Take care when changing Medicare coverage during the Medicare Advantage disenrollment period
Medicare is a very important subject of concern to baby boomers. Today, I have another guest contribution by Ross Blair, President and CEO of Plan Prescriber, Inc., a leading provider of comparison tools and educational materials for Medicare-related insurance products.
The Medicare Advantage Disenrollment Period (MADP) runs from January 1 through February 14, 2012. During that time, people enrolled in Medicare Advantage have the opportunity to cancel their Medicare Advantage plan if they find it’s not fitting their needs.
Those who do elect to drop a Medicare Advantage plan will be placed back on “Original Medicare” and have the option to enroll in a stand-alone Medicare Part D Prescription Drug Plan (PDP), so that they don’t have a lapse in drug coverage. If you’re considering taking advantage of the ADP, take care to avoid gaps in coverage. Here are few important pieces of advice I’d encourage people to consider:
1. Know the gaps in Original Medicare (Parts A and B):
Similar to Medicare Advantage, original Medicare (Parts A and B) has deductibles and coinsurance. But, unlike Medicare Advantage, Original Medicare doesn’t have a cap on how much you may have to spend out of your own pocket each year if you get sick or injured. Per the 2010 health care reform law, all Medicare Advantage plans must place a $6,700 limit on what you can be asked to spend out of your own pocket for covered medical services (some have lower caps). And, original Medicare does not cover the cost of prescription drugs.
2. Look before you leap:
I encourage people to make a checklist of benefits they want to keep before they drop a Medicare Advantage plan. For example, be sure your doctor will see you if you change from private Medicare Advantage insurance to basic Medicare. And, be sure affordable prescription drug coverage is available through a stand-alone Medicare Part D plan that will cover the specific drugs you take at a reasonably low price.
3. Look into Medicare Supplements–
If you’re going with Medicare Parts A and B, you may want to look into augmenting it with a Medicare Supplement plan. Most states have 10 Medicare Supplement plan types: A, B, C, D, F, G, K, L, M and N (some plans types are not available in all areas). Each plan type must have the exact same level of supplemental coverage, so an F plan from one company must legally provide the same level of coverage as an F plan from another insurer.
You can compare plans side-by-side at PlanPrescriber.com. If you’re canceling your Medicare Advantage plan, Medicare Supplement may be a good alternative. NOTE: After your first three months on Medicare Part B, Medicare Supplement plans are medically underwritten, which means some people may not qualify.
4. Don’t lose additional benefits:
Some Medicare Advantage plans provide routine dental and vision coverage, which original Medicare does not. And, Medicare Supplement plans do not typically provide these services either. So, if you drop Medicare Advantage, during the ADP you may need to purchase stand-alone coverage for routine vision and dental care.
Web sites like eHealthInsurance.com allow you to research and compare those types of policies side-by-side.If you follow my tips, you should be well prepared for the ADP.
Other recommendations: Don’t stop at Medicare.
There are an increasing number of insurance products not related to Medicare that people are starting to consider and take advantage of. Accident and critical illness policies are now available in many states.
When you have a claim, these plans give you money directly and you can use it your discretion. These aren’t comprehensive insurance products, but they can help you pay for deductibles, coinsurance, rent or groceries if you have a major claim.
Medicare has neither reviewed nor endorsed this information.
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I am still a few years away from Medicare age but I find articles like this very helpful. Up until the last year or so I assumed Medicare was pretty straightforward…you hit 65 and you are covered. Obviously, the choices and limitations and decisions that must be made are much more complicated than that. It is important that I begin to understand the choices and costs I will face now so I don’t panic in another 2 years when it is my turn.
I’m right where you are Bob! I have a few years til Medicare kicks in. I know my parents spend a lot on Medicare and supplements but at least any and all of their medical expenses have been covered so far. Medicare isn’t really free either, as a monthly fee is deducted from people’s social security check. I find articles like these very helpful in sorting it all out. Thanks for writing!
Joan
Joan gives EXCELLENT advice about how to properly use the Medicare Advantage Disenrollment Period. This window is designed to help people who may have made a decision for coverage duriing the fall annual election period that they now regret. You can use the window to change your coverage, but it will affect your Part D drug formulary, and as Joan said, possibly your access to medical providers. Since you only get to use this window ONCE, be sure you fully understand what will happen when you disenroll, so that your access to doctors and prescriptions will be adequate for the year ahead.
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