Health Care Choices For Minnesotans On Medicare - Metropolitan ...

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Health Care Choices for Minnesotans on MedicarePart C1. Enrollment rules for Medicare Advantage plans• You may switch Medicare Advantage plans, with orwithout Part D, or dis-enroll from a Medicare Advantageplan during the Part D Annual Election Period fromNovember 15 through December 31 each year.• You can enroll in a Medicare Advantage plan up totwice per year, unless you use a Special EnrollmentPeriod.• There is the Medicare Advantage Plan OpenEnrollment Period from January 1 through March 31of each year.nYou may not add Part D if you don’t already have itand you may not drop Part D if you have it as partof your Medicare Advantage plan.2. Medicare Advantage Special Enrollment PeriodsIf any of the following situations applies to you, youmay leave your Medicare Advantage plan any timewithin the first 12 months and enroll in OriginalMedicare Part A and B with a separate Part D plan andin a Medicare supplement with no health screeningrequired:• You enrolled in a Medicare Advantage plan for the firsttime when first eligible for Medicare at age 65.• You previously had Original Medicare Part A andB, plus a supplement, and you decided to enroll ina Medicare Advantage plan for the first time to try itout during the last Annual Election Period or OpenEnrollment Period.3. Medicare Advantage and Medicare SupplementsIf you join a Medicare Advantage health plan (or otherMedicare health plan) for the first time, you havespecial rights to buy a Medicare supplement policy ifyou return to Original Medicare within 12 months ofenrolling in a Medicare Advantage or other Medicarehealth plan.The rules allow that:• If you had a Medicare supplement policy before youjoined, you may be able to get the same policy back ifthe company still sells it.nThe Medicare supplement policy can no longer haveprescription drug coverage even if you had it before,but you may be able to join a stand alone MedicarePrescription Drug Plan.• If you joined a Medicare Advantage or other Medicarehealth plan when you were first eligible for Medicare,you can choose from any Medicare supplement policy.• If you buy a Medicare SELECT policy you also haverights to change your mind within 12 months and switchto a standard Medicare supplement policy.Medicare Part DLate enrollment penaltyIf you don’t enroll in Medicare Part D during your InitialEnrollment Period for Part D, you may be subject to apremium penalty.• Equal to 1% of the national average premium for everymonth you didn’t enroll when first eligible.• If you have creditable coverage, the penalty will notapply as long as you were not without the creditableprescription drug coverage for 63 consecutive days.• Percentage is based on the current year’s national averagepremium, which is approximately $32 in 2010.• The penalty continues for as long as you have Part D.• The penalty is waived for those on the Part D Extra Helpprogram (LIS).Still working?• If your coverage at work includes prescription drugcoverage that is at least as good as the standard MedicarePart D benefit, you don’t need to enroll in Medicare PartD at that time.• You will want to avoid the Part D late enrollmentpenalty by making sure your employer or union coverageis “creditable” (as least as good as the current Part Dbenefit).• Your employer’s insurance company must send youcreditable coverage notices, either a letter or informationpacket, when requested, and at a minimum, prior toNovember 15 of each year.• Keep the notice to ensure you will be able enroll in PartD later with no penalty.• If your prescription drug coverage at work is notcreditable, you must sign up for Part D at age 65 orface the premium penalty later. This is the case even ifyou waive Part B because of current employer healthinsurance.26
A publication of the Minnesota Board on Aging Senior LinkAge Line ®Part D Special Enrollment PeriodThis is a window for enrolling in Part D that avoids apremium penalty. Timelines vary. Here are some commonexamples:• Monthly window: Change plans once per monthwith no penalty1. You have Medical Assistance (Medicaid) or any of theMedicare Savings Programs (QMB, SLMB or QI-1)or Part D Extra Help (LIS).2. You live in an institution (including a nursing home).• Two-month window:1. You move out of a long-term care facility.2. You had been working, you retire and creditable drugcoverage ends.3. You lose creditable coverage through no fault of your own.• Three-month window:1. You voluntarily drop your employer creditablecoverage during open enrollment.2. You lose your Extra Help (LIS) to help withMedicare Part D costs.3. You move outside your Part D plan’s coverage area.• This window starts the month you notify your oldplan, if notification is after the move.• If you don’t notify your old plan, your SpecialEnrollment Period is from the sixth month throughthe eighth month after your move, otherwise youmust wait for the Annual Election period and besubject to a penalty for the months you no longerhad Part D coverage.Medicare Advantage Plan open enrollment period optionsIf you have this type ofhealth care coverage:Medicare Advantage planwith Part D coverage.Medicare Advantage planwith Part D coverage.You can make a one-time switch* annually from January 1 to March 31 to:A different Advantage plan withPart D coverage.Original Medicare with a stand-alonePart D plan.Provided you had:Part D coverage as of Jan. 1in the year you are switching.Part D coverage as of Jan. 1in the year you are switching.Original Medicare with astand-alone Part D plan.Advantage plan with Part D coverage. Part D coverage as of Jan. 1in the year you are switching.Medicare Advantage planwith no Part D coverage.Original Medicare withno Part D coverage.Original Medicare with no Part D coverage.Advantage plan with no Part D coverage.You cannot add Part D if youdid not have it before Jan. 1.You will need to wait untilNov. 15 through Dec. 31.You cannot add Part D if youdid not have it before Jan. 1.You will need to wait untilNov. 15 through Dec. 31.*The change is effective the first day of the month following the month you made the change.27
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