Last Chance To Change Medicare Health Plans Before Lock-In On April 1, USA

06 Mar 2008
http://www.medicalnewstoday.com/articles/99695.php

People with Medicare have one last chance to change their Medicare health plan before they are locked into their plans for the rest of the calendar year.

During the Open Enrollment Period, which began January 1 and lasts through March 31, people with Medicare are allowed to change their choice of Medicare health coverage once, but cannot add or drop the Medicare drug benefit. The new coverage will start the first of the month after they make their selection. Most Medicare recipients will not be able to change their plan again until 2009.

"Doctors can drop out of a private health plan at any time, yet people with Medicare do not have the right to change plans when they discover that their plans do not meet their health or financial needs," said Robert M. Hayes, president of the Medicare Rights Center, a national consumer service organization. "Take the month of March to make the best choice of plans to protect your health care for the rest of 2008, especially if you have incurred unanticipated high copays," he said.

In some states, enrollment in a Medicare private health plan also impacts a person's right to purchase a supplemental Medicare plan, or "Medigap" policy. Many people are not aware that if they are enrolled in a Medicare private health plan for longer than 12 months, they may be giving up-for life-their right to purchase a Medigap policy, Mr. Hayes said.

If someone is eligible to buy a Medigap policy to supplement Original Medicare but chooses to enroll in a Medicare private health plan instead, or if he dropped a Medigap policy to join a Medicare private health plan, he retains his right to purchase a Medigap policy only if he disenrolls from the Medicare private health plan within 12 months. Some insurance companies may be willing to sell a Medigap policy after that time, but there is no guarantee unless you live in a state that offers more protection.

During the Open Enrollment Period, a person in a Medicare private health plan (such as a HMO, PPO or Private-Fee-for-Service Plan) with drug coverage, for example, can change to Original Medicare-with a stand-alone drug plan, since she must continue to have drug coverage-or another Medicare private health plan with drug coverage. She is not permitted to switch to a private health plan without drug coverage.

Someone with Original Medicare and a stand-alone drug plan cannot use this period to switch to another stand-alone drug plan. This would be considered as only a drug coverage change-not a health plan change.

People may be eligible for a Special Enrollment Period (SEP) to change health or drug plans if they meet certain criteria. Moving out of a plan's service area, for example, qualifies one for an SEP, as does being misled into enrolling in a private Medicare health or drug plan.

One group is always exempt from the lock-in rules: People with Extra Help-a federal assistance program that helps pay for the costs of Medicare drug coverage (Part D) are allowed to change plans once a month.

To learn more about the Open Enrollment Period, Special Enrollment Periods and when you have the right to buy a Medigap plan, log on to Medicare Interactive Counselor at the Medicare Rights Center's website at http://www.medicarerights.org/help.html.

Medicare Interactive Counselor is a resource provided by the Medicare Rights Center, the largest independent source of health care information and assistance in the United States for people with Medicare.

Medicare Rights Center (MRC) is the largest independent source of health care information and assistance in the United States for people with Medicare. Founded in 1989, MRC helps older adults and people with disabilities get good, affordable health care.