FOR IMMEDIATE RELEASE
Contact: Mitchell Clark
Senior Communications Associate
Decmeber 4, 2012
Last Chance to Change Your Medicare Health and Drug Coverage Options without Restriction
--Fall Open Enrollment Period Ends on December 7—
New York, NY–People with Medicare have until Friday, December 7 to make changes to their Medicare health and drug coverage without restriction. The changes will take effect on January 1.
“Fall Open Enrollment is ending this week, so now is the time to review all of the options available to you, even if you are happy with your coverage.” said Joe Baker, president of the Medicare Rights Center. “Plans can change their costs and benefits every year, and what works for you this year may not be your best choice in 2013. It’s important to take stock of your current health and drug coverage and to consider your health and financial needs. If you decide to make a change, make sure to do so by December 7.”
Medicare Health Coverage
Medicare beneficiaries have the choice of receiving their Medicare health benefits through Original Medicare, which is administered by the federal government, or through a Medicare Advantage plan, which is run by a private insurance company.
The Medicare Rights Center urges people to ask questions before enrolling in a Medicare Advantage plan, including the following:
- Will I be able to use my doctors? Are they in the plan’s network and are they taking new patients who have this plan?
- Have my doctors’ experiences with this plan been positive? What problems have my doctors seen with patients in this plan?
- How much will it cost to see my primary care physician? A specialist?
- Do I need a referral to see a specialist?
- What service area does the plan cover?
- What kind of coverage do I have if I travel outside of the service area?
For a full list of questions to ask, go to Medicare Interactive (http://www.medicareinteractive.org/page2.php?topic=counselor&page=script&slide_id=322)
People with Medicare who become unhappy with the Medicare Advantage plan they chose are able to switch to Original Medicare and a stand-alone prescription drug plan during the Medicare Advantage Disenrollment Period (MADP), which begins January 1 and ends February 14. They will also have the right to add a Part D prescription drug plan during the MADP. They will not, however, be able to switch from one Medicare Advantage plan to another. People with Original Medicare will not be allowed to make changes during the MADP.
“The Medicare Advantage Disenrollment Period is a limited window of opportunity that can be useful for some beneficiaries,” said Baker. “But it’s important to remember that if you make a change during that time, you may not be able to get a Medigap plan to fill the gaps in coverage, or your Medigap choices may be limited. It’s best to put the time in now to find the best plan for you, because after December 7 may be too late.”
Medicare Prescription Drug Coverage
Medicare beneficiaries who have a Part D prescription drug plan should not only find out if a plan covers their drugs, but also pay particular attention to coverage restrictions, such as quantity limits, prior authorization and step therapy.
For a step-by-step guide to comparing Part D drug plans, go to Medicare Interactive (www.medicareinteractive.org/page2.php?topic=counselor&page=script&slide_id=1204)
The Medicare Rights Center recommends that beneficiaries call the plan to confirm the information they find, and keep a record of the conversation with the plan representative. We also recommend enrolling in a plan by calling 800-MEDICARE rather than the plan itself.
Reminder for those affected by Hurricane Sandy
In order to give beneficiaries and their families adequate time and presence of mind to fully weigh the scope of their health care needs, the Centers for Medicare & Medicaid Services (CMS) is granting an extension of the Medicare Fall Open Enrollment Period for individuals who were affected by Hurricane Sandy and who are unable to make a Medicare enrollment decision by the December 7 deadline. Call 1-800-MEDICARE (1-800-633-4227) to make a plan selection at anytime, 24 hours a day, 7 days a week. Each request will be reviewed individually to determine the best course of action based upon individual circumstances. Any enrollment into a plan after the December 7 deadline will be effective the month after the enrollment request is made.
For more detailed information about the Fall Open Enrollment Period, please see www.medicarerights.org/pdf/2012-Fall-Open-Enrollment-Resource-for-Journalists.pdf.
- Medicare Interactive (www.medicareinteractive.org), provides free consumer-friendly information about Medicare benefits, rights and options.
- State Health Insurance Assistance Programs (SHIPs) provide free counseling services. To find your local SHIP, go to shipnpr.shiptalk.org or call 800-677-1116.
- end -
Follow us on Facebook and Twitter:
Medicare Rights Center is a national, nonprofit consumer service organization that works to ensure access to affordable health care for older adults and people with disabilities through counseling and advocacy, educational programs, and public policy initiatives.
520 Eighth Avenue, North Wing, 3rd Floor ∙ New York, New York 10018
1224 M Street, NW, Suite 100 ∙ Washington, D. C. 20005 ∙ www.medicarerights.org