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Changes In Medicare Advantage And Part D Plans
Every year, insurers make small changes to their Medicare Advantage and Part D plans. Typically, these changes include changes in premiums, deductibles, and other costs. Keep in mind, the Medicare program may not finalize these changes until right before fall Open Enrollment.
See the latest Medicare premiums and deductibles now or come back in October. Well share finalized changes as soon as they become available.
Refresh your general Medicare knowledge
While the Medicare program changes a bit each year, much of it stays the same. It never hurts to refresh your Medicare knowledge. We recommend starting with an overview of Medicare. This Medicare Glossary could come in handy, too, as you read through insurance documents.
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Medicare Supplement Enrollment Dates
When you think about your Medicare coverage, consider whether you will be better off with a Medicare Advantage plan or original Medicare plus a Medicare Supplement plan. You cant have both Advantage and Medigap plans since they provide the same benefit a safety net against runaway medical bills.
If you join original Medicare in your initial enrollment period when you turn 65 and enroll in Medicare Part B, you can buy any Medigap policy regardless of your health history. You will not be asked questions about your health. But if you join after the initial six-month period , the insurer will question you and may refuse to sell you a policy or charge you higher premiums based on your age and health. An exception to this rule is if you have a guaranteed issue right .
What Was The Former Medicare Advantage Disenrollment Period
The Medicare Advantage Disenrollment Period was before 2019 a time when Medicare Advantage plan members could disenroll from their plan and revert back to Original Medicare.
This disenrollment period was done away with. Starting in 2019, the Centers for Medicare & Medicaid Services instituted the Medicare Advantage Open Enrollment Period .
The Medicare Advantage Open Enrollment Period lasts from January 1 to March 31. During this time, Medicare Advantage plan beneficiaries can:
Switch from one Medicare Advantage plan to another, even if they are provided by different insurance carriers
Disenroll from their Medicare Advantage plan and return to Original Medicare
If you choose to disenroll from a Medicare Advantage plan during this period and return to Original Medicare, you can also enroll in a standalone Part D prescription drug plan.
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Assuming There’s No Better Option
The number of Advantage plans you can pick from largely depends on where you live. The more rural the area, the fewer the options you’re likely to have. For example, in Wyoming and Alaska, fewer than 10% of all beneficiaries are in Advantage plans in 2019, according to the Kaiser Family Foundation. Nationwide, that share is more than 30%.
However, new plans continuously become available, as insurance carriers expand their options and coverage areas and new players enter the market. This makes it important to make sure there isn’t a more cost-effective option for you.
New stand-alone prescription drug plans also could be available where you live, which makes it worthwhile to comparison-shop.
“Your plan might be great, but if one similarly priced saves you $500 next year, you’d probably want to know about that,” Roberts said. “If you don’t do the analysis, you might miss out on that savings.”
Medicare General Enrollment Period
If you don’t sign up during your Initial Enrollment Period and if you aren’t eligible for a Special Enrollment Period, the next time you can enroll in Medicare is during the Medicare General Enrollment Period.
The General Enrollment Period lasts from each year.
You can only sign up for Part A and/or Part B during this period, and your coverage starts on July 1. You may have to pay a late enrollment period for Part A and/or Part B, as detailed below.
Part B Late Enrollment Penalty: If you do not enroll in Medicare Part B during your Initial Enrollment Period but decide to enroll later in life, you will have to pay a late enrollment penalty.
Your Part B monthly premium could go up 10 percent for each 12-month period that you were eligible for Part B but didn’t sign up. You pay the Part B late enrollment penalty for the rest of your life as long as you remain enrolled in Part B.
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Reasons People Leave Or Switch Part D Plans
- The new plan formulary moved your medications to a different tier
- The plan will drop one of your drugs completely
- Your monthly premium increased
And This Year Isnt Just Shorter
Several other changes were made over the past few years that will magnify the impact of a shorter health insurance Open Enrollment Period.
No More Individual Mandate: The tax penalty for going without health insurance no longer exists starting in 2019. This will remove one incentive to get health insurance in a timely manner, as stragglers can now rely on short-term insurance plans to fill coverage gaps instead. To date, only 4 states have added a local individual mandate.
Stricter Special Enrollment Requirements: Previously, the federal government would take your word for it if you tried to join a plan outside of open enrollment due to a special circumstance. As of this year, there are strict verification standards that involve sending the documents in a short period of time.
Removal of Non-Payment Loophole: Some consumers had also learned to stop paying their premiums in the months leading up to open enrollment. They bet that it would take a while for their coverage to be canceled, or even decided to lose coverage since they no longer needed it. This five-finger discount loophole was closed for 2018. Now, youll only be able to switch to new coverage if your old coverage is paid in full. Consumers especially those who are behind on payments by accident may not be able to learn about the issue, reconcile their bills, and sign up in time.
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When Can I Join Switch Or Drop A Plan
You can join, switch, or drop a
with or without drug coverage during these times:
- Initial Enrollment Period. When you first become eligible for Medicare, you can join a plan.
- Open Enrollment Period. From October 15 December 7 each year, you can join, switch, or drop a plan. Your coverage will begin on January 1 .
- Medicare Advantage Open Enrollment Period. From January 1 March 31 each year, if youre enrolled in a Medicare Advantage Plan, you can switch to a different Medicare Advantage Plan or switch to Original Medicare once during this time.
Learn more below about enrollment periods below.
When You First Get Medicare
- I’m newly eligible for Medicare because I turned 65.
What can I do?
Sign up for a Medicare Advantage Plan and/or a Medicare drug plan.
During the 7-month period that:
- Starts 3 months before the month you turn 65
- Includes the month you turn 65
- Ends 3 months after the month you turn 65
If you join
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Can I Still Make Changes To My Medicare Coverage For 2021
Q: Can I still make changes to my Medicare coverage for 2021?
A: For 2021 coverage, open enrollment for Medicare Advantage and Medicare Part D ended on December 7, 2020. The enrollment window for 2022 coverage will follow the same schedule, starting October 15, 2021 and continuing through December 7, 2021.
Medicare Open Enrollment Period : What You Need To Know
Medicare Open Enrollment runs from October 15 through December 7 each year. During this period, millions of Medicare recipients evaluate their current coverage and make changes that will affect their health care costs and coverage beginning in January of the following year.
Considering making changes to your coverage this fall or just want to learn more about this enrollment period?
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When Is Open Enrollment 2021 Dates & Deadlines For Each Stat
Enrolling in Medicare . Individuals who are first eligible for Medicare generally have a 7-month Initial Enrollment Period. While local Social Security offices are closed to the public, some continue to provide services over the phone. For individuals who need to apply for Medicare Parts A and B: We suggest creating an account on www.ssa.go Beneficiaries who were eligible for a different election period but were unable to enroll* in a plan during the allotted time period have until June 30, 2020, to enroll. Enrollments received are. There is also an extended MA open enrollment period from Jan. 1, 2020, to March 31, 2020. You must be enrolled in an MA plan to use this extended open enrollment period to make any changes The 2021 open enrollment period starts Sunday, November 1, 2020, and closes Tuesday, December 15, 2020. If you don’t purchase health insurance by the December 15 deadline, you can’t get 2021 coverage unless you qualify for a special enrollment period
You Do Not Look Into Medicare Advantage Supplemental Benefits
If you need certain services, especially dental, hearing, and vision coverage, you may want to consider a Medicare Advantage plan. Original Medicare does not cover them, but many people on Medicare need dentures, hearing aids, and eyeglasses.
The Centers for Medicare & Medicaid Services recently allowed Medicare Advantage plans to expand what types of benefits they could offer.
In 2019, they extended what they considered primarily healthcare-related benefits. These could include adult daycare services, medical alert devices, rideshare services for health appointments, and even carpet cleaning for people with asthma.
In 2020, they added services specifically for people who had chronic conditions. Not all of those benefits had to be primarily healthcare-related. They included possible coverage for services like acupuncture, food and produce, pest control for the home, and subsidies for utilities like electricity, gas, and water.
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Medicare Open Enrollment: What You Cant Do
The annual Medicare open enrollment period does not apply to Medigap plans, which are only guaranteed issue in most states during a beneficiarys initial enrollment period, and during limited special enrollment periods.
If you didnt enroll in Medicare when you were first eligible, you cannot use the fall open enrollment period to enroll. Instead, youll use the Medicare general enrollment period, which runs from January 1 to March 31.
Medicares general enrollment period is for people who didnt sign up for Medicare Part B when they were first eligible, and who dont have access to a Medicare Part B special enrollment period. Its also for people who have to pay a premium for Medicare Part A and didnt enroll in Part A when they were first eligible.
If you enroll during the general enrollment period, your coverage will take effect July 1.
What Are My Coverage Options
You can learn more about your coverage options by:
- Contacting your local Health Insurance Counseling & Advocacy Program , also called State Health Insurance Assistance Program . Your local HICAP has county-specific information on the Medicare advantage and Part D plans available in your area, as well as info on Medicare supplement plans known as Medigap.
- Using the Plan Finder on Medicare.gov to find Medicare Advantage and Part D plans in your area and to see what Part D plans cover the drugs you use.
- Reading the official U.S. government Medicare handbook: Medicare & You 2022. The section in the back lists Medicare Advantage and Part D plans available in your area. Hard copies were mailed to beneficiaries between September 16-30, and it is also available online. See the Go Paperless option on Medicare.gov for more info. Also, Medicare is now offering Medicare & You in Spanish, Chinese, Korean and Vietnamese.
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What Is The Best Supplemental Insurance For Medicare
Medigap policies help cover some of the costs that Original Medicare doesnt cover. Private companies sell these plans, which can reduce costs such as:
Medigap plans dont cover all additional costs. For example, they typically dont cover long-term care, vision or dental care, hearing aids, eyeglasses, or private-duty nursing.
There are 10 different types of Medigap plans, which are named by letter — such as Plan A, Plan B, etc. Each plan differs in terms of how much of your health care costs you will be responsible to pay.
In addition, not all plans are available in every state. Three states — Massachusetts, Minnesota, and Wisconsin — offer different standardized plans.
Choosing the right Medigap plan depends on your individual needs.
What Changes Can I Make During Medicare Advantage Open Enrollment Period
If your Medicare Advantage plan isnt serving your needs, you may want to compare the plans available in 2022 and change to a different one.
- During the new Medicare Advantage Open Enrollment Period, you can switch Medicare Advantage plans.
- Or, if you decide Medicare Advantage isnt the best choice for you, you can drop your Medicare Advantage coverage and go back to in Original Medicare.
- You can also make changes to your Part D prescription drug coverage in certain situations:
- If you have Medicare Advantage without prescription drug coverage, and you switch to a Medicare Advantage prescription drug plan.
- If you drop Medicare Advantage altogether, and go back to Original Medicare . You can then enroll in a stand-alone Part D prescription drug plan during this open enrollment period.
Note that you must be currently enrolled in Medicare Advantage to make any changes in coverage during the Medicare Advantage Open Enrollment Period. If youre enrolled in Original Medicare , the new open enrollment period doesnt apply to you.
If you want to switch from Original Medicare to one of the new Medicare Advantage plans for 2022, youll need to make changes during one of the enrollment periods described below. You also cant use the new Medicare Advantage Open Enrollment Period to switch between stand-alone Medicare Part D prescription drug plans.
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