If your Medicare Advantage Plan is ending on December 31, 2018, you need to make timely decisions about your Medicare coverage. Keep in mind that most Medicare Advantage Plans include Medicare health and prescription drug coverage, so you will need to think of about both types of coverage.
Below are steps to take regarding Medicare health and prescription drug coverage when your Medicare Advantage Plan is ending.
1. If your Medicare Advantage Plan is ending at the end of the calendar year, you should receive a letter from your plan by October 2, 2018 to tell you that your plan won’t be available next year. Make sure you keep this letter from you plan. You may need it later to prove you have the right to join other Medicare plans or to sign up for a Medigap plan as explained below.
2. Decide how you want to want to get your health and drug coverage next year. You can either select another Medicare Advantage Plan or switch to Original Medicare to continue getting Medicare health benefits. If you need Medicare prescription drug coverage, most Medicare Advantage Plans include drug coverage. If you change to Original Medicare, you will need to join a stand-alone Part D prescription drug plan to get Medicare drug coverage.
Learn about the main differences between Medicare Advantage Plans and Original Medicare. To make your decision, consider your current and upcoming health care needs and compare the costs and restrictions associated with your care under Original Medicare versus a Medicare Advantage Plan.
Also, know that if you change to Original Medicare, you will have special rights to buy a Medigap plan because your Medicare Advantage Plan is ending. Medigaps help pay for gaps in Original Medicare coverage. Remember, you can only have a Medigap if you have Original Medicare. Under federal law, if you are 65 or over, you will have a special right to buy a Medigap policy because your Medicare Advantage Plan is ending. During this time, you have the right to sign up for certain Medigap plans, and plans cannot impose a pre-existing waiting period. Contact your State Department of Insurance or State Health Insurance Assistance Program (SHIP) to learn more about the Medigap rules and regulations in your state.
3. Make your plan selections before the end of 2018 to ensure you have the drug and health coverage you need on January 1, 2019.
If you want to join a Medicare Advantage Plan, sign up for one that offers prescription drug coverage by December 31, 2018 so that you can have drug coverage beginning January 1 of the next year. You technically have until February 28, 2019, to sign up for prescription drug coverage. However, if you wait until January or February to enroll in the new plan, your coverage will start the first of the month after you enroll.
If you want to change to Original Medicare, you will be automatically enrolled in Original Medicare by December 31, 2018, unless you enroll in a Medicare Advantage Plan. Sign up for a stand-alone Part D plan by December 31, 2018 so you can have drug coverage beginning January 1 of the next year. If you do not enroll in a Part D plan, you may face gaps in prescription drug coverage. You officially have until February 28, 2019, to sign up for prescription drug coverage. However, if you wait until January or February to enroll in the new plan, your coverage will start the first of the month after you enroll.
If you want to sign up for a Medigap plan, enroll by December 31, 2018 so your supplemental coverage will start on January 1, 2019. Although your right to purchase a Medigap in many states lasts through March 4, 2019 if you are 65 or over, waiting wait until January, February, or early March to enroll will leave you without supplemental coverage for up to three months. Medigap plans only start the month after you apply.
4. Beware that other considerations apply if you have retiree coverage.
If you have retiree coverage from a union or former employer, ask your plan’s benefit administrator how joining another Medicare Advantage Plan or switching to original Medicare, along with a stand-alone drug plan will affect your retiree coverage. You may need to enroll in certain plans to keep your retiree coverage. Enrolling in the wrong plan could cause your retiree coverage to end for you or your dependents.
Still have Medicare questions? Call the Medicare Rights Center’s free national helpline at 800-333-4114.