RENEWAL TIME
WHAT TO THINK ABOUT at RENEWAL TIME
What to consider when holiday shopping includes searching for new health coverage
Open enrollment happens every year from October 15 to December 7. And while you may be pleased with your Medicare coverage. It’s still important to take time to review your benefits and consider whether you want to change plans for the coming year. While you may not like the idea of having to compare plans annually (shouldn’t once be enough?), doing so could save money–and more than a few headaches.
As renewal time draws near, focus on the three C’s: coverage, costs, and care. That is, make sure your healthcare needs (including drugs) are covered, at a price you can afford, from providers you trust. Simple, right?
What’s Not Changing
The benefits you receive from Original Medicare won’t generally change from year to year because they’re determined by the government. Likewise, if you have a Medigap policy, your benefits won’t change, either. Medigap plans themselves are also standardized by the government, even though they’re provided by private insurers. Your premiums for Original Medicare and Medigap won’t go up beyond the rate of inflation unless:
- Your income Goes Up
A higher-income could affect whether you pay an income-related monthly adjustment amount for Part B.
- Your Medigap Policy Premium Is Based on Attained-Age
If so, your premium will go up each year on your birthday—but if you did your homework, this increase shouldn’t come as a surprise.
Original Medicare and Medigap policies can be used anywhere in the country. This means that you’ll still be covered if you move or you’re a winter traveler, no matter where you are. There’s no need to renew your Original Medicare and Medigap plan each year. Your coverage will continue unchanged as long as you pay your premiums.
What Can Change
Part D plans and Medicare Advantage plans make changes reasonably frequently. Any changes for the coming year must be detailed in your plan’s Annual Notice of Change (ANOC), which you’ll receive by the end of September. If you haven’t received it by the beginning of October, call your plan and request one immediately, so you’ll have plenty of time to review it.
There may be changes to:
- Your Part D formulary
- Your Part D pharmacy network
- Your MA plan’s provider network
- Your MA plan’s policies
- Your premiums of deductibles for MA or Part D
Your plan willingness to grant you an exception for specific drug coverage can also change.
CHANGING YOUR COVERAGE
Just because your plan made an exception to cover a drug outside of its formulary this year doesn’t mean it has to do so next year. Call your plan to ask whether or not you’ll need to reapply for the exception. Suppose plan administrators are going to make it difficult to get the drugs you need. In that case, you may be better off switching plans while you have the opportunity.
Back to the Plan Finder
Using Medicare’s Plan Finder (medicare.gov/find-a-plan)—the online tool provided by the government that helps you find a private insurer—can seem tedious at first. However, you’ll likely find that the process gets easier as you get used to it. Even if it doesn’t, using it is still worth the time and effort cause even if your plan’s ANOC doesn’t detail any changes that could affect you. Other plans may have made changes that could make them a better option. For example, a new insurance company could have entered your area, offering a comparable plan to yours but with a much lower premium or deductible. If you don’t bother to check the Plan Finder, you may never hear about new, more attractive options.
Switching from Medigap to Medicare Advantage
Suppose until now you’ve had Original Medicare with a Medigap plan. In that case, you may be considering switching to a Medicare Advantage plan for additional benefits or to limit your out-of-pocket expenses. Be careful if you decide to take this step because you may not be able to get it back once you leave Medigap.
Here is what happens when you drop a Medigap policy:
- Your first 12 months in your new MA plan are considered a “trial period.” You can still switch back to your original Medigap plan with the same benefits and the same government protections that you had previously during this trial period.
- This special protection only applies the first time that you switch from Medigap to Medicare Advantage. And it only applies if you already had a Medigap policy. You can’t take advantage of the trial period if you’re simply going from Original Medicare (with no Medigap) to MA.
- After a 12-month trial period, you no longer have the guaranteed right to a Medigap plan and maybe denied one in the future. However, you’ll still be able to switch between MA plans.