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Extended Medicare Open Enrollment Period 2019

This year you have more chances to make sure you chose the best health care coverage available for your needs. There will be an Extended Medicare Open Enrollment Period 2019.  The extended period is called the Medicare Open Enrollment Period (OEP) and will run from January 1 through March 31st.

The Medicare Annual Election Period (AEP) is from October 15 until December 7 each year. The dates changed in 2011, but have been the same ever since.  For 2018 Medicare coverage, open enrollment ended on December 7, 2017. For 2019 coverage, open enrollment will run from October 15, 2018, until December 7, 2018.

During the annual enrollment period (AEP)  you can make changes to various aspects of your coverage.

• You can switch from Original Medicare to Medicare Advantage, or vice versa.
• You can also switch from one Medicare Advantage plan to another, or from one Medicare Part D (prescription drug) plan to another.
• And if you didn’t enroll in a Medicare Part D plan when you were first eligible, you can do so during the general open enrollment, although a late enrollment penalty may apply.

If you want to enroll in a Medicare Advantage plan, you must meet some basic criteria.

• You must be enrolled in Medicare Part A and B.
• You must live in the plan’s service area.
• In most cases, you cannot have End-Stage Renal Disease (some exceptions apply).

Extended Medicare Open Enrollment Period 2019 –  More about OEP

During the Medicare OEP from January 1 to March 31st you will have one more chance to make a plan change.  If you have a Medicare Advantage plan, you will be able to drop the advantage plan and go back to Original Medicare.  You can also add a drug plan at that time if you choose.  If you have a current Medicare Advantage plan or a PDP plan, you will be able to change to a different Medicare Advantage or PDP.  This is a one time election.

Extended Medicare Open Enrollment Period 2019 – Information about auto renewals on Advantage, Part D and Medicare Supplements

If you are enrolled in a Medicare Part D prescription plan or  Medicare Advantage Plan and you are happy with your coverage, you don’t need to do anything during open enrollment.  You should just confirm your current plan will continue to be available. If your plan is going to be discontinued and isn’t eligible for renewal, you will receive a notice from your carrier before open enrollment. If you don’t, it means you can keep your plan and don’t need to do anything during open enrollment.

Keep in mind, every year your benefits and premium could change.  Although you want to keep your current coverage for the following year, it’s important to check for and understand any changes that may apply. You should always check to make sure that your current plan is still the best choice available to you. The coverage of the available plans can changes from one year to the next. Although the plan you have now was the best option last year, you should make sure that is still the case for next year.

Following AEP is the Medicare Advantage Disenrollment Period that runs from January 1st through February 14th.  During this time, a Medicare Advantage plan member is able to disenroll from their current Medicare Advantage Plan. They can then go back to original Medicare and purchase a Medicare supplement plan if they choose.  They can purchase a new Part D Prescription drug plan ony if they disenrolled from an MAPD.

In 2019, the new enrollment period will be from January 1st through March 31st.

This enrollment period will allow Medicare Advantage Plan members to disenroll from their current plan and switch to a different Medicare Advantage plan.  They can only do this one time within this period.  They can also return to original Medicare and purchase a Medicare supplement if they choose. This is not Guaranteed Issue business.   Similar to the dis-enrollment period, members can only enroll in a new Part D plan if they have disenrolled from an MAPD.

Crowe and Associates is open from 8:00 am to 5:00 to answer any questions.  Call us at 203-796-5403

Choosing Medicare Supplement or Medicare Advantage

Choosing Medicare Supplement or Medicare Advantage plans can be both confusing and frustrating. Many seniors simply go with a company name they are familiar with (Most commonly AARP). A plan that a relative or friend suggested or they just stay in their current plan because that is what they have always had. The end result is usually a bad choice of plan for the given situation. The reality is that there is not one “best plan” for everyone. To choose the best plan for the situation, it is important to know all the options available.

Here is a quick overview of the options available to Connecticut residents and the strengths and weaknesses of each…..

Medicare Supplement Plans:

Medicare Supplement plans are secondary plans you can purchase from a private insurance company to help cover the gaps in Medicare part A and B.  In all states, the plans offer standard benefits.  Plans provide different levels of coverage.  This depends on which plan you choose. The plan benefits cannot change.  This means any company that offers a plan must offer the exact same benefits. For Example Plan N with Anthem BCBS is exactly the same as Plan N with AARP (United HealthCare). The only difference is the rate that the private company charges for them. Please keep in mind, the rate can vary greatly.  One company in CT charges $184.00 a month for plan J while another charges over $300.00 for the exact same plan.

Supplement plans are best for a person who uses a high volume of health care services. Supplement plans tend to be costly but have very little out of pocket expense. If someone is consistently receiving a high volume of medical services, it may be wise to look at a supplement.  It may also be wise to use a supplement as some doctors that will not accept Medicare Advantage plans. In such a case, a Medicare supplement plan will provide coverage when an Advantage plan will not.

If you are in the market for a supplement plan it goes without saying that AARP should be considered.

They currently have the best rates available.  If you are considering plan F, you should purchase plan J instead. Plan J cost less, has all the benefits of F and some additional benefits as well.

The drawback to a supplement in the monthly premium cost compared to the premiums of Medicare Advantage plans. Also, supplements do not come with Rx coverage which must be purchased separately if it is needed.  If you are not a high volume user of medical services, it is warranted to look at the available Medicare Advantage plans.

One last thing to mention with supplements is that some people are simply more comfortable with them.  For some seniors the most important thing is to be able to see any doctor and not worry about copays or anything associated with managed care.  The person who feels this way may be willing to pay the extra monthly premium for this luxury.

Medicare Advantage Plans:

Medicare Advantage Plans are a low cost way to for seniors to obtain health care coverage. Advantage plans provide benefits equivalent to Medicare Part A and B with most plans providing additional benefits beyond what is covered by A and B. The plans can come with or without Rx coverage build into the plan design. Medicare advantage plan administer your benefits instead of Medicare Part A and Part B which makes the plan primary. Premiums range from $0 monthly premium to $179.00 month premium depending on the plan selected.

Medicare Advantage Plans do have some drawbacks compared to supplements such as the fact that you need to stay in network in most cases (There are PPO plans with out of network benefits)  There are also copays associates with services.  The higher premium plans have very low or no copays for many services but the lower premium plans ($0 premium) tend to have more out of pocket costs on things such as hospitalization)

Here is a breakdown of the plans available in Connecticut for 2009….

AARP Medicare Complete:

Positives– $0 monthly copay, Rx coverage build in with Medical, very low copays to primary doctors and specialists and out of network coverage.
Negatives– The network can have a lack of physicians in network in certain parts of the state, New Milford and some other key hospitals are not participating and the hospital copay is stiff at $225 a day for a total of 17 days.

Aetna Golden Medicare:

Positives-The Golden Medicare plans offer a national network which is nice for people who travel out of the Connecticut area. The Physician and hospital network is now one of the largest in Connecticut.  The $59 plan is the lowest cost plan on the market that still covers Inpatient hospitalization at 100%. There are a number of different plans to choose from including PPO options that provide out of network coverage, the $0 premium plan offers strong benefits compared to the rest of the $0 premium plans in the market.
Negatives-Some drugs fall into the 4th tier when they are only 2nd tier with other plans.

HealthNet:

Positives- Strong provider network, many high dollar drugs are on the 2nd tier.
Negatives-At current premium levels, the benefits are not competitive with other carriers in the Connecticut market. The Navy plan has weak benefits ($150 copay for 5 days inpatient hospital) for the high premium charged ($179.00)

Evercare (Secure Horizons/United Health):

Positives-$0 premium plans with low physician copays and Rx coverage, Chronic conditions plans coverage more conditions than any other in the state, only Dual Eligible Plan (Medicare and Medicaid) offered in CT market.
Negatives- High out of pocket costs for inpatient hospitalization, weak network can be difficult to deal with from an administrative standpoint, weak out of network benefits compared to AARP Medicare Complete

Be cautious of anyone who is only able to sell one or two of the companies listed above.  If they only offer a few plans, they may not know everything available that could best fit your needs.  Find someone who has the ability to work with all plans available in Connecticut in order to see all of the choices.  Although there are a number of plans available, each person has their own needs.

Image by Jose R. Cabello from Pixabay