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 …