Preferred Pharmacies Do Not Always Offer The Lowest Costs
According to medicare.gov, a preferred pharmacy has agreed with your plan to charge less, which means it has negotiated lower prices than those available at a standard or non-preferred pharmacy. This year, I found several examples of higher costs at preferred pharmacies. Heres the most dramatic one.
Total estimated drug and premium costs at a standard pharmacy were $2,016 and at the preferred pharmacy, $3,141, an $1,100 difference. This plan also had another preferred pharmacy with total costs of $1,606. The beneficiary opted for this plan and would make sure to use the second preferred pharmacy.
Changing Medicare Advantage Plans: Compare Plans Before You Switch
If you want to change Medicare Advantage plans, you may want to make sure youre choosing the right plan for your needs and not missing out on a plan that might be better for you. For an instant side-by-side look at Medicare Advantage plans in your area, start by entering your zip code in the box on this page.
From the list of plans displayed, you can enter your medications to see if theyre covered, look at specific plan costs, and more. Follow the links below to request an email with customized information, or to set up a phone call with me.
New To Medicare?
Becoming eligible for Medicare can be daunting. But don’t worry, we’re here to help you understand Medicare in 15 minutes or less.
Special Enrollment Periods For Limited Income
If youre on a limited income, youre eligible for a few Special Enrollment Periods.
Medicare Advantage Dual SEP
If you have both Medicare & Medicaid, youre eligible for this SEP. This SEP allows you to enroll, disenroll, or switch to another plan once per quarter during the first three quarters.
During the 4th quarter, dual beneficiaries must use the AEP to make changes. If you lose Medicaid, this SEP will end two months after.
Medicare Advantage Low-Income Subsidy & Extra Help SEP
This enrollment period is for beneficiaries who are eligible for the Extra Help. This Special Enrollment Period is also for those who are dual-eligible for Medicare & Medicaid.
This period allows you to change to another Advantage plan once per quarter during the first three quarters of the year.
This Extra Help SEP begins the month youre eligible for Extra Help. If you lose Extra Help, this SEP will end two months after.
Medicare Advantage State Pharmaceutical Assitance Program SEP
For states that take part in State Pharmaceutical Assistance Programs, recipients can sign up or switch Part D plans. The period can only be used once per the calendar year.
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How To Sign Up For And Change Medicare Plans
Once youre enrolled in Medicare, youll have various opportunities to change certain aspects of your coverage. Heres an overview:
- During the annual open enrollment period , you can make a variety of changes, none of which involve medical underwriting:
- Switch from Medicare Advantage to Original Medicare or vice versa.
- Switch from one Medicare Advantage plan to another.
- Switch from one Part D prescription plan to another. Its highly recommended that all beneficiaries use Medicares plan finder tool each year to compare the available Part D plans, as opposed to simply letting an existing drug plan auto-renew.
- Join a Medicare Part D plan.
- Drop your Part D coverage altogether.
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It’s important to review any changes your current Medicare health and drug plan may have made to its benefits, premiums or coverage options. These changes will be outlined in “Evidence of Coverage” and “Annual Notice of Change” forms you’ll receive in the mail.
If your current coverage is meeting your medical and prescription needs, there’s no further action you must take to retain the same coverage you’ve had this year. However, there are a few circumstances in which changing plans could greatly benefit you and put money back in your pocket.
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How To Cancel A Medicare Supplement Plan
There is not a required disenrollment period for canceling your Medicare Supplement plan. You may drop your Medigap policy at any time by requesting a cancellation through your insurance company however, if you decide to leave, you may not be able to buy a Medicare Supplement Insurance plan at another time, unless you have a trial right or guaranteed issue right .
Need help choosing a Medicare Supplement Plan? No matter where you are in your Medicare journey, Medicare.orgs information and resources can help make it easy to find the quality and affordable Medicare plan thats right for you. We offer free comparisons for Medicare Advantage Plans , Medicare Supplement Plans , and Medicare Prescription Drug Plans .
Get an online quote for Medicare plans that fit your health care needs today! Or call TTY 711 to get answers and guidance over the phone from an experienced licensed sales agent.
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When Is Open Enrollment For Medicare Advantage Plans
The Medicare Advantage Open Enrollment Period runs between January 1st and March 31st. It allows you to make a one time change to your current Medicare Advantage plan. Unless you have an Advantage plan, you cannot make any changes to your coverage. Open Enrollment Period is not for you to enroll in an Advantage plan for the first time. But, its to change your policy to another one or switch back to Medicare.
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Medicare Advantage Trial Period Special Enrollment Period
If you enrolled in a private Medicare Advantage plan during your ICEP, you have a trial period. This trial period is a 12-month window.
During this 12-month window, you have a SEP that allows you to disenroll from your first Medicare Advantage plan and go back to Original Medicare.
At this same time, youll have a Guaranteed Issue Right to enroll in a Medigap plan. The Guaranteed Issue Right will last for 63 days after you disenroll from your Medicare Advantage plan.
The Medicare Supplement Free Look Period
When you switch Medicare Supplement Insurance plans, you generally are allowed 30 days to decide to keep it or not. This 30-day free look period starts when your new Medicare Supplement plan takes effect. To qualify, you need to pay the premiums for both your new plan and your old plan for one month.
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When Can I Change My Medicare Coverage
You can make changes to your Medicare coverage during a few key times.
- The Medicare Annual Enrollment Period , October 15 December 7
- The Medicare Advantage Open Enrollment Period, January 1 March 31
- The Medicare Special Enrollment Period for qualifying life events dates vary based on qualifying event
Last Day To Change Medicare Drug Plan
- Tammie Smith
A crush of people who waited until the last minute to inquire about changing their Medicare drug plans was keeping Linda Barnhart very busy yesterday.
Medicare enrollees who want to change their Part D drug plan or add Part D drug coverage have until midnight today to do so.
“This year was a little bit different,” said Barnhart, manager of senior resources and advocacy for Senior Connections, The Capital Area Agency on Aging. “The first couple of years after the initial year where everybody had to make a choice, people tended to stay put.”
This year, many plans increased premiums and co-pays and people were encouraged to shop around, she said.
“Medicare was running ads. There were some local ads running,” said Barnhart. “So everybody was made aware they maybe should look at this coverage annually. What we are finding now is a lot of people did end up staying put, and hopefully that will work out for them. But we did help a lot of people change plans.”
Medicare is health insurance for people 65 and older, people under 65 who are eligible because of disability and people with end-stage renal disease. An estimated 43 million people are enrolled in Medicare.
Barnhart’s agency offers its services for free. Some private insurance agents also help enroll people and get a commission from the insurance companies.
Contact Tammie Smith at 649-6572 or .
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Your Plan Changes Its Contract With Medicare
- Medicare takes an official action because of a problem with the plan that affects me.
-
What can I do?
Switch from your Medicare Advantage Plan or Medicare Prescription Drug Plan to another plan.
When?
Your chance to switch is determined by Medicare on a case-by-case basis.
- Medicare ends my plan’s contract.
-
What can I do?
Switch from your Medicare Advantage Plan or Medicare Prescription Drug Plan to another plan.
When?
Your chance to switch starts 2 months before and ends 1 full month after the contract ends.
- My Medicare Advantage Plan, Medicare Prescription Drug Plan, or Medicare Cost Plan’s contract with Medicare isn’t renewed.
-
What can I do?
Join another Medicare Advantage Plan or Medicare Prescription Drug Plan.
When?
The Medicare Advantage Open Enrollment Period
The Medicare Advantage Open Enrollment Period is for current Medicare Advantage plan members. It runs from January 1 to March 31. During this time, Medicare Advantage plan members can revisit their plan choices and choose to make coverage changes.
You can do the following during the Medicare Advantage Open Enrollment Period:
- Switch to a different Medicare Advantage plan.
- Drop your Medicare Advantage plan and go back to Original Medicare .
- Enroll in a stand-alone Medicare prescription drug plan , if you go back to Original Medicare.
And similar to the Medicare Annual Enrollment Period, if you choose to return to Original Medicare, you are now able to apply for a Medicare supplement insurance plan, though you are not guaranteed coverage and could face higher costs. Please note that you can apply for a Medicare supplement plan at any time during the year and aren’t limited to the enrollment periods described above.*
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Additional Resources To Help You Choose The Best Plan
Auto-renewing your current Medicare plan when your needs or finances have changed may result in lost savings and potential confusion about your medical coverage. One way to help educate yourself on your options is the GoodRx Medicare Center, which offers useful content, tools and savings opportunities for Medicare enrollees. This resource can help you better understand a complex Medicare topic, break down your coverage, and even help you save money on health costs.
Why Change Medicare Advantage Plans
Medicare Advantage plans deliver your Medicare Part A and Part B benefits through a private insurance company that contracts with Medicare. How different can they be?
Medicare Advantage plans can be different in many ways. Here are just a few.
- Many but not all Medicare Advantage plans cover prescription drugs.
- Some Medicare Advantage plans give you extra benefits, like routine dental or hearing care.
- Some plans may require you to use doctors in the plans provider network, or pay more if you go outside the network.
- Premiums vary among plans. So do other costs, like deductibles and coinsurance.
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Make Sure You Are Eligible To Make Coverage Changes
If youre newly eligible for Medicare, or delayed coverage for one reason or another, and are not yet signed up for Part A and Part B, this is NOT the enrollment period for you. You wont be eligible to make changes at this time unless youre within your Initial Enrollment Period or are eligible for a Special Enrollment Period. Youll need to wait until the General Enrollment Period to enroll in Original Medicare.
When Is Medicare Open Enrollment
Medicare open enrollment also known as Medicares annual election period runs from October 15 through December 7 each year.
During this annual window, Medicare plan enrollees can reevaluate their coverage whether its Original Medicare with supplemental drug coverage, or Medicare Advantage and make changes or purchase new policies if they want to do so.
During the Medicare open enrollment period, you can:
- Switch from Original Medicare to Medicare Advantage .
- Switch from Medicare Advantage to Original Medicare .
- Switch from one Medicare Advantage plan to another.
- Switch from one Medicare Part D prescription drug plan to another.
- Enroll in a Medicare Part D plan if you didnt enroll when you were first eligible for Medicare. If you havent maintained other , a late-enrollment penalty may apply.
Prior to 2021, patients with end-stage renal disease were unable to enroll in Medicare Advantage plans unless there was a Medicare Special Needs plan available in their area for ESRD patients. But that changed as of 2021, under the terms of the 21st Century Cures Act. People with ESRD gained the option to enroll in Medicare Advantage as of 2021, and CMS expected more than 40,000 to do so. This can be particularly advantageous for beneficiaries with ESRD who are under age 65 and living in states that dont guarantee access to Medigap plans for people under the age of 65.
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Should You Change Your Medigap Policy
You may want to consider changing your plan or insurance company to increase your benefits or lower your monthly costs.
If you are happy with your current policy, there is no reason to change plans. But you may be interested in changing policies under certain circumstances:
- Better priceEvery September, insurance companies must send out a Medicare Annual Notice of Change letter to Medicare beneficiaries. This letter tells you of any changes to your rates. If your rates go up, you may want to consider looking for a new policy. You can shop around for a similar plan offered by the same company or a different company for a lower premium.
- More coverageIf you decide you need more coverage, you can switch to a different plan letter to get more benefits.
- Less CoverageLikewise, if you dont need or want to keep paying for benefits you dont use, you might consider switching to a more basic plan if it offers a lower premium.
- Different ProviderIf you are unhappy with your insurance company for any reason, you can purchase a plan from a different insurance underwriter.
Can I Still Make Changes To My Medicare Coverage For 2022
Q: Can I still make changes to my Medicare coverage for 2022?
A: For 2022 coverage, open enrollment for Medicare Advantage and Medicare Part D ended on December 7, 2021. The enrollment window for 2023 coverage will follow the same schedule, starting October 15, 2022 and continuing through December 7, 2022.
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Medigap Plan C And Plan F Changed In 2020
A slight but important change was made to the selection of standardized Medigap plans available in most states.
Plan C and Plan F are no longer available to new Medicare beneficiaries who became eligible for Medicare after January 1, 2020.
If you were already eligible for Medicare before January 1, 2020, you may still purchase Plan C or Plan F in 2020 and beyond if either plan is available where you live.
But anyone who became eligible for Medicare after January 1, 2020, will not be allowed to enroll in either of those two plans.
Anyone currently enrolled in Plan C or Plan F will be allowed to keep their plan going forward.
This 2020 Medigap plans change came as a result of federal legislation that prohibits full coverage for the Medicare Part B deductible. Plan C and Plan F are the only standardized Medigap plans that provide this benefit.
Reasons To Switch Medicare Plans
Whether you have new health needs or your circumstances have changed, here are a few reasons you might want to consider switching plans before it’s too late.
You Have New Health Needs
If you have additional health needs, be sure to review your current plan to see what you may need to add for next year. Maybe you’ve developed a new health condition or need some additional health coverage going forward. For example, Medicare A and B do not cover dental or vision benefits, but Medicare Advantage plans do. You can switch to a bundled MA plan to gain those benefits for a teeth cleaning or a vision exam.
You may also want to take advantage of the additional health benefits that other plans offer. For instance, some MA plans can provide transportation services to appointments, caregiver benefits, and adult day care options. Reach out to a specific plan provider to learn more about their extra benefits.
You Don’t Need The Same Benefits
If your health situation has changed over the last year, and you no longer require certain benefits offered by your current plan, you may benefit from switching plans. Whatever your circumstances, map out the services you feel comfortable having and compare them to what your current plan offers. If you find you no longer require certain services, consider switching to a plan that encompasses all the essentials without anything additional.
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