What to Do if Your Current Medicare Plan Won't Exist Next Year
Don't worry, you still have choices
Part D prescription drug plans
Whatever state you live in, you'll still have plenty of choices in 2012 among these private "stand-alone" plans, which provide prescription drug coverage to people enrolled in traditional Medicare. The options range from 25 plans in Hawaii and Alaska to 36 in Pennsylvania and West Virginia. But some plans will be unavailable next year.
What you can do: Compare plans that are available in your state using the online drug plan finder on the Medicare website. If you enter your ZIP code and the names of the prescription drugs you take, plus their dosages and how often you take them, the plan finder automatically does the math to find the plan that covers all your drugs at the lowest out-of-pocket cost. Or call the Medicare help-line at 1-800-633-4227 for the same information.
Even if your current plan will still be available next year, making this comparison is still very worthwhile. Every year, most Part D plans change their premiums, deductibles and copayments. In 2012, premiums will slightly fall on average nationwide, but some plans will charge substantially lower premiums and others much higher ones than this year. You can compare plans and, if you want, switch to another during open enrollment, between October 15 and December 7. Coverage in the new plan starts Jan. 1.
Can you lose your drug coverage if you take no action? It depends on the circumstances:
• You will not lose coverage if your current Part D plan is still offered for 2012. Unless you actively switch to another plan, your current coverage will automatically continue next year in the plan you have now.
• You will not lose coverage if your current plan is disappearing but the insurance company that provides it offers another plan. You will be automatically switched to this other plan for 2012, unless you take steps to enroll in different plan from another insurer.
• You will lose coverage if the insurance company that provides your current plan withdraws from the Medicare Part D program in your area for 2012 and you do not enroll in another plan from a different insurer for next year. In this case, if you take no action, you will not be able to join another plan until open enrollment at the end of 2012. You will also receive a late penalty for the 12 months you were without drug coverage, in the form of a surcharge permanently added to your Part D premiums.
How will you know which category applies to you? If you fall into one of the last two groups above, you should have received a letter from your plan by October 1 saying that your current plan will not exist next year and explaining your options. If you fall into the first group, you should have received an Annual Notice of Change in September explaining all changes in costs and benefits for next year. If you can’t remember receiving a letter, or can’t find it, call your plan at the customer service number provided on your plan membership card.
Medicare Supplemental Insurance (Medigap)
It doesn't happen often, but from time to time medigap insurers go out of business or stop selling medigap policies in some areas. This is a cause of considerable anxiety to people who hold these policies because many believe that if they have to buy a new policy, they will lose the federal guarantees and protections they had before. But that's not true.
What you can do: If you lose medigap coverage through no fault of your own, you still have the right to buy policies A, B, C, F, K or L from any medigap insurer in your state with full federal protections. This means that an insurer cannot deny you coverage or require you to pay a higher premium based on your health status or preexisting medical conditions. But to receive those guarantees, you must apply for a new policy within 63 days of the end of your old coverage. To be on the safe side, it's best to apply before your current coverage runs out.
To compare Medigap policies available to you, and for contact information of insurers that sell them, go to the Medicare website, click on "Compare Medigap Policies" and enter your zip code. For more information, see the official publication "Choosing a Medigap Policy."
Patricia Barry is a senior editor at the AARP Bulletin.
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