Open Enrollment for Medicare Advantage plans has ended, and most people are locked into their plan for the rest of the year. But there are exceptions for people with certain chronic illnesses or low income subsidies.
CareMore has Medicare Advantage plans for people with diabetes or breathing illnesses, and because these are “special needs plans”, people can enroll in them all year long. In order to qualify for these plans, a doctor must sign a form confirming that the Medicare beneficiary has the chronic illness.
Evercare has Medicare Advantage plans for people with certain chronic illnesses such as heart disease, respiratory disease (such as asthma), high blood pressure, diabetes or dementia.
Low Income Subsidies: Medicare beneficiaries who are getting help with their Part B premium or Part D drug costs can change Medicare Advantage plans throughout the year.
People who have monthly income of less than $1,354 (for a single person) or $1,821 (for a couple) can get help with their Part D premium and their prescription costs. This help is received through an application to Social Security.
AHCCCS (Arizona Medicaid) will pay the Medicare Part B premium for a single person living on less than $1,218 per month, or a couple with monthly income of less than $1,639. An application for this help is made to AHCCCS and usually requires a copy of the annual letter from Social Security that shows how much a person receives and what is deducted from that amount. The qualifying amount is the gross Social Security payment – before $96.40 (or $110.50) is taken out for the Medicare Part B premium.
If AHCCCS approves the application for “Medicare Cost Sharing”, they will notify Social Security that the individual or couple also qualifies for help with their Part D premium and drug costs.
FYI: AHCCCS stands for Arizona Health Care Cost Containment System and is pronounced “access”.
So, while the vast majority of Medicare Advantage enrollees are “locked into” their plans, about 30% of seniors qualify for the low income subsidy, and many have chronic illnesses that would allow them to join a special needs plan.
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