Medicare Advantage January – March: Clarificationby Denise Early on Dec. 21, 2009, under Health
A reader responded to my last post and accused me of misleading seniors about the timeframe for changing their Medicare coverage. Here is some clarification.
If a person is enrolled in a Medicare Advantage plan which includes a drug plan (Part D), that person can change their plan during the Open Enrollment Period of January 1 – March 31st. Most of the Advantage plans in Tucson include Part D, and people enrolled in these plans can make one plan change during the first three months of 2010. They can only move to another plan that has a Part D drug plan.
If a person does not have a Part D drug plan before December 31st, (as part of a Medicare Advantage plan or as a stand-alone plan), they cannot enroll in a Part D plan until next November’s Annual Election Period. So if a person wants to enroll in a Humana Medicare Advantage plan in January (all of which include Part D) , they will be refused by Medicare – because they cannot pick up a Part D plan after December 31st.
Some examples :
Mrs. Jones is enrolled in Health Net’s Ruby plan. She has not paid attention to mailings from the company. In January she realizes she must pay a monthly premium and she decides to shop around for another plan. She can change to another Medicare Advantage plan that has Part D (as her Ruby plan does).
Mr. Smith has Medicare and a stand-alone Part D plan. He decides he’d like to enroll in a Medicare Advantage plan in February. He can enroll in a Medicare Advantage plan which includes a Part D plan – because he has Part D already.
Mr. Rivera is a veteran who gets his prescriptions filled at the VA, so he never enrolled in Part D. In February he decides to enroll in a Medicare Advantage plan. He cannot enroll in a Medicare Advantage plan that includes a drug plan. This is because Medicare will not allow him to get a Part D plan at that time of year. Medicare recognizes VA pharmacy coverage as “creditable” coverage, so Mr. Rivera won’t face a late-enrollment penalty for Part D if/when he enrolls in a Part D plan. But for some reason, Medicare doesn’t recognize VA pharmacy coverage during the Open Enrollment period (January-March). He can only enroll in a Medicare Advantage plan with Part D during the Annual Election Period which is November 15 – December 31st.