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Medicare Plans

Medicare OEP 2020: How Mrs. Jones Made Changes to Her Medicare Advantage Plan

by My Senior Health Plan
written by My Senior Health Plan

The new year is upon us and so is Medicare Open Enrollment Period (OEP) 2020. Yes, just when Annual Enrollment Period 2020 has finished, it’s time for OEP 2020! We know the Medicare system can be difficult, so today we’re going to follow Mrs. Jones through the Medicare Open Enrollment Period.

Mrs. Jones is a little confused since the Medicare rules can be complicated. But we’re here to help!

What is Medicare Open Enrollment Period?

Mrs. Jones wasn’t happy with the Medicare Advantage Plan she chose in the fall during AEP, and she’s been waiting for January 1st so she can make a change to her Medicare coverage. She has until March 31st, and she’s allowed to make just one change to her plan.

During the Medicare Open Enrollment Period, she:

CAN switch from one Medicare Advantage plan to another Medicare Advantage Plan

CAN disenroll from a Medicare Advantage Plan and return to Original Medicare (with or without a Part D drug plan).

But Mrs. Jones:

CAN’T switch from Original Medicare to a Medicare Advantage Plan

CAN’T add or switch a Medicare Prescription Drug Plan (if enrolled in Original Medicare).

If Mrs. Jones was in the first three months of her Initial Enrollment Period, she would also be able to:

Change to another Medicare Advantage Plan (with or without drug coverage)

Or go back to Original Medicare (with or without a drug plan).

What kinds of changes can be made during OEP?

Mrs. Jones changed her Medicare Advantage Plan during AEP. That plan became active on January 1st. But just a month after her new plan began, she realized that plan doesn’t cover her prescription drug needs.

Fortunately for Mrs. Jones, she can make a change because it’s Open Enrollment Period. She’s choosing to switch from the Medicare Advantage Plan she chose during AEP to another Medicare Advantage Plan that covers her prescription drug needs. This is a one-time change for Mrs. Jones that will go into effect on March 1st.

But what if her new Part D plan begins, and she finds she doesn’t need the coverage? Unfortunately, she’ll have to wait until AEP on October 15th to make additional changes.

But she may qualify to change her coverage during a Special Election Period (SEP). Here’s how.

What is a SEP?

A Special Election Period is a time when you can make changes to your Medicare Advantage and prescription drug coverage outside the typical AEP and OEP periods.

SEPs are granted for many different circumstances. A few of these are:

  1. A change of address that impacts your coverage
  2. Residency in an area affected by a FEMA-sanctioned emergency or natural disaster during a previous enrollment period (either for the beneficiary or caregiver)
  3. Moving into or out of an institution.

 

Also, if you lost your previous insurance, whether it’s Medicaid or employer-provided, you may be eligible to enroll in Medicare Advantage during an SEP.

Medicare is complicated, but MySeniorHealthPlan.com is here to help you confidently navigate your health insurance decisions.

If you have questions or need to talk to a licensed Medicare specialist, visit our website or call (877) 255-6273. You’ll be able to talk to a knowledgeable member of our team who will help you find the right plan for you.

 

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close up of senior man and doctor at hospital
Medicare Plans

What is the Medicare Special Enrollment Period?

by My Senior Health Plan
written by My Senior Health Plan

Right now, we’re in Medicare’s Open Enrollment Period (OEP). But what happens if a major disaster strikes and you’re not able to take advantage of OEP? Don’t worry, you’ll still be able to change your plan if you need to. The Medicare Special Enrollment Period (SEP) extends the Medicare enrollment period during extenuating circumstances.

For example, you might find yourself in the midst of a life-altering weather event that prevents you from selecting coverage during OEP. Or you might need to move to a new state and discover that your previously selected coverage is not offered in your new state of residence. You can’t go without coverage, so a SEP allows you to choose a new plan.

Life changes, and sometimes your coverage has to change as well. SEPs can be difficult to understand, but we’re here to help you understand what you need to know about Medicare SEPs and how you can take advantage of this important enrollment period.

Am I eligible?

There are several circumstances for qualifying beneficiaries for SEPs. The most common are FEMA-designated natural disasters and changes in residence.

Extreme weather event or natural disaster

In order to initiate a SEP, the Federal Emergency Management Agency (FEMA) must officially declare an area affected by an emergency or a major disaster. This includes but isn’t limited to, extreme rain and flooding events, hurricanes, tornadoes, wildfires, man-made environmental catastrophe and more.

If you were planning to initiate or alter coverage during a predesignated enrollment period, like OEP, but weren’t able to because of the FEMA-designated disaster, you may take advantage of the SEP.

One extra benefit is that it doesn’t have to be you that lives in the disaster area to qualify. The SEP takes into consideration that many seniors rely on a family member to assist with their Medicare coverage selections. If the family member or caregiver charged with this duty lives in a FEMA-designated area, the same principle applies.

Change of residence

You may not have realized that moving can impact your Medicare coverage. For example, if you live in Arizona and selected a plan during last year’s OEP, but you now need to move to California to be closer to family, you will also need to also change your coverage. Different Medicare plans service different areas, and if you move into a state not serviced by your current plan, you’ll need to take advantage of this SEP.

You’ll want to take advantage of the SEP to find better coverage options in your new state that wasn’t available in your previous area of residence.

How long are SEPs?

The length of SEPs varies based on the circumstances. If you have a qualifying change of residence, you have two months to alter coverage. In the case of extreme weather or natural disasters, the SEP begins the day the disaster strikes and runs for four full calendar months thereafter.

This is almost always the case, but there have been a few cases when FEMA-designated SEPs were extended beyond four months. Hurricane Katrina, for example, made U.S. landfall on August 25, 2005 before pummeling the Gulf Coast for several days thereafter. The SEP for this natural disaster was extended through December 31, 2006—more than 16 months.

What can I change during SEP?

During SEP, you can enroll in, disenroll from, or switch Medicare health or prescription drug plan. Essentially, you can add, update, change, or drop both medical and prescription drug coverage during the SEP period.

Usually, if you need to take advantage of a SEP, you’re experiencing some significant life change. During these times, the last thing you want to worry about is your Medicare coverage.

If you need help or have questions about SEP, visit our website or call (877) 255-6273. You’ll be able to talk to a knowledgeable member of our team who will help you navigate SEP and find your best coverage options.

You may also seek assistance from Medicare by calling (800) MEDICARE (1-800-633-4227).

 

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Medicare Plans

Medicare OEP 2020: How to Make Changes to Your Medicare Advantage Plan

by My Senior Health Plan
written by My Senior Health Plan

Medicare Open Enrollment Period (OEP) 2020 will begin on January 1st. If you are enrolled in a Medicare Advantage Plan (maybe you signed up for a new plan during AEP 2020?) and wish to adjust your coverage, you may qualify to make a one-time change to your existing policy.

Medicare OEP 2020. What is it?

OEP is the Medicare election period that runs from January 1st to March 31st each year. It allows Medicare beneficiaries enrolled in Medicare Advantage Plans to:

  • Switch from one Medicare Advantage plan to another Medicare Advantage plan
  • Disenroll from a Medicare Advantage plan and return to Original Medicare, with or without a Part D drug plan

 

Note: According to Medicare.gov, the following are changes that you cannot make during OEP.

You will not be able to:

  • Switch from Original Medicare to a Medicare Advantage Plan.
  • Join a Medicare Prescription Drug Plan if you’re in Original Medicare.
  • Switch from one Medicare Prescription Drug Plan to another if you’re in Original Medicare.

 

Also, if you’re within the first three months of your Initial Enrollment Period, you have the option to

  1. Change to another Medicare Advantage Plan (with or without drug coverage) OR
  2. Go back to Original Medicare (again, with or without a drug plan)

Let’s look at an example.

During AEP, Sylvia enrolled in a Medicare Advantage Plan. The plan will activate January 1st. However, early in February, she decides she could benefit from Medicare Advantage Plan D.

Being in the OEP window and having had her existing plan since January, Sylvia can make the one-time change. Her new policy will go into effect on March 1st.

However, that’s not where Sylvia’s story ends. Her plan activates March 1st, but after a couple of weeks (and still within the OEP), she finds that the new plan isn’t a good fit for her needs.

Unfortunately, Sylvia will have to wait until October 15th when AEP begins again—unless, of course, she qualifies for Special Election Period (SEP).

What is SEP?

SEP allows seniors to make changes to their Medicare Advantage and Medicare prescription drug coverage under particular circumstances.

Examples of when you may qualify for SEP include the following.

You’re moving to a new address that affects your coverage (e.g., moving back to the States after living overseas or moving to a new address that isn’t in your existing plan’s service area).

You’re living in an area where a weather event has occurred—one that FEMA has determined as an emergency or major disaster. Due to the weather situation happening during another valid election period (e.g., AEP), you may qualify for SEP.

Additionally, the weather-related SEP is available to beneficiaries who depend on friends or family members living in the affected areas to manage their healthcare needs.

You will lose your other insurance coverage. For example, if you are no longer eligible for Medicaid, you may qualify for SEP and the opportunity to sign up for a Medicare Advantage Plan. Also, if you no longer have coverage from your employer (or union), SEP will allow you to apply for Medicare Advantage coverage.

Tapping into your Medicare resources

Medicare election periods from OEP to SEP can get complicated. However, you have access to resources—from your insurance specialist to online information (such as the Medicare.gov website). The key is to keep an eye on election period dates that apply to you, take action early and, if necessary, ask for help.

Need to adjust your Medicare Advantage coverage during OEP? The MySeniorHealthPlan.com team can answer all your questions and guide you through the process.

Call today toll free: 877.255.6273

 

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Medicare Plans

When Does Medicare Annual Enrollment Period End? Soon!

by My Senior Health Plan
written by My Senior Health Plan

If you need to make changes to your Medicare coverage for the upcoming year, mark your calendar for December 6th! It’s when the 2020 Medicare Annual Enrollment Period (AEP) will end.

After that date, you will not be able to make changes to your existing Medicare coverage until next October.

In case you’ve been thinking about making changes to your existing Medicare plan, now is the time to take action!

Book your appointment as soon as possible

While December 6th may seem a ways off, November is a busy month for everyone, including your plan providers.

Additionally, Thanksgiving falls on the 28th of this year, a little over a week before the end of AEP.

If we factor in weekends, the available time for getting an appointment and processing your application starts to narrow.

Get in early to get the one-on-one attention you deserve

During AEP, your carrier’s calendar fills up fast and they get strapped for time. Each application is time-intensive, requiring much more than a simple phone call or filling out a form.

During your scheduled appointment, your plan specialist will discuss your existing benefits and any Medicare changes that may affect your plan. For instance, this year, some beneficiaries may not qualify for Medicare Plan F.

Once you and your plan specialist have worked out what you need, they’ll submit any plan changes. The insurance carrier must then approve the application.

If any adjustments need to be made, your plan specialist will let you know, discuss your options, and resubmit your application.

The AEP application process—from your consultation to plan approval—must be completed by December 6th.

How to prepare for your Medicare plan call

Once you have a scheduled appointment with your plan provider, take some time to prepare for your AEP appointment.

After all, Medicare can get complicated. That includes understanding plan changes you can make during AEP 2020.

Here are some questions to consider:

Have you had the same plan for two or more years?

It’s easy to get comfortable with an existing plan. Maybe you receive the Annual Notice of Change letter each year and figure you don’t need to make any changes.

However, your health needs may have changed—or improved. Maybe you no longer take medication because your health improved. By revisiting your prescription drug plan, you may be able to adjust your benefits and save some money on coverage costs.

Were you happy with your coverage last year?

If you made changes to your plan last AEP or started receiving Medicare benefits for the first time, you may want to assess how well your insurance plan held up.

Did you have enough coverage? Are you comfortable paying the same deductibles for another twelve months? Were there any surprises? Make a note of your experiences and share them with your plan specialist.

Are there additional services or medications you may need this year?

Maybe you and your medical provider are monitoring a health condition. Now is an excellent time to talk to your physician about a timeline for treating it.

If you decide to take action this year, you will want to make sure you have the right coverage.

Also, if you wish to make changes to your Medicare benefits, make sure your healthcare provider will accept your new plan.

Taking charge of your healthcare

If you’ve decided your Medicare benefits are working well for you, that’s great! However, should you want to make any changes to your existing coverage, you must make an appointment with your plan specialist as soon as possible.

The MySeniorHealthPlan.com team can answer all your questions and guide you through the process. Call today toll free: 877.255.6273

 

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Understanding Special Enrollment Periods on Medicare
Health Insurance

Understanding Special Enrollment Periods on Medicare

by Jagger Esch
written by Jagger Esch

Special Enrollment Periods for Medicare are known as SEPs. There are a variety of reasons why a Medicare enrollee would be eligible for a SEP. Having the information needed to utilize a SEP when necessary will save you problems getting Medicare coverage when you need it. please email your resume to Christina Dailey at CDailey@senior.com. She can also be reached 949-454-2418. Understanding Special Enrollment Periods on Medicare
Navigating the Medicare system does not have to be complicated. If you have with the right information and resources, you will avoid the complications of missing your SEP and being without coverage, which could be devastating for you and your family. Understanding Special Enrollment Periods on Medicare

Who Qualifies and When?

The qualifications for a SEP are as follows:
If you are:

  • 65 or older
  • still employed or your spouse is still on the job
  • you have health insurance through your – or your spouse’s – employer
  • eligible for Medicare because of a disability

You can qualify for a SEP:

  • while you still have an employer or employment union health plan
  • eight months following the last month of employer or union group health coverage, or when you or your spouse no longer work, whichever comes first.

If your group coverage, provided by your employer, ends and you neglect to sign up for Medicare Part B during the SEP, you then must wait until the General Enrollment Period (GEP) to sign up for your Medicare plan. You may pay a penalty of a higher Part B premium because of late enrollment.

What About if You Relocate?

Relocation is a fact of life for many on Medicare. Moving to be near family, for financial reasons, for a change of scenery or other circumstances happens all the time. You won’t lose your Medicare coverage, but there are issues to manage:

  • If you live in the United States or its territories, you can keep your Original Medicare Part A and Part B coverage.
  • Make sure to have your medical records transferred from your previous doctors to the doctors you find in your new hometown.
  • If you are covered by a Medicare Advantage plan or a Medicare Part D Prescription Drug Plan, moving to a new state may qualify you for a Special Election Period (SEP).
  • During your SEP, you can enroll in a plan offered in your new service area.
  • If you have a Medicare Supplement plan (also known as Medigap) and relocate to a new state, it’s likely you will be able to keep that coverage, because the plans are the same in most states (Minnesota, Massachusetts and Wisconsin have their own Supplement programs).
  • Keep in mind that costs may vary from state to state, since Medigap plans are provided by private insurers.

What if You’re Incarcerated?

If you are incarcerated after enrolling in Medicare, it’s best to maintain your coverage for Parts A & B, if you can. Medicare does not cover your treatment while in prison, but keeping your coverage will ensure that when you are released, you will maintain your Medicare insurance coverage and not have to pay penalties, which can be permanent.

What if You Qualify for Extra Help for Prescription Coverage?

If your financial status qualifies you for aid with prescription drug expenses, you are eligible to enroll anytime for Medicare Prescription Part D. There is no SEP in this case.

What if Your Medicaid Status Changes?

If your Medicaid status changes, there are some scenarios that may apply to you, including:

  • You may be eligible for a two-month SEP during which you can assess your needs. If you wait longer than that, you may be assigned coverage without your input.
  • If you are covered by PACE, the Program of All-inclusive Care for the elderly, you may need different coverage.
  • If your coverage is dropped from a Special Needs Plan (SNP), you may need coverage.

These situations can be difficult to navigate within the Medicare system, so it’s best to find out how the facts apply to you. Don’t hesitate to reach out to a Medicare specialist if you are overwhelmed by the details.

How to Find Out if You Qualify for a Medicare Part B SEP

Eligibility for a Part B SEP can be determined by filling out these forms, available through the Social Security Administration office:

  • CMS 40B
  • CMS L564

After you have enrolled in Medicare Part B, it’s important to look into a Medigap or Medicare Supplement Plan. Medicare only covers 80% of your medical care, which means you will be paying the remaining 20% as well as deductibles, coinsurance, and copayments. A Medigap plan can cover those expenses.

Understanding Special Enrollment Periods on Medicare

Understanding Special Enrollment Periods on Medicare Understanding Special Enrollment Periods on Medicare Understanding Special Enrollment Periods on Medicare Understanding Special Enrollment Periods on Medicare Understanding Special Enrollment Periods on Medicare Understanding Special Enrollment Periods on Medicare Understanding Special Enrollment Periods on Medicare Understanding Special Enrollment Periods on Medicare Understanding Special Enrollment Periods on Medicare Understanding Special Enrollment Periods on Medicare Understanding Special Enrollment Periods on Medicare
 
 
 
 
 
 

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