I missed Medicare’s 12/15 Annual Deadline … Now What?

February 11, 2019

Every year around this time of year I get a few calls from apparent members of the Procrastinator’s Club about what to do now because they want to change their plan. Well, the good news is that you may still have options available to you, depending on what you are hoping to change. The rules vary depending upon whether you are asking about your Medicare Supplement (Medigap) Plan, your Medicare Advantage (typically HMO or PPO) Plan, or your Prescription Drug (Part D) Plan. So let’s take a look …

Medicare Supplement (Medigap) – For close to fifteen years I have been reminding my clients that there is NO ANNUAL ENROLLMENT PERIOD for Medigap plans. You can change at any time, often subject to each individual company’s underwriting questions. Perhaps you have comprehensive Plan F and want to cut costs by switching to Plan G or Plan N? Maybe you are looking to upgrade your plan to Plan F or Plan G? You can do this at any time … like right now! Depending on the plan you have, the company it is with, and the state you reside in, it could be as simple as a phone call. Talk to an agent and let them explain your options. You don’t have to wait.

Medicare Advantage (HMO/PPO, etc.) – If you have one of these plans, from now until March 31, you can change your plan or you can go back to Original Medicare and presumably get a Medigap Plan and a prescription plan (Part D). After March 31, you will have to wait till the next Annual Enrollment Period (10/15 – 12/7) unless you qualify for a Special Enrollment (such as moving out of the area). This Enrollment Period is new this year and it’s a great opportunity for those who learned about a Medicare Advantage plan after the Annual Enrollment Period (when it used to be too late). Remember, however, that this is only open to those who already have a Medicare Advantage plan now. In addition, see below about a Special Enrollment if you qualify for a State Pharmaceutical Assistance Plan.

Prescription Drug Plan (Part D) – This one is a little tougher to change now, but not impossible. The easiest way is if you have now or qualify for a State Pharmaceutical Assistance Plan. For example, in my home state, NJ offers PAAD and Senior Gold. Both have income based, not asset based qualifications, so more people qualify than they think. Once you qualify, you are entitled to one additional Special Enrollment to change annually. You can even switch to a Medicare Advantage Plan at that time. In NY, the program is called EPIC, also an income only based qualification. Many, but not all, states offer a State Pharmaceutical Assistance plan.

In short, contrary to what Dandy Dan Meredith used to sing often on Monday Night Football, you DON’T have to “turn out the lights because the party’s over”. So talk to your agent, you might be glad you did (so would he or she). If you wish, feel free to call me at (201) 445-3239 or email me at david.tirpak@msn.com. I’ll be happy to point you in the right direction. The party’s not over and you can have your cake and eat it too. Until next time …

The Medicare Annual Enrollment Period

October 12, 2018

October 15 through December 7 is the time of year when those on Medicare such as myself can review and change their Medicare Advantage (Part C) or Prescription Drug (Part D) plan.  Each year I remind my clients that you can change your Medicare Supplement (Medigap) at any time (subject to underwriting).

For agents it is the CRAZY season.  For Medicare recipients it the CONFUSING season.  To keep sane, I wrote the following several years ago.  Enjoy!

Twas the night before Medicare’s Annual Enrollment Period, and all through the town
Not a creature was laughing, not even a clown;
The Annual Notices of Change were stacked on the floor,
At least they could be used to hold open the door;
The seniors and baby-boomers were sitting in chairs;
Looking at all the mail with confounded stares;
And my wife in her shawl, and I in my sweater,
Had started to see if next year’s plans might be better,
When all of a sudden I heard the door bell,
“Our agent is here” to my wife I did yell,
I opened the door and welcomed him in,
“I’ll explain everything” he said with a grin,
He was like an old friend and he smiled with a dimple,
I knew that he could make this all so simple,
With his briefcase in hand by the table we sat,
And he asked all the right questions after a short chat,
He explained all our options and we definitely felt better,
I’m so glad years ago we answered his introductory letter,
We setup another appointment to get everything done,
He said at this time of year he had to continue to run.
But I heard him exclaim as he walked to his car —
“Whenever you need me, I’ll never be far!”

With a wink of my eye to Clement Clarke Moore and a nod to all my friends that I help each year at this time … David Tirpak (201-445-3239) / (david.tirpak@msn.com)

An Overlooked Special Enrollment for Medicare Parts C and D

April 20, 2018

In my last post, I explained that, although most people are aware of the Medicare Annual Enrollment Period from October 15 to December 7, many do not know that they can change their Medigap policy at any time.  Today, I want to possibly help those who feel that they are locked into their current Medicare Part C (HMO, PPO, etc.) or Part D (prescription drug) plan.

If you want to change these plans outside of the Annual Enrollment Period, you need to qualify for a Special Enrollment.  There are many Special Enrollment reasons but too many are very limited such as moving out of the area.

Many states, however, offer a Pharmaceutical Assistance Program.  These programs are typically income-based and, since many people on Medicare are no longer working, they might qualify.  In my home state of New Jersey, for example, a married couple with income no higher than $43,334 would qualify for one of these programs.  In nearby New York, the income cut-off is even higher.

Once you qualify for a State Pharmaceutical Assistance Plan, you will be eligible for an additional Special Enrollment each calendar year, meaning you could switch that Medicare Advantage or Part D plan now, rather than wait till the end of the year.  I like to call it one of the “Get Out Of Jail Free” cards that too many people are not aware of.

Want to learn more about State Pharmaceutical Assistance Programs in your state? Click on the following link …  https://www.medicare.gov/pharmaceutical-assistance-program/state-programs.aspx.  You might be more special than you think.

Need further assistance or have questions?  Feel free to call me at 201-444-4414, email me at david.tirpak@msn.com, or visit my web site at thetirpakagency.com.  Till next time …

 

Changing Your Medigap Plan

April 4, 2018

Thanks to the success of advertising, most people I meet are aware of Medicare’s Annual Enrollment Period from October 15 to December 7.  They know that it’s the time when everyone can change their Medicare Advantage (HMO, PPO, etc.) or Prescription Drug Plan (Part D).  They can also change their Medigap (Medicare Supplement) plan at that time.

In reality, however, Read the rest of this entry »

Twas the Night Before Medicare’s …

October 14, 2015

Twas the night before Medicare’s Annual Enrollment Period, and all through the town

Not a creature was laughing, not even a clown;

The Annual Notices of Change were stacked on the floor,

At least they could be used to hold open the door;

The seniors and baby-boomers were sitting in chairs;

Looking at all the mail with confounded stares;

And my wife in her shawl, and I in my sweater,

Had started to see if next year’s plans might be better,

When all of a sudden I heard the door bell,

“Our agent is here” to my wife I did yell,

I opened the door and welcomed him in,

“I’ll explain everything” he said with a grin,

He was like an old friend and he smiled with a dimple,

I knew that he could make this all so simple,

With his briefcase in hand by the table we sat,

And he asked all the right questions after a short chat,

He explained all our options and we definitely felt better,

I’m so glad years ago we answered his introductory letter,

We setup another appointment to get everything done,

He said at this time of year he had to continue to run.

But I heard him exclaim as he walked to his car —

“Whenever you need me, I’ll never be far!”

With a wink of my eye to Clement Clarke Moore and a nod to all my friends that I help each year at this time … David Tirpak (201-445-3239) / (david.tirpak@msn.com)

Time for Spring Cleaning … Without the Sweat!

March 23, 2015

This past Friday marked the beginning of Spring, although if you live in the Northeast you probably doubted it.  It has been a cold and snowy winter, hasn’t it?  The beginning of Spring, however, is typically a time when we think of freshening things up.  We often start our seasonal Spring Cleaning.  All that work and cleaning, however, wears us out.  Today, I want to share with you another aspect of Spring Cleaning that should be part of your routine and it won’t wear you out at all. Read the rest of this entry »

Beware the Ides of March! (Insurance Lessons Learned from Shakespeare)

March 2, 2015

I always found reading Shakespeare difficult, as I’m sure some others have in the 399 years since his death.  All of us, however, can probably quote at least a few famous Shakespearean lines such as “To be or not to be …” or “Romeo, Romeo, wherefore art thou Romeo?”.  For me, the line I most remember is (part) of the title of this post … “Beware the Ides of March” from Julius Caesar.  The soothsayer (psychic) was warning Julius Caesar of his impending assassination on the Ides of March (March 15).  So, 2059 years later, as we approach the Ides of March, let’s reflect a few moments on some insurance lessons we can learn from Shakespeare. Read the rest of this entry »

Back to the Future … And Long-Term Care

February 19, 2015

Most of us can remember the popular trilogy of “Back to the Future” movies. In the second installment, Marty McFly traveled into that futuristic year of 2015 (from 1985). Well, here we are! Perhaps this is a good time to think about what it might be to look at the future of long-term care costs … it might be part of your future. Read the rest of this entry »

I Care. You Care. We All Care!

January 26, 2015

As a natural-born American, sometimes I take for granted part of what it seems to be an American.  Almost daily we read of a crisis or tragedy that takes place and we open up our hearts and/or our wallets to help others in need. Part of being an American seems to mean to care … Read the rest of this entry »

The Party’s Not Over and Your Ship Hasn’t Sailed!

January 19, 2015

Most of us, OK, many of us, are familiar with Medicare’s Open Enrollment Period which ended on December 7. If you are of Medicare eligible age, you should be aware because of all that funny looking stuff in your mailbox that you had been receiving for months. What’s that called again? Oh, yeah, “mail” … some of us might even say “junk mail”. So if you missed the party or the boat, you’ll have to wait until the next enrollment starting 10/15/2015 right? Maybe not … Read on! Read the rest of this entry »


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