Is Your Medicare Advantage/Plan D Ending Soon? Here’s What to Do

Oct 10, 2019

The weather is turning crisp, the holidays are approaching, and before we know it, we’ll be in 2020. A new year can mean big changes—especially when it comes to health insurance.

If your Medicare Advantage or Part D plan is slated to expire, you should receive a letter in the mail in October alerting you to this fact. But don’t panic! This is just a warning. You should still have coverage until December 31, which will buy you some time to study out your options.

A Closer Look at Medicare Plans

Before we dive into the options, note that Medicare can be confusing. So let’s take a closer look at the different plans before we move forward.

  • Original Medicare (Parts A and B). This is also known as Traditional Medicare and is the federal healthcare insurance program created under the Lyndon B. Johnson presidential administration back in 1965. Under Original Medicare, the government pays healthcare providers directly for each service that they provide. Most people with Medicare are enrolled in Traditional Medicare, and most physicians, hospitals, and skilled nursing facilities accept this type of insurance.

There are two parts to Original Medicare—Part A and Part B. Part A can be summed up as hospital insurance and covers inpatient services at hospitals and skilled nursing facilities. Part B can be described as medical insurance and covers most outpatient services and care, such as when you go to your doctor for an annual check-up.

  • Medicare Advantage (Part C). This is an alternative to Original Medicare. The biggest difference is that it is not offered by the government. Rather, it is offered through private providers that have been approved by Medicare.

Medicare Advantage presents both benefits and drawbacks when compared to Original Medicare. One major benefit is that most Advantage plans offer more robust prescription drug coverage than Original Medicare. Often, these Advantage plans also offer other perks not covered by Original Medicare such as routine vision, dental, or hearing services, gym memberships, etc. Disadvantages include the fact that you must be within your plan’s geographic area to get services. (Medicare provides services country-wide for those who are traveling, etc.) Another disadvantage of some Medicare Advantage plans is that they only allow you to see doctors in your plan’s network.

  • Drug Coverage (Part D). This prescription drug benefit may be rolled up into a Medicare Advantage plan. People who have Original Medicare can enroll in Part D as a stand-alone plan that will augment the limited prescription drug benefits provided through Original Medicare.

Options for Renewal or Change

And now for a closer look at what your options are if your plan is expiring. You essentially have two time periods for renewing or adjusting your plan.

Medicare Fall Open Enrollment.
Time period: October 15 through December 7
Changes take effect on: January 1

What you can do:

    • Stay with Medicare Advantage but pick a new plan
    • Switch from Medicare Advantage to Original Medicare (adding Plan D prescription drug coverage if desired)

Special Enrollment Period (SEP)
Time period: December 8 through February 28

Changes take effect on:

    • Changes made by December 31 take effect January 1
    • Changes made by January 31 take effect February 1
    • Changes made by February 28 take effect March 1

If you haven’t settled on whether or not to continue with the same Medicare Advantage/Plan D, Medicare will kick you back to the Original plan as of January 1. That will tide you over with basic coverage until you can reach a decision, but be warned that there could be some gaps in coverage. For example, since Original Medicare doesn’t have the same prescription drug benefits as most Medicare Advantage/Plan D coverage, you will lose that coverage.

What’s Best?

The bottom line here is that even though you have the option to extend your decision into 2020, it is recommended that you make your choice by December 31 of this year. Now’s a good time to start doing your homework. Many people have been able to find lower-priced plans—particularly where Plan D prescription drug benefits are concerned—by shopping around the marketplace.

If you need help making your decision, there’s a handy, dandy Medicare Plan Finder Tool that can steer you toward the best plan based on your needs for medical and hospital care and prescription drug coverage.

Infographic

Medicare is known as a federal health insurance program that caters to people who are 65 years old older, young people with disabilities, and those who have End-Stage Renal Disease. There are different kinds of insurance offered with varying coverage such as hospital insurance, medical insurance, and prescription drug coverage. With the news of Medicare ending soon, what will happen next?

Medicare Ending Soon? 5 Things to Know [infographic]

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