New Disenrollment Period Offers Some Medicare Consumers One More Chance To Change Their Health Coverage

-- Consumers Should Carefully Review Their Options Before Making a Change --

New York, NY—Medicare consumers who are enrolled in Medicare private health plans, commonly known as Medicare Advantage plans, and who become dissatisfied with their choice, can disenroll during the Medicare Advantage Disenrollment Period (MADP), which runs from January 1 to February 14. Consumers who disenroll from their private plan can switch only to Original Medicare—the traditional Medicare program administered by the federal government. Most people who switch to Original Medicare can also change their Medicare prescription drug coverage. The MADP replaces the Open Enrollment Period, which ran from January 1 to March 31 in past years.

“People with Medicare who become unhappy with their Medicare Advantage plan have one more opportunity to change their coverage before being locked in until next fall,” said Joe Baker, president of the Medicare Rights Center. “Because the window is shorter than in past years, consumers should review their coverage options carefully and consider all of the implications of making a change before doing so.”

What are my options during the Medicare Advantage Disenrollment Period? If you have: A Medicare Advantage private health plan with prescription drug coverage, you can switch to Original Medicare plus a prescription drug plan OR Original Medicare without a prescription drug plan A Medicare Advantage Private Fee-For-Service (PFFS) plan that does not include prescription drug coverage and a stand-alone prescription drug plan, you can switch to Original Medicare, but you must keep your current prescription drug plan Original Medicare or Original Medicare and a prescription drug plan, you cannot make any changes during this time

Although Original Medicare covers most necessary services and is accepted by most doctors and facilities across the country, it does not cover the full cost of care. Many consumers who enroll in Original Medicare choose to purchase supplemental coverage to help pay for out-of-pocket costs such as deductibles and coinsurance.

However, people who disenroll from their Medicare private health plan may have limited ability to buy supplemental coverage. State laws vary on when consumers can purchase Medicare supplemental policies, also known as Medigaps. Call your State Health Insurance Assistance Program (SHIP) to find out if and when you can enroll in a Medigap plan in your state. You can find the number for your local SHIP by visiting www.shiptalk.org or calling 800-MEDICARE.

Consumers who disenroll from their private plan should be aware that they may need to join a stand-alone Medicare prescription drug plan in order to maintain drug coverage. Medicare Rights advises consumers who are choosing a plan to consider not only premium and copayment costs, but also whether the drugs they take are on the plan’s formulary (list of covered drugs). Consumers should also check to see whether the plan places any restrictions on the drugs they take. Restrictions can take the form of quantity limits, prior authorization, and step therapy. To learn more about choosing a Medicare prescription drug plan that best meets your needs, visit Medicare Interactive.

Medicare Rights advises consumers who wish to change their health coverage to do so by calling 800-MEDICARE rather than their plan. If you need to keep or add Medicare prescription drug coverage, it is best to make your coverage change by enrolling in a stand-alone drug plan. When you enroll in a drug plan, you will automatically be enrolled in Original Medicare. Changes made during the MADP are effective the first of the following month.

Learn more about changing your Medicare private health plan on Medicare Interactive.

Resources

• Find the number for your local State Health Insurance Assistance Program (SHIP) at www.shiptalk.org.
• 800-MEDICARE
• Medicare Interactive (www.medicareinteractive.org), the Medicare Rights Center’s free web-based counseling tool, can help you evaluate your coverage options.