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Ability to Change 2010 Medicare Health Plans Closes on March 31

medicareIf you haven’t looked at your Medicare health plan for 2010 you should. You only have a little over two weeks to make changes. People with Medicare coverage are only allowed to change their choice of Medicare health coverage once and it must be within the Open Enrollment Period, January 1 through March 31. Most people with Medicare won’t be able to change their health plan again until January 2011.

The Medicare Rights Center is a national, nonprofit consumer service organization that works to ensure access to affordable health care for older adults and people with disabilities through counseling and advocacy, educational programs, and public policy initiatives. They have a very useful web site that summarizes what can and cannot be changed and questions that you should get answers to before making a change.

It’s particularly important to take great care when considering switching from standard Medicare, or Medicare and “Medigap“, to Medicare private health plans, also known as Medicare Advantage plans or, in some cases, Medicare HMOs. Joe Baker, President of the Medicare Rights Center offers this advice:

Changing how you receive your Medicare health benefits is not simply a matter of changing to a plan with a cheaper premium. Switching plans can change which doctors you are allowed to see, access to benefits you may need as well as the cost of your care. And since you are allowed to make just one change, be sure you understand how the new plan works before signing up.

Ask questions, or call us or your local State Health Insurance Assistance Program (SHIP) for help. Don’t let a salesperson use the March 31 deadline to pressure you into signing up for a plan.”

Aspects that can or cannot be changed
There are many rules, both at the federal and state levels, that govern who can make changes to their Medicare health plan, what can be changed and when changes are allowed, or are applied. The following is based on information provided by the Medicare Rights Center.

Enrollees Can:

  • Change from Original Medicare with a stand-alone (private) drug plan to a Medicare private health plan with drug coverage.
  • Change from enrollment in a Medicare private health plan with drug coverage to either:
    • Another that also offers drug coverage, or
    • Original Medicare and a stand-alone private drug plan.
Enrollees Cannot:
  • Add or drop the Medicare drug benefit (Part D).
  • Switch from one stand-alone prescription drug plan to another.
  • Keep Medigap coverage and switch to a Medicare private health plan.
    • In certain states and situations, they may not be able to get their Medigap policy back, or may have to pay a higher premium if they have a history of illness.
  • Change from enrollment in a Medicare private health plan with drug coverage to another one that does not offer drug coverage.
  • Stay in Original Medicare (Parts A and B) and change only their stand-alone drug plan.
    • This would be considered a Medicare drug coverage change, not a health coverage change.

Special cases
Medicare consumers who have coverage from a former employer should be aware that signing up for a Medicare private health plan can sometimes cause permanent loss of that coverage. They should always check with the company that provides their retiree coverage before enrolling in a Medicare private health plan.

The rules about purchasing Medigap policies differ from state to state, and consumers are advised to use the resources mentioned below to check the rules in their state before making a switch.

There are some exceptional circumstances where people may be eligible for a special enrollment period to change health or drug plans. For example, people who were misled into enrolling in a Medicare private health plan automatically qualify for a special enrollment period.

Getting help
There are many free resources that can help Medicare consumers make the right decision for their needs:

  • State Health Insurance Assistance Programs (SHIPs):These federally funded programs offer free health insurance guidance in every state. Consumers can find their local SHIP office by calling 1-800-677-1116 or at this SHIPtalk web site
  • The Medicare Rights Center: This offers free resources for people who want to learn more about Medicare private health plans.
    • Medicare Interactive, their free, web-based counseling tool, is available at www.medicareinteractive.org.
    • You can also find a full list of helpful questions that you should ask before making a switch on Medicare Interactive.
    • People who prefer to speak with a counselor can do so by calling the toll-free hotline at 1-800-333-4114. Counselors are available Monday through Friday, 9:00 am to 5:00 pm (Eastern Time).

CAUTION!
If you decide to change plans you must do it correctly:
DO – simply enroll in the new plan. This will automatically disenroll you from the old plan.

DO NOT – disenroll from one plan and then enroll in another, as this will count as two changes, which is not allowed. You could lose coverage for the rest of the year if you make this mistake.

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