JANNA HERRON | USA
TODAY | 6:01
am EST December 19, 2018
You
picked your Medicare Advantage plan, but you’re worried it’s not a good fit for
your medical needs. Are you stuck with it until next year’s open enrollment?
No,
thanks to new policy changes this year from the Centers for Medicare &
Medicaid Services.
If you
chose a Medicare Advantage plan during this year’s enrollment period that ended
Dec. 7, then you have a three-month trial period next year for your selection.
If the plan doesn’t meet your needs, you can switch to another through March
31, 2019.
“You
basically get to test drive the plan” says Ryan McCostlin, a health care
adviser at Bernard Health, a benefits brokerage company.
What’s
Medicare Advantage?
The
trial period applies to Medicare Advantage plans only. If you’re enrolled in
Medicare Parts A or B – known as original Medicare – you can’t make any changes
until the new enrollment period later in 2019.
Created
in 2003 to offer more options, Medicare Advantage plans are administered by
private insurance providers. Similar to an employee-sponsored health plan, the
insurer manages your care and pays claims on your behalf. With original
Medicare, the government pays for your claims.
There
are hundreds of Medicare Advantage plans and the ones available to you depend
on your location. Some plans may include benefits that original Medicare
doesn’t traditionally provide such as dental care, vision insurance and gym
memberships, McCostlin says.
This
year, the federal government estimates that more than 36 percent of Medicare
recipients will enroll in a Medicare Advantage plan for 2019, an all-time high.
Four in five Medicare Advantage enrollees who remain in their current plan will
have the same or lower premium next year. Almost half of enrollees in their
current plan will have no premium.
What
changes can you make?
Starting
next year, a new open enrollment period for Medicare Advantage plans will run
from Jan. 1 through March 31. If you’re enrolled in one of these plans,
you can make the following changes during this time.
·
Switch to another Medicare Advantage plan.
·
Drop your Medicare Advantage plan and enroll in original
Medicare, Part A or Part B.
·
Sign up for the Medicare Part D Prescription Drug Plan, if you enroll
in original Medicare, which doesn’t provide a prescription plan.
Previously,
you could only switch from a Medicare Advantage plan to original Medicare and
Part D from Jan. 1 through Feb. 14. You couldn't choose another Medicare
Advantage plan.
Why switch
up?
Many of
the benefits the Medicare Advantage plans offer go beyond what original
Medicare provides and can change from year to year. For instance, this year
your plan may cover a prescription medicine that you regularly take, but next
year it may not be on the list of covered medications, even if it’s the same
plan.
Typically,
you should receive notices of annual changes in the fall during open
enrollment, but there’s always a chance you missed a key change.
If you
selected a new plan, McCostlin recommends a few actions to help you decide
whether to stick with it or make a change. Talk with your primary care provider
or the office’s medical billing department about the specific plan and if you
will pay what you’re expecting to pay for coverage.
Check
with your pharmacy if you have a regular prescription to see how the plan
affects that cost. If your health often requires visits to specialists, look
into the plan’s network of doctors and if it covers any out-of-network
providers.
“If you
need more comprehensive care, pay attention to what the experience was like,
such as the coordination between doctors and plan provider,” McCostlin says.
“When people feel frustrated with a health plan, it’s when they have to step in
and make sure claims are paid appropriately.”
No comments:
Post a Comment