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Did You Miss Medicare Open Enrollment?

Posted by David Ghiorso, CPA, December 12, 2016

Each fall, Medicare operates their Annual Enrollment Period. During this time, you can make changes to your existing Medicare plan, and enroll in a new plan if desired. But we all tend to get busy toward the end of the year, and occasionally some people completely forget about enrollment! If you missed the enrollment cut-off on December 7, read on to find out what you can do now.

Ask your doctor about other prescription medication possibilities. Let’s say that you’ve just found out one of your medications won’t be covered under your Medicare plan next year, and now it’s too late to change to a different plan. Talk to your doctor about this limitation, and see if there is another drug that will work just as well for your condition. It might be covered, or at least cost less than the prescription you’re using now.

Add drug coverage during the Annual Disenrollment Period. During this time, you can disenroll in any Medicare Advantage plan if it doesn’t suit your needs. In many cases we don’t recommend taking this action, because you will lose access to your network of providers and the cap on your out-of-pocket spending for medical bills. These benefits aren’t provided by Original Medicare, so this is a decision to weigh very carefully. If you do drop your Advantage plan, you can enroll in a stand-alone prescription drug plan to complement Original Medicare.

Investigate the possibility of a Special Enrollment Period. Sometimes it is possible to change your Medicare coverage, outside of the Annual Enrollment Period. It’s called a Special Enrollment Period, and you’re eligible for it under certain conditions such as:

  • You moved outside of your plan’s service area
  • Your income and changed, and you’re now eligible for a subsidy to help with the cost of premiums
  • You received incorrect information about creditable drug coverage
  • You lose your drug coverage through no fault of your own
  • You live in, move into, or move out of certain types of nursing facilities
  • You receive a retroactive Medicare entitlement determination
  • … and some other conditions

The best way to find out whether you’re eligible for a Special Enrollment Period is to give us a call. We can help you assess your situation and decide how to proceed with making changes to your Medicare plan.

Talk to an experienced agent. The best thing you can do is discuss your specific problem with a trained professional who is familiar with Medicare plans. You don’t have to remain trapped in a plan that doesn’t meet your needs. Call us to discuss your concerns, and we can help you identify opportunities to make changes to your plan outside of the Annual Enrollment Period.

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