Medicare beneficiaries who are unhappy with their Medicare Advantage plans have until Thursday, Feb. 14, to disenroll. According to the Medicare Rights Center, beneficiaries can drop their private plan and enroll in Original Medicare.
If people don’t make changes this week, they won’t be able to change their health coverage until the Fall open enrollment period, which begins Oct. 15, 2013.
“Time is running out for beneficiaries to take advantage of the Medicare Advantage Disenrollment Period,” said Joe Baker, president of the Medicare Rights Center. “People who are unhappy with their plan and wish to make the change back to Original Medicare should do so promptly, but also thoughtfully. The window of opportunity is closing, but you should review your coverage options carefully before you disenroll.”
Original Medicare, the traditional fee-for-service program offered through the federal government, covers most necessary services and is accepted by most doctors and facilities across the country. However, it does not cover the full cost of care. Many people who enroll in Original Medicare choose to purchase supplemental coverage to help pay for out-of-pocket costs such as deductibles and coinsurance.
Beneficiaries who disenroll from their Medicare private health plan should be aware that they may have limited ability to buy coverage that supplements Original Medicare. State laws vary on when beneficiaries can purchase Medicare supplemental policies, also known as Medigaps. Call your State Health Insurance Assistance Program to find out if and when you can enroll in a Medigap plan in your state. You can find the number for your local SHIP by visiting www.shiptalk.org or calling 800-MEDICARE.
Beneficiaries who disenroll from their private plan may need to join a stand-alone Medicare prescription drug plan to maintain drug coverage. Medicare Rights advises beneficiaries who are choosing a plan to consider not only premium and copayment costs, but also whether the drugs they take are on the plan’s list of covered drugs and whether they can use the pharmacies they prefer. Beneficiaries should also check to see whether the plan places any restrictions on the drugs they take. Restrictions can take the form of quantity limits, prior authorization and step therapy. To learn more about choosing a Medicare prescription drug plan that best meets your needs, visit Medicare Interactive.
There is a special enrollment period which allows beneficiaries to switch their coverage even after Feb. 14 when the MAPD ends. Beneficiaries can make a one-time switch into a Medicare Advantage plan or stand-alone prescription drug plan with a five-star rating. This star rating is an overall performance rating that the government gives to all Medicare plans based on measures such as customer service, pricing and member satisfaction.
“It is important that someone thinking about switching into a five-star plan consider how the switch will affect their access to health care,” Baker said. “Even if a plan has five stars, you should always check to make sure that it fits your needs, for example, that your drugs are on the plan’s formulary or your doctors are in the plan’s network.”
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.