Reprieve for People with Medicare Advantage


Yesterday, a lady from Michigan asked me some very good questions.  I shared them in my post yesterday, “Q and A about Medicare Advantage and Medigap in Michigan.”

Today another change in variables has taken place for people with Medicare Advantage.  The Department of Health and Human Services has extended the  Special Election Period for people who formerly had prescription drug coverage included in their Medicare Advantage MA-PD plans.  In plain language this means that people who need to change from Medicare Advantage now have an additional 2 weeks to get a Medicare D prescription plan to cover their prescription drugs in 2011.  They now have through the end of February.  February 28 is now the deadline to sign up with a Medicare D plan.

This Special Election Period (SEP) is not available for everyone.  The SEP allows only those who lost their drug coverage because either their MA-PD plan was canceled on them or had their services reduced, like happened to people with Spectrum Health in West Michigan.

This announcement does not affect the deadline for people to switch from Medicare Advantage plans to traditional Medicare.  That deadline remains.  People who are wanting to make such a change have only until next Monday.

People who do make the change will need two different types of Medicare Supplements to maintain coverage similar, but not exactly the same, as what they had.

Medigap

The first type of supplement they will need is called a Medigap. Medigap was our spotlight topic for January on this blog and our website.  You can find several posts, including, “Major Underwriting Change for Plan N” by searching the category, Medicare.

In short, Medigap covers all or a portion of medical bills that Medicare does not pay.  It all depends on which plan you elect.

The most important thing to remember is that Medigap plans are medically underwritten unless CMS declares a Special Election Period for them or you are in your Open Election Period when Medigap is guarantee issue.

The most recent Special Election Period announcement from HHS does not include Medigap.  It is only for Medicare D.

Medicare D

In plain language, this announcement extends the right to obtain a Medicare D Prescription Drug Plan for people whose Medicare Advantage plan was canceled or services were reduced.

Normally, people have only until December 31 of the previous year to make a formal enrollment in Medicare D.  This decision allows those in West Michigan, as well as all those in other places in the nation who qualify,  obtain coverage for their prescription drugs that they would otherwise be losing.

I am able to help people in Texas with Medicare D issues but not in Indiana or Michigan.  I can only refer them to the HHS website if they need a Medicare D plan.

Those people in Texas, Indiana or Michigan who elect to disenroll from a Medicare Advantage plan still must make their election to rejoin traditional Medicare by Monday, February 14 or wait until the next year to change.  The Insurance Barn is able to help them with the Medigap portion of their new plans if they need help.

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