Your medical status might have changed over the last year.
- You might have found that your Medicare Advantage Plan doesn’t provide enough coverage for your current medical needs.
- You might now need the services of a specialist and your Medicare Advantage Plan does not have your specialist in their network.
- Make sure you are not paying for coverages you no longer need.
- Don’t ignore mailings from your current Medicare Advantage or Stand-Alone Part D companies.
- You should receive a letter with an annual change notice from your company prior to annual enrollment.
- Along with this annual change notice, most companies will also include any changes in their formularies.
Appropriate Actions during Medicare Open Enrollment:
(Note: You might need to qualify medically to change your plan.)
- Switch from one Medicare Advantage Plan to another Medicare Advantage Plan
- Switch from an Medicare Advantage Plan without drug coverage to one that has drug coverage.
- You may also switch from a Medicare Advantage Plan with drug coverage to a Medicare Advantage Plan without drug coverage plus add a Stand-Alone Part D Plan.
- Sign up for Medicare Advantage or Stand-Alone Part D plan, if you didn’t have one previously.
Note: Once Annual Open Enrollment period closes on December 7, 2017, you will have to wait until 2018 Annual Open Enrollment to make any changes unless you have a Special Open Enrollment available to you.
Special circumstances (Special Enrollment Periods)
You can make changes to your Medicare Advantage and Medicare prescription drug coverage when certain events happen in your life, like if you move or you lose other insurance coverage. These chances to make changes are called Special Enrollment Periods (SEPs). Rules about when you can make changes and the type of changes you can make are different for each SEP.
You change where you live
- I moved to a new address that isn’t in my plan’s service area.
- I moved to a new address that’s still in my plan’s service area, but I have new plan options in my new location.
- I moved back to the U.S. after living outside the country.
- I just moved into, currently live in, or just moved out of an institution (like a skilled nursing facility or long-term care hospital).
- I’m released from jail.
You lose your current coverage
- I’m no longer eligible for Medicaid.
- I left coverage from my employer or union (including COBRA coverage).
- I involuntarily lose other drug coverage that’s as good as Medicare drug coverage (creditable coverage), or my other coverage changes and is no longer creditable.
- I had drug coverage through a Medicare Cost Plan and I left the plan.
- I dropped my coverage in a Program of All-inclusive Care for the Elderly (PACE) plan.
You have a chance to get other coverage
- I have a chance to enroll in other coverage offered by my employer or union.
- I have or am enrolling in other drug coverage as good as Medicare prescription drug coverage (like TRICARE or VA coverage).
- I enrolled in a Program of All-inclusive Care for the Elderly (PACE) plan.
Your plan changes its contract with Medicare
- Medicare takes an official action (a “sanction”) because of a problem with the plan that affects me.
- Medicare ends (terminates) my plan’s contract.
- My Medicare Advantage Plan, Medicare Prescription Drug Plan, or Medicare Cost Plan’s contract with Medicare isn’t renewed.
Other special situations
- I’m eligible for both Medicare and Medicaid.
- I qualify for Extra Help paying for Medicare prescription drug coverage.
- I’m enrolled in a State Pharmaceutical Assistance Program (SPAP) or lose SPAP eligibility.
- I dropped a Medigap policy the first time I joined a Medicare Advantage Plan.
- I have a severe or disabling condition, and there’s a Medicare Chronic Care Special Needs Plan (SNP) available that serves people with my condition.
- I’m enrolled in a Special Needs Plan (SNP) and no longer have a condition that qualifies as a special need that the plan serves.
- I joined a plan, or chose not to join a plan, due to an error by a federal employee.
- I wasn’t properly told that my other private drug coverage wasn’t as good as Medicare drug coverage (creditable coverage).
- I wasn’t properly told that I was losing private drug coverage that was as good as Medicare drug coverage (creditable coverage).
We, at Brownell Insurance Center want to help you be in the best Medicare plan possible that meets your current needs. Give us a call at 603-437-1992 and book your appointment today for your FREE Medicare review. We are glad to help you navigate the tricky waters of Medicare!