When is the deadline? Does this apply to me?
If you received a Medicare Advantage Reassignment Notice and receive Extra Help the deadline to enroll in a Medicare Advantage plan is December 31, 2012!
How do I know if I am being reassigned?
In October, 2012, the Center for Medicare and Medicaid Services sent notices to individuals who qualify for Extra Help and are currently enrolled in a Medicare Advantage plan that is leaving the Medicare Program on December 31, 2012. (This notice was printed on blue paper.)
What happens if I do not enroll in a new Medicare Advantage plan?
If you do not enroll in a new Medicare Advantage plan with built a built-in Prescription Drug Plan (also known as “MAPD”) by December 31, 2012, then Medicare will enroll you in a Medicare Prescription Drug Plan (also known as “PDP”) only. You will no longer have a Medicare Advantage plan. This, in turn, means that you will return to original Medicare Part A and Part B, and be responsible for the cost-sharing, or out-of-pocket expenses, associated with original Medicare Part A and Part B. You will not have the advantages of out-of-pocket maximums, set co-pays, as well as some additional services provided by Medicare Advantage plans such as dental and vision. You will be responsible for original Medicare’s Part A recurring hospital deductible of $1,184.00, co-pays up to $578.00 per day you are hospitalized, as well as original Medicare’s Part B deductible of $147.00 and 20% coinsurance of every doctor bill, medical test or medical procedure. The Prescription Drug Plan that Medicare enrolls you in will go into effect January 1, 2013.
What should I do?
If you received the Medicare Advantage Reassignment Notice you have very limited time to complete your enrollment into a new Medicare Advantage plan. Contact a Benefit Specialist at Medicare Pathways for assistance in reviewing your options regarding Medicare Advantage plans or Medicare Supplement plans available in your area.
If you received the Medicare Advantage Reassignment Notice you have three options for Medicare coverage.
- Option 1: You can join another Medicare Advantage or other Medicare health plan, including a plan that offers drug coverage. The Benefit Specialist at Medicare Pathways can help you find a plan that meets your needs.
- Option 2: If you do nothing, you will have original Medicare, and Medicare will enroll you in a Prescription Drug Plan to make sure you get Extra Help paying for Medicare drug coverage. If you do not enroll in a new Medicare Advantage plan then the Medicare Prescription Drug Plan that Medicare enrolls you into may not cover all of your prescription drugs.
- Option 3: You can choose and join a Medicare Prescription Drug Plan on your own. This means you would have the drug plan you choose and original Medicare Part A and Part B for your other health care services.
If you have already received the notice from Medicare notifying you of your reassignment into a Prescription Drug Plan, it is not too late to shop and find a Medicare Advantage with a built-in Prescription Drug Plan that will better suit your needs and assist you with your out-of-pocket costs original Medicare leaves you to pay. If you enroll in a new Medicare Advantage plan between now and December 31, 2012, you will automatically be disenrolled from the Prescription Drug Plan Medicare chose for you.
Additionally, when you qualify for Extra Help you can join, switch, or drop a Medicare Prescription Drug Plan at any time. You may also want to buy a Medicare Supplemental (also known as “Medigap”) instead of a Medicare Advantage plan to help pay health care costs that original Medicare Part A and Part B does not cover. Because your current plan is leaving Medicare, you have a special right to buy a Medicare Supplement policy. This is called a Special Enrollment Period (also known as “SEP”). You will have this Special Enrollment Period for 63 days after your current plan coverage ends. This Special Enrollment Period applies only to purchasing a Medicare Supplement plan.
What to do next? Consider your options carefully. If you do nothing, Medicare will enroll you in a Prescription Drug Plan. If you want to join a different Medicare health plan, such as a Medicare Advantage plan with a built in Prescription Drug Plan, or a Medicare Supplement with a “stand-alone” Prescription Drug Plan, it is a good idea to do so as soon as possible. The last day to enroll in a Medicare Advantage plan for individuals who received a Reassignment Notice is December 31, 2012.
The Center for Medicare and Medicaid Services recommends that you get help comparing your health and drug plan options. The Benefit Specialists at Medicare Pathways will assist you in making the most appropriate and most affordable decision regarding a new Medicare Advantage or Medicare Supplement plan. The Benefit Specialist at Medicare Pathways are highly qualified agents who will consider your financial and medical situation, make sure your doctor is a part of the network if you choose a new Medicare Advantage plan and, upon request, will make sure the medications you currently take are on a Prescription Drug Plan’s formulary. If a prescription drug is not on a Plan’s formulary then the plan will not pay for the medication. Overall, the Benefit Specialist will take your needs into consideration before recommending enrollment into a plan. The Benefit Specialist will also make sure you understand the plan in which they are recommending and assist you with enrollment.
Medicare Pathways, Inc. 1-866-466-9118
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