If you are enrolled in Medicare, your annual opportunity to make changes to your coverage is between October 15 and December 7 this year. Changes will be effective January 1, 2019. During this period, you can choose to:
· Keep everything the same, in which case you do not need to do anything
· Switch to a Medicare Advantage plan from Original Medicare, or vice versa
· Change Medicare Advantage plans
· Change your drug plan (Part D), sign up for one if you don’t have one, or drop drug coverage
It’s important to note that if you have a Medicare Supplement Plan (also called Medigap), you can change that at any time, within the guidelines of your supplement insurance carrier. Typically, they will send you an annual notice of any premium changes and will give you the opportunity to change at that time.
Medicare Supplement plans are offered by private insurance companies and can cover health care costs not included in Original Medicare. They do not include prescription drug coverage but may offer a stand-alone prescription drug plan (Part D).
As you consider Original Medicare versus Medicare Advantage, it might be helpful to have a brief refresher on the differences:
Original Medicare consists of hospital insurance (Part A) and medical insurance (Part B). Part B provides coverage for medical services such as doctor visits, diagnostic tests, X-rays, blood transfusions, chemotherapy, dialysis, some preventive services and some vaccinations. Most people don’t pay a monthly premium for Part A, while most do pay a premium for Part B.
Medicare Advantage, also called Part C, provides coverage through private insurance companies approved by Medicare. These plans are required to provide coverage for everything that’s covered under Part A and Part B (Original Medicare), except hospice care. Some plans also include other benefits such as drug coverage, dental and vision care. With most Medicare Advantage plans, you still must pay your Part B premium in addition to any Part C premium.
To qualify for enrollment in a Medicare Advantage plan you must be enrolled in both Medicare Part A and Part B and live within the service area of the desired Medicare Advantage plan. Note that people with end-stage renal disease generally do not qualify for Medicare Advantage plans.
There are a variety of Medicare Advantage plans, many of which include prescription drug coverage (Part D). Medicare Advantage plan types include:
· Health Maintenance Organization (HMO)
· Preferred Provider Organization (PPO)
· Private Fee-for-Service (PFFS)
· Special Needs Plans (SNPs)
· HMO Point-Of-Service (HMOPOS)
· Medical Savings Account (MSA)
Here are some additional things to consider:
· If you switch from a Medicare Advantage Plan (Part C) back to Original Medicare (Part A and Part B) and want prescription coverage, you’ll need to enroll in a Medicare Prescription Drug Plan (Part D)
· If you’ve been on a Medicare Advantage plan for more than a year and switch back to Original Medicare, it may be more expensive to enroll in a Medicare Supplement plan as you are outside the “guaranteed issue” period for Medigap plans.
Starting in 2019, Medicare Advantage will have a new open enrollment period: from January 1 – March 31. So, you’ll have another opportunity to switch to the coverage that works for you.
For more information about plans in your area visit Medicare.gov. Or call 1-800-MEDICARE (1-800-633-4227).