People with Medicare have one last chance to change their Medicare health plan before they are locked into their plan for the rest of the calendar year.
During the Open Enrollment Period, which began January 1 and lasts through March 31, people with Medicare are allowed to change their choice of Medicare health coverage once.
For example, a person who is enrolled in a Medicare private health plan with drug coverage (like an HMO or PPO) can switch to another that also offers drug coverage. They can also switch to Original Medicare with a stand-alone drug plan. If someone has Original Medicare with a stand-alone drug plan, they can switch to a Medicare private health plan with drug coverage. They cannot, however, add or drop the Medicare drug benefit (Part D) and they cannot switch from one stand-alone prescription drug plan to another one. Most people with Medicare will not be able to change their health plan again until 2010.
“Don’t let a salesperson use the March 31 deadline to pressure you into signing up for a plan. Changing how you receive Medicare coverage can change which doctors you can see and how much you will have to pay for care,” said Paul Precht, Director of Policy and Communications at the Medicare Rights Center, a national consumer service organization. “Don’t sign up for coverage you don’t understand.”
If you are thinking of signing up for a Medicare private health plan, there are a number of questions you need to answer before you enroll, including:
· How much is the premium?
· Does the plan have an annual limit on how much you would pay out of pocket for medical care? How much is the limit and does it cover all services?
· Will I be able to use the doctors, hospital and other medical providers I want?
· Does the plan cover the prescription drugs I take at a cost I can afford without restrictions?
A full list of helpful questions is available on Medicare Interactive.
“It can be tricky figuring out if a Medicare private health plan is right for you. Unlike with Medigap supplemental plans, benefits of Medicare private health plans are not standardized, and some plans can leave you on the hook for high bills if you get sick,” said Mr. Precht.
If you have coverage from a former employer, signing up for a Medicare private health plan can also cause you to lose that coverage. Consumers should also know that a Medicare private health plan will not work with their supplemental “Medigap” plan like Original Medicare does. If you have Original Medicare with a Medigap plan and switch to a Medicare private health plan for the first time, you have 12 months to change your mind and get your Medigap plan back. If, however, you decide you want to switch back to Original Medicare after 12 months in the Medicare private health plan, you may not be able to get your Medigap policy back or may have to pay a higher premium if you have a history of illness. Rules about purchasing Medigap policies differ from state to state.
People may be eligible for a special enrollment period to change health or drug plans if they meet certain criteria. Moving out of a plan’s service area, for example, qualifies you for a special enrollment period to change coverage. If you were misled into enrolling in a Medicare private health plan, you also qualify for a special enrollment period.
To learn more about the Open Enrollment Period, Special Enrollment Periods and when you have the right to buy a Medigap plan, go to Medicare Interactive Counselor at www.medicareinteractive.org.
Medicare Interactive (MI) Counselor is an independent, online resource that helps the nearly 45 million people with Medicare navigate the complex world of health insurance. The only comprehensive, consumer-friendly source for Medicare information on the web, MI Counselor provides easy-to-understand answers to the questions posed by older people and people with disabilities, and the advocates and caregivers that navigate the system on their behalf. MI Counselor is a service of the nonprofit Medicare Rights Center.