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Medicare Savings Program Changes CT 2018

In this post we give you some valuable information about the Medicare Savings Program Changes CT 2018.  We realize many of you may be confused about all the recent news of changes in eligibility and income limits.  Please note: the effective date of any changes in this program has been extended until July 1, 2018 in the state of Connecticut.

Medicare Savings Programs (MSPs) are put in place to help the Medicare beneficiary pay their Part B premium.  In some instances, MSPs help beneficiaries pay for Part A premiums.  Usually, Part A is free, although if either the beneficiary or their spouse has not worked enough, he or she will need to pay the Part A premium.

Just to recap:

The program is not going to change until July 1, 2018. In the event that the income limits are lowered and that results in the loss of your QMB status, DSNP members will still have 90 days before you are dropped from the program. If you are being dropped you will receive a letter that explains this to you.  If yo do lose your QMB Status you will no longer qualify for protection of balance bills.  This means that you will be responsible for these bills as of the date that you lose your QMB coverage.

Each year in March the income limits for the MSP Program are reviewed, and usually raised.  This will not change the fact that the state is going to fund the program until at least July 1.

Click here to learn more about the different levels of help and Husky vs Medicaid

These following income limits are effective in March 2018:

QMB (Qualified Medicare Beneficiary):
Pays both Medicare Part A and Part B premiums, deductibles and co-insurances.
QMB income limits (211% FPL):
Single person – $2,135.32/month (previously $2120.55)
Married couple – $2,894.92/month (previously $2854.83)

There is no asset limit for people who receive benefits from this program.

To Apply: You can download an application form in either English or Spanish, CLICK HERE FOR APPLICATION.

Applicants may also apply by going to the Connecticut Department of Social Services office for their town.

National General Short Term Health Plans

If you find yourself in need of a short-term health care plan you should look into National General Short Term Health Plans.  Short term health insurance is major medical insurance that you purchase for a defined period of time.  In most cases the monthly premium is lower than other major medical health insurance coverage.  There are other advantages to purchasing short-term health insurance beside the price.  There are also no open enrollment restrictions on these plans, that means you can apply for coverage anytime. You will receive notification within minutes if your application is approved. You can use your coverage the day after you are approved.

Life can sometimes throw you a curve ball, if this happens you don’t want to be caught without insurance coverage. Spending any time without insurance coverage can be a little risky.  National General’s Short Term Health Plans give you the safety net you need for those unpredictable times.  These plans give you protection from unexpected medical bills and health care expenses for things such as:

• Doctor visits and some preventive care
• Emergency room and ambulance coverage
• Urgent care benefits, and more

You can click on this link  for the Aetna PPO Network Provider Lookup for Short Term Medical: (search using the Open Choice PPO Network)

This coverage is great for people who:

• need to bridge the open enrollment gap
• have recently graduated from college
• Are either part-time or temporary employees
• Do not have adequate health insurance coverage
• May be between jobs or have been laid-off
• Are waiting for employer benefits to start

National General Short Term Health Plans Offer:

• Coverage Period Maximum of $250,000 and $1,500,000
• Deductible options from $1,000, $2,500, or up to $5,000
• Coinsurance Percentage of In-Network plan 100/0, 80/20, 70/30, and 50/50
• Both Doctor Office Visit as well as an Urgent Care Co-pay of $50

Why should you join a National General Short Term Health Plan?

1. These plans are generally far more affordable than an ACA plan,  even after you consider the tax penalty.
   In the event that you do not qualify  for Obamacare plan subsidies, you will be stuck paying very high premiums.  For instance, A 29-year-old woman making $33,000 annually in South Florida will pay about $2,200 each year for a bronze-level Obamacare plan.   On the other hand,  she could purchase four short-term plans back-to-back for less than $500 a year.  Even after you add in tax penalty of $695, she will still save over $1,000 per year. The plans have a comparable deductible.
2.  You will still be eligible to join an ACA plan in the event that you develop a condition that prevents you from reapplying for a Short Term Health Insurance plan.
   Affordable Care Act health plans cannot deny coverage for pre-existing conditions therefore, you will be eligible to join an ACA plan during open enrollment.
3.  Short Term Health Insurance is Flexible.   Did you know that the ACA requires every plan to cover 10 essential health benefits.  These benefits include maternity services.  This means that a  single male with an ACA plan will have maternity coverage that he can never use.  Short-term health insurance covers services that a healthy member is more likely to actually use.
4.  There is No Annual Open Enrollment Period for these plans.  In fact, you can enroll in a plan anytime you need one.  In contrast, you cannot purchase an Obamacare plan if you do not sign up during the short, six-week Open Enrollment Period.  Unless you meet certain criteria for a special enrollment period.

If you have any questions, please contact us either by phone at (203)796-5403 or by email at edward@croweandassociates.com.  We will be happy to go over your options for insurance coverage.

link to resources

MetLife Dental Plans

MetLife dental plans are available through MetLife TakeAlong Dental.  TakeAlong dental is a PPO dental program that offers coverage to both you and your family.  Three PPO plan designs are currently available to choose from.  All three plans have affordable monthly premiums and a large network of participating providers.  The MetLife dental plans offer you a number of benefits…

CLICK HERE TO QUOTE PLANS

Having the right Dental insurance can protect you and your family from unexpected dental expenses! MetLife TakeAlong Dental offers comprehensive coverage today and in the future, even through different stages of your life.

CLICK HERE TO QUOTE AND ENROLL

About Crowe and Associates

Aetna Medicare OTC Catalog

This post will give clients who have insurance through an Aetna Medicare plan a clear picture of which items are in the Aetna Medicare OTC Catalog.

For those individuals who have either an Aetna or Coventry Medicare plan, their benefits include an over-the-counter (OTC) benefit.  This benefit allows members to order
approved OTC items every month.

THIS POST HAS BEEN UPDATED; CLICK HERE FOR INFORMATION

Some information about this benefit:

The OTC benefit gives you an easy way to receive generic over-the-counter health and wellness products by mail.
All you need to do is, place an order using the list of approved OTC items and Aetna will mail them directly to your home.  It is that easy.
Here are the program rules:
1.  Clients can place only one order per month.  This can be either less than or equal to their approved benefit amount.
2.  They will receive the generic (non branded) equivalent of all chosen items.
3.  If you do not use the benefits, they will not be rolled over from one month to another.
4.  The items you choose to order are for the members use only.
5.  It is prohibited to order OTC items for use by either family members or friends.

LOOKING TO COMPARE MEDICARE PLANS- call our office at 203-796-5403 or email admin@croweandassociates.com

With this benefit members are able to buy specific, approved generic OTC products.  These products are not covered by either Medicare Part B or Medicare Part D.  It will benefit members to keep this list handy.  If you use this program, it can save you money on certain items that normally you would have to pay out of pocket for.   If you would like to view a copy of the Aetna Medicare OTC Catalog, click the following link:  Aetna OTC Catalog .

There are 2 ways for members to order supplies:

You can order either by phone 1-888-628-2770 (TTY: 711) Monday through Friday from 9a.m. until 5p.m., or you can order online at order.otchs.com.

Aetna Medicare offers members  PDP, HMO and PPO plans with a Medicare contract. Aetna’s SNPs catalog are also contracted with State Medicaide programs.  Enrollment in these plans depends upon contract renewal.  Members can contact their individual plans for more benefit details.  Limitations, co-payments as well as restrictions may apply.  Benefits are subject to change on January 1st of every year.  Plan features as well as availability may differ depending on the members service area.

Agents- Click here for a Medicare Scope of Appointment

QUESTIONS ABOUT YOUR MEDICARE PLAN?  CALL US TO GET THE ANSWERS 203-796-5403 or send an email to teal@croweandassociates.com.

If you would like to get a quote for a Medicare Advantage or Supplement plan, CLICK HERE

Getting Started With Medicare

Getting started with Medicare is not a complicated process.  Anyone turning 65 or enrolling in Medicare for the first time for any reason can use our guide to understand the process. You will also find guidance on the choices you have to make.   We will cover the process from start to finish.  Learn if you need to enroll in Medicare Part B or not. Should you enroll in a Medicare Advantage plan (MAPD), Medicare Supplement or a Part D prescription drug plan (PDP). Read below to find out.  While we feel our Medicare guide is much easier to understand, than the information  Medicare has on how to get your Medicare benefits.  You can review that by clicking here if you would like a different opinion.

Getting Started With Medicare “quick guide” for those that do not want to read everything below –Click here for Medicare Quick Start Guide

Outline of the process and steps to take:

1. When you are eligible for Original Medicare and costs
2. Should you enroll in Part B of Original Medicare?
3. Medicare Part A Benefits
4. Medicare part B Benefits
5. Explaining Medicare parts C and D
6. Understanding a Medicare Supplement and Part D drug/Rx plan (Medicare part D)
7. Understanding a Medicare Advantage plan (Called Medicare part C)
8. Comparing Advantage plans vs. Medicare Supplements and stand alone Medicare part D drug plans
9. The process to enroll in a plan and when to do so.
10. Working with an independent broker/agent
11. When can you change plans?
12. Medicare Part D coverage gap
13. Medicare Part B and D penalties
14. Coverage when you have VA benefits
15. Getting started with Medicare other resources and Medicare Supplement benefit description

When you are eligible for Original Medicare and costs

The first step to getting started with medicare is to learn about Medicare A and B. You are eligible for Medicare the first of the month you turn 65.  If someone has a birthday on June 20th, they will be eligible for Medicare A and B on June 1st.  Some people may be eligible for Medicare prior to turning age 65 due to disability. Keep in mind Medicare benefits and Social Security payments are two different things.  You do not need to take Social Security payments in order to enroll in Medicare benefits. If you are drawing Social Security payments at the time you turn 65, you will automatically be enrolled in Medicare A and B.

If you are not taking Social Security payments at the time you turn 65 you will be enrolled in Medicare Part A only.

You must elect part B to be enrolled.  You can enroll in Part B at your local social security office or online through the Medicare.Gov website. The online enrollment is very easy to use.    CLICK HERE FOR SITE TO ENROLL IN MEDICARE PART B   Note:  This is the Social Security site but you can enroll in Medicare only on this site.

Most people will pay nothing for Medicare Part A. (There is no cost for part A as long as someone worked at least 10 years on the books paying FICA tax. You can also qualify through a working spouse that put in at least 10 years)  Just about everyone will pay for Medicare part B however.  The standard Medicare part B premium for 2018 is $134 a month per person.

If you are receiving Social Security payments, your part B premium will be taken out of your check every month automatically.

If you are not taking Social Security payments, you will be billed for Part B quarterly.  Some people pay more for part B if they make over certain amounts of income.  We will review that later in this post.  Some individuals receive extra help and do not pay part B at all. If they are enrolled in a Medicare Saving Program.   Again, more on that later.

Should you enroll in Part B of Original Medicare?

The quick answer to this question is, it depends.  Anyone that wants to enroll in a Medicare Advantage plan or a Medicare Supplement must also be enrolled in Medicare part B.  (You don’t need to have B to enroll in a stand alone part D drug plan only.)  There are times when you may not want to take Medicare part B however. This usually comes up when someone is 65 or older but they get coverage through their employer or through the employer of a spouse.  If you are getting coverage from an employer, you may keep that coverage and may not be required to purchase part B (saving you $134 a month).

If at any time down the road you lose access to that employer plan, you can then sign up for Medicare part B through a special election to do so.

You have 3 months to enroll in part B once you lose coverage. (the month you are notified and two months after that)  Be careful, if you don’t sign up when eligible for a special election you will need to wait and sign up during the general Medicare Part B enrollment period. You many need to pay a penalty for the rest of your life.  The part B general enrollment period runs from Jan 1 through March 31 for a July 1 start date.

One other special rule to consider when getting started with Medicare.

If you have coverage through your work or your spouses work, one of you must be actively working. Part B is not needed if actively working but if the spouse getting the coverage through work retires, you must sign up for Part B within two months, even if your employer is still offering coverage.  Failure to do so can lead to a life long penalty. CLICK HERE TO LEARN MORE ABOUT THIS TOPIC

Medicare Part A benefits

Part A provides Inpatient hospital benefits, Skilled nursing and home health care benefits.  Medicare part A has an inpatient deductible fo $1340 per benefit period for 2018.  Means you pay the first $1,340 out of your pocket. You are then covered in full for the next 60 days and have a cost share per day after that. Most people do not pay a premium for Medicare part A. If you do pay a premium is will be $422 a month.  A benefit period is 60 days and ends when you have not had a skilled nursing or inpatient hospital services for 60 days.

CLICK HERE TO SEE MEDICARE PART A BENEFITS 2022

Medicare Part B benefits

The cost for Medicare part B is usually $134 a month for 2018. Medicare part B covers outpatient services and part B drugs.  Outpatient services are things like doctors visits, lab work, scans, testing, specialist visits and outpatient surgeries.  There is an annual deducible of $183 for 2018 which means you pay the first $183 of cost and then you are covered at 80%.  Keep in mind, it is 80% of what Medicare allows and not what the doctor charges. This means the 20% you pay will be a lot less than 20% of what is initially charges. Our getting started with Medicare guide is not going to cover all the details on Medicare A and B.  A link has been provided below with more detail.

CLICK HERE TO SEE MEDICARE PART B BENEFITS

Explaining Medicare parts C and D

Ok…it is easier to start with Medicare part D.  Medicare part D is the drug coverage portion of Medicare. Medicare A and B do not provide drug coverage.  If you want to have drug coverage, you must buy a stand alone part D drug plan from a private insurance company or you can get it built-in with a Medicare Advantage plan.  Medicare does not provide you with a plan.  You can purchase them through a private insurance company. You are able to have Medicare A and B for your Medical and then buy a stand alone part D drug plan.

Medicare Part C is a Medicare Advantage plan.

They are private plans insurance companies offer and they usually include drug coverage.  This means they include the Medicare Part  D benefit.  If you enroll in a Medicare Advantage plan (MAPD) you are using that plan instead of your Medicare A and B.  Medicare Advantage is an alternative to using Medicare A and B as your medical benefits.

The Advantage plan becomes your primary and secondary Medical and drug coverage. (assuming you get an MAPD that includes Medicare part D coverage) When you are enrolled in an MAPD plan, your Medicare A and B benefits are not used. The MAPD and its benefits are your coverage.  You cannot buy a stand alone Medicare part D drug plan and also have the advantage plan.  More on this later.

Understanding a Medicare Supplement and Part D drug/Rx plan (Medicare part D)

So, original Medicare A and B provides medical coverage.  It does not cover all costs however.  Medicare Part A has a deductible and cost shares and Medicare part B covers at 80% leaving you paying at 20%. There is no out-of-pocket cap on your costs with Medicare A and B. One of the ways to cover what Medicare does not is to buy a Medicare supplement plan.  They are also called Medigap plans.  Same plans but different names.

A Medicare supplement covers after Original Medicare pays.

When you go to any medical provider, they will bill Original Medicare.  Medicare pays their portion and a bill for the remainder of the charges is sent to your Medicare supplement plan provider. The supplement you choose will determine how much of the remainder will be covered. Some plans such as plan F cover all approved Medicare costs.

You will need to pay a monthly premium for the Medicare supplement plan.

Medicare supplements are secondary to Original Medicare so you are able to see any medical provider that accepts Original Medicare.  Medicare supplement plans are standardized in most states.  What is a standardized Medicare supplement?

Medicare Supplements do not cover prescription drugs so you could choose to buy a stand alone part D drug plan (PDP) from a private company.

The stand alone plan will also have a monthly premium.  You will use the PDP id card at the pharmacy for your drug coverage.  Please note that stand alone PDP plans are not all the same.  Time should be taken to find the one that covers your specific medications the best.

This set up will have you using 3 cards, Original Medicare A and B card and Medicare supplement card for Medical services and a stand alone Part D card for drug coverage.  You will also pay 3 monthly premiums.  Your part B premium, Medicare supplement plan premium and the stand alone part D (PDP) plan premium.

Understanding a Medicare Advantage plan (Called Medicare part C)

Medicare Advantage plans are completely different from Original Medicare A and B and a supplement.  A MAPD plan looks and works similar to an employer group plan.  The plan has copays for services such as primary and specialist visits, lab work, scans and other services. There are larger copays for major services such as inpatient hospital stays. Most Advantage plans include drug coverage so you do not buy a stand alone drug plan.

When you use an MAPD plan:

The plan is both your primary and secondary insurance. You do not use Medicare A and B as your primary insurance. As a result, medical providers will bill your MAPD plan.  An MAPD plan can be very low-cost with plans as low as $0 per month. The trade-off is you have copays, medical management and networks you must stay in with MAPD plans.

You cannot have an MAPD plan and a Medicare supplement at the same time and you cannot have an MAPD plan and purchase a stand alone PDP plan.  This is the case even if you buy an Medicare Advantage plan without prescription drug coverage. Our getting started with Medicare guide is a brief description of MAPD plans. Use the links below to learn more.

Comparing Advantage plans vs. Medicare Supplements and stand alone Medicare part D drug plans

Click here to watch a recorded webinar on the difference between a Medicare Advantage plan and a Medicare supplement plan and drug plan.

Click here for a blog on the differences between Medicare Advantage and Medicare supplements

The process to enroll in a plan and when it can be done

1. You will automatically be enrolled in Medicare part A when you turn 65. If you are already taking Social Security payments, you will automatically be enroll in part B as well. Regardless of which day of the month you turn 65, you’re Medicare A and B start date will be the first of that month. If you are not taking Social Security payments, you will need to enroll in Part B through the local Social Security office or online at https://www.ssa.gov/benefits/medicare/
2. Keep in mind that most people pay $134 a month for Medicare Part B. If you draw Social Security (SS payments) Medicare will take your payments out of your check every month. If you do not take SS payments, you will be billed quarterly.
3. Some people pay more for Medicare part B based on their income from 2 years previous to the current year. A chart has been provided for your reference Click here to learn about Part B Medicare costs.
4. Once you have Medicare A and B, you can determine which type of plan you want to provide drug coverage and how you want to cover the Medical portion not covered by Original Medicare.
5. You could enroll in a Medicare Advantage plan up to 3 months prior to the month you’re Medicare A and B starts. If you do not want to go with a Medicare Advantage plan, you can enroll in a Medicare Supplement and PDP plan.  Watch this webinar on the differences between Medicare Advantage and a Supplement and drug plan  Click here for webinar recording.
6. Once you determine the plan type you want, you should speak with an independent agent to find the best price or fit for your specific situation. Any application that goes in the first 3 months before you turn 65 will start on the first of the month you turn 65 to coincide with your Medicare A and B start dates.  If you put in an application during the month you turn 65 it will start the first of the next month.  You have 3 months after you turn 65 to put an application in.  When you turn 65, you are guaranteed to be accepted into Medicare. They cannot block you due to health conditions.
7. There is an opportunity to change the plan you are in every year during the Medicare Open Enrollment Period. This runs from October 15^th through December 7^th every year.  Any change you make will take effect on January 1st

Working with an Independent agent or broker

An Independent Medicare Insurance Broker does not work for any insurance company.

They often run their own insurance agency.  They have contracts with the major insurance companies or at least those with the most competitively priced products in your area.  Because the independent Medicare insurance agent or broker can work with any of the companies available, they can show you all the plans that are available to you, the prices from multiple companies and the prices from each of these companies.

A good independent agent will work in your best interest, finding the right plan and best price for your situation.

It doesn’t matter which plan or company choose, because the independent Medicare insurance broker can help you with any option you choose.  Note that some agents may only work with one or two companies. Make sure you ask your independent agent which insurance companies they represent.  You want to be sure they can offer a good selection.

You will not need to pay the independent Medicare insurance agent or broker.

They receive a commission from whichever company you choose to get your Medicare supplement through as long as the broker helps you with the application process.

Rates do not change when you worth with an independent agent or broker.  You pay the same price whether you go directly to an insurance company, use one of their internal agents or have an independent broker help you. The independent Medicare insurance broker receives a commission to introduce your business to the insurance company.

When can you change plans?

Each year, you have a chance to make changes to your Medicare Advantage or Medicare prescription drug coverage for the following year. There are 2 separate enrollment periods each year you can utilize to make a plan change.

The National Council on Aging also has good resources and information for new recipients of Medicare. Click for the site

The CMS website has info on the basics of starting Medicare A and B.   Click for Site

HSA plan contributions:

Be sure not to contribute to an HSA if you have Medicare A and/or B  Click to read more

More about how to enroll in Medicare by WebMD

Turning 65 checklist

Medicare Part B Premium and Benefits 2018

Under the Hold Harmless provision:

Medicare savings program CT 2018

There have been major changes made to the Medicare Savings Program CT 2018.  The changes have substantially lowered the income guidelines for those receiving help with their Medicare Part B premium, drug co-pay costs and Medical cost shares.  Prior to 1-1-18 anyone that was under the monthly income levels below qualified for help. There is not an asset test on the programs.

Those who no longer qualify for programs based on the new income limits will notice changes for 2018. If you no longer qualify, you will start to again pay your Medicare part B premium which is $134 a month for most people.  If you are taking Social Security payments, they will start to take it out of your payment every month. Those not taking Social Security will be billed quarterly for it.

Anyone receiving drug help with co-pays will continue to receive that help throughout 2018 even if they no longer qualify for the program. Those receiving cost share help with co-pays and Medicare deductibles and coinsurance will cease getting that help as of 1-1-18. (assuming you no longer qualify based on the new income amount)  Anyone qualifying at any of the below levels does not pay the monthly part B premium, has help on drug costs and is not subject to the drug plan coverage gap. Those that qualify at QMB level also have help with medical costs.

Medicare Savings Program CT 2018 – Update

NOTE:  UPDATE: It has recently been decided the program will be extended under the 2017 income levels through the month of February 2018

**Please note: The chart below gives income levels for 2017 and the new income levels for 2018.  Allowable income levels for all program have dropped.

Health Insurance Open Enrollment 2018

Health Insurance Open Enrollment 2018 runs from November 1, 2017 through December 15, 2017.  This is an opportunity to make any desired changes to your existing health insurance plan. This could be changing plan options with the same company or looking a plans from other companies.  Those with an Exchange plan (obamacare) plan may want to look at other offerings in the exchange or possible outside of the exchange for 2018.  For exchanged and non exchange based plans, the insurance companies can not block enrollment due to health issues.  This is a guaranteed issue period on exchange and non-exchange type plans.  All changes during this time will take place on 1-1-18.

Benefit Changes and Rate Increases

Benefit changes and the inevitable rate increases for the plans also take place on 1-1-18.  The preliminary estimate shows that most companies will have increases of over 20% for 1-1-18. It is not yet know how the subsidy for those on Obamacare plans will be effected.  Usually, those receiving an income based subsidy are best staying on an exchange plan given they are getting help with the premium.  The monthly subsidy can be substantial if the insured persons income falls within the guidelines.  Although the plans will be increasing their premiums, it is hard to tell how much of that will be offset by the subsidy.

Health Insurance Open Enrollment 2018: Other options

Those that are not planning on being able to get a subsidy for 2018 may want to explore other options.  Non subsidized plan premiums are very expensive for someone age 50+ and the 20+ percent increase will only make that worse.  A non subsidized silver level plan for a 50 year old is currently about $640 a month.  After the increase that number will be around $768 a month.

Crowe and Associates has access to other non-exchange and non-subsidized plans for 2018 that have substantially lower premiums.  Call our office to learn more at 203-796-5403 or email Edward@croweandassociates.com

Our plan is a full major medical plan that waives the penalty for being uninsured. There are copays for services prior to paying any type of deductible.  Rates are the same for all ages and are as follows…

• Single -$548 month
• Parent and Children- $898 month
• Couple- $1,022 month
• Family- $1,298.00 month

 What is an annuity

This is a more complicated question than one might realize. So what is an annuity?  The standard definition from the dictionary is listed below but it does not really help to answer the question.

Independent Medicare insurance agents

This post will help clients understand why it is important to work with independent medicare insurance agents.  Here at Crowe and Associates, we want our clients to feel confident about their insurance choices. We are happy to meet with anyone either in our office or at your home, if necessary.  Because every client is important to us, you can reach us by phone at (203)796-5403 or by email at edward@croweand associates.com anytime you have questions or concerns.

We DO NOT charge clients for our services. 

Independent Medicare insurance agents work with multiple insurance companies on a general contractor basis.  Independent agents do not work for any one specific company.  This arrangement gives clients more choices when they shop for Medicare plans.  This also helps to ensure that clients will receive the best offer available.  Unfortunately, not all independent insurance agents work with all of the companies.  It is important to ask your agent which companies they work with.  In general, they should be contracted to offer Anthem/Empire BCBS, United Healthcare Medicare Advantage and Medicare Supplement plans, Aenta Medicare, Wellcare, Connecticare, Emblem, Mutual of Omaha and First United American.  Crowe and Associates works with all of the mentioned carriers and a few others. There is never one insurance company with the best plan for everyone, therefore it is important to have access to all the major companies.

Crowe and Associates is an agency of Independent Medicare Insurance agents

Let the experienced professionals at Crowe & Associates help you understand the difference between Medicare Supplement and Medicare Advantage plans. We are here to make sure you get the coverage you need at a price you can afford.  We don’t want you to make the wrong health plan choice and get yourself into a mess that you could have avoided.   Let Crowe & Associates guide you through your Medicare enrollment and you can rest easy.

Medicare Advantage dis-enrollment period 2018

You are only eligible to enroll and dis-enroll in Medicare Advantage Plans at specific times of the year.  Therefore, some of you may want to know when the Medicare Advantage dis-enrollment period 2018 is.  The (MAPD) Medicare Advantage Dis-enrollment Period starts on January 1 and lasts until February 14 every year.  During this time, you can leave your MA plan and go back to Original Medicare.  You also have a chance to enroll in a Part D drug Plan, if you haven’t already done this.

During the Medicare Advantage Dis-enrollment Period 2018:

You can decide to leave a Medicare Advantage plan and go back to Original Medicare. The length of your enrollment does not matter.  Even If you have just joined the Medicare Advantage plan during the AEP (Annual Election Period).   You are able to change your mind and go back to original Medicare (Part A & Part B).  If you do decide to dis-enroll from your MA Plan, that goes into effect on the first day of the following month after you make your request.

Example:  if you dis-enroll from your plan on January 1, it won’t be in effect until February 1.

Be aware of  the date your Medicare Advantage dis-enrollment goes into effect. Some kinds of Medicare Advantage plans require you to use in-network providers in order to be covered. If you’re in a SNP (Special Needs Plan) or an (HMO) Health Maintenance Organization, you must only use doctors that are in the plan’s provider network until you are dis-enrolled. If you use out of network providers, your plan may not pay for the services you receive.

If you decide to dis-enroll during this period, you will be eligible to join a Medicare Prescription Drug Plan(PDP). This is true whether or not the Medicare Advantage plan you leave included drug coverage.  If you are enrolled in a Medicare Advantage Prescription Drug plan, you can just join a stand- alone Medicare prescription drug plan.  If you do this, you will be automatically dis-enrolled from your Medicare Advantage plan.  You could also just submit a dis-enrollment request to your plan.  As we stated earlier, when you join a Medicare prescription drug plan, your coverage starts the first day of the following month.

It would be wise to enroll in a PDP very close to the time you decide to dis-enroll from a MA plan.  This way you can avoid any lapse in drug coverage.   Original Medicare doesn’t come with prescription drug benefits. Additionally, Medicare Part D has a penalty if you go without creditable prescription drug coverage for over 63 days in a row. If you have other prescription drug coverage, it must be the equivalent of standard Medicare Part D prescription drug coverage.

You CANNOT use The Medicare Advantage Dis-enrollment Period 2018 to either join or to change plans.

The only thing you can do during the MADP is to dis-enroll from Medicare Advantage to go back to Original Medicare.  The Medicare Advantage Dis-enrollment Period is not the same thing as the Open Enrollment Period also known as the AEP.  The Open Enrollment Period is only to enroll in a Medicare Advantage Plan or a prescription Drug Plan, make plan changes or dis-enroll from a Medicare Advantage plan and go back to Original Medicare plans.

There is also a difference between the MADP and the Initial coverage election period.  The Initial coverage election period is the time that you are first eligible to enroll in a Medicare Advantage Plan.  There is no other time that you can change your Medicare Advantage plan unless you qualify for a special election period. In certain circumstances you can dis-enroll from your Medicare Advantage plan and switch to a different plan. For example; if you move out of the plan’s service area or if someone used deceptive marketing practices on you when you signed up for your plan.

Please contact us with any questions about this information.  You can reach us either at (203)796-5403 or at edward@croweandassociates.com.

Medicare Open Enrollment 2018

If you have questions about Medicare Open Enrollment 2018, you should read this.  The Open Enrollment Period (OEP) starts on October 15 each year and runs through December 7. This time is also referred to as the Annual Election Period.  This period of time is for Medicare clients to re-evaluate their coverage, check for changes and explore any new options that may meet their needs more efficiently.  You should speak with your broker and at that time he/she can help you compare your current plan against others on the market.   If you find a better health coverage option is available, you can make the desired changes.  Your new coverage will begin on January 1 of the following year (Jan.1, 2018)

For example:

If you have Medicare Parts A or B, you can either join or drop a Part D prescription drug plan.

If you already have a Part D prescription drug plan, you can change to a different Part D prescription drug plan.

You can also drop your Medicare Advantage Plan (also called Part C) and change back to Parts A & B (Original Medicare)

If you have a Medicare Advantage Plan, you can change to a new Medicare Advantage Plan.

Learn more about the difference between a Medicare Advantage plan and a Medicare Supplement plan

 Do I really need to re-evaluate my Medicare coverage during Open Enrollment?