Selecting Medicare Advantage plan during special enrollment period
My mother had a Medicare Advantage Plan for the past two years. I took her to the doctor yesterday and was informed that she is no longer enrolled in her Medicare Advantage Plan. She now only has Medicare A and B. She has no drug coverage.
Apparently, information about the plan’s “non-renewal” was mailed to my mother’s home. She didn’t understand the letter and ignored it. What can be done?
Since your mother was enrolled in a Medicare Advantage plan that did not renew its contract for 2019, she has a special enrollment period to make changes. Her special enrollment period lasts until Feb. 28. She has the following options:
Option 1: Remain in Original Medicare
If she decides on this option, she will want to consider enrolling in both a Medigap plan and a Medicare Part D drug plan. Read the notice she received from her Medicare Advantage plan; it should indicate that she has a “guarantee issue right” for certain Medigap plans (Medicare supplemental insurance). Medigap plans are standardized plans designed to help cover her out-of-pocket costs for Original Medicare parts A (hospital) and B (medical).
The booklet “Choosing a Medigap” explains Medigap plans. This booklet is available online at www.medicare.gov. She may also call 1-800-MEDICARE to request a copy of this booklet. The Maryland Insurance Administration at 1-800-4926116 (or www.mdinsurance.state.md.us) provides a listing of premium costs for Medigaps plans sold in Maryland.
In addition to considering a Medigap plan, she will want to consider a Medicare Part D drug plan to cover her prescription drug costs. To compare her Medicare Part D options, visit www.medicare.gov and use the Find Health and Drug Plan tool. 1-800-MEDICARE has customer service representatives available to run a Medicare Part D comparison and explain coverage options.
Option 2: Select another Medicare Advantage plan
Medicare Advantage plans are private companies that have contracted with Medicare to offer the basic Medicare benefits. Medicare Advantage plans may also have added benefits such as vision, dental and hearing services.
Information on 2019 Medicare Advantage plans is available at www.medicare.gov by using the Find Health and Drug Plan tool.
Pay special attention to how she must use a Medicare Advantage plan. Typically, these plans have a contracted network of doctors and hospitals. These plans will have out-of-pockets costs that will be her responsibility. Request a summary of benefits for any plan she considers and read the information carefully. Medicare Advantage plans typically cover prescription medicines; make sure she understands the out-of-pocket costs for her particular medicines.
She may also sit down with a SHIP counselor for free, unbiased counseling about her Medicare options. Please have her call 410-222-4247 to schedule an appointment.