Medicare Updates by HICAP
By David Weil
Medicare beneficiaries who are unhappy with their current coverage have very few choices when it comes to changing plans during this time of year. So, what can you do if you are intent on changing? You have two basic choices: 1) dis-enroll from your current coverage and return to original Medicare. Should you dis-enroll from a Medigap, also known as a Medicare Supplement, you can still keep your Part D prescription drug plan, but you will be responsible for all the cost-sharing, copays and co-insurance in addition to the monthly Part B premium; 2) Enroll in Kaiser Senior Advantage plan, an HMO Medicare Advantage plan that includes prescription drug coverage and is allowed to take enrollees all throughout the year because it has been designated a 5-Star plan by Medicare. (If you have Extra Help or Medi-Cal, you can change plans during any month). Before making any changes, speak with a HICAP counselor and make sure you have considered all the implications. Call 858-565-1392 to make an appointment.
When Medicare Plans Go Bad
When a Medicare Advantage plan or Part D drug plan is not performing up to the standards set by the Centers for Medicare and Medicaid Services (CMS), the governmental overseers of Medicare and Medi-Cal, that plan may be sanctioned. Sanctioned plans are often restricted from marketing and taking on any new enrollees until CMS is satisfied that they have remedied the conditions that caused the sanctions. Beneficiaries that are already enrolled in these plans have a choice to stay with it for the remainder of the year or they can select another plan using Special Enrollment Period rules established by CMS. If you are aware that your plan is a Medicare sanctioned plan and want to choose another one, consider that a new Medicare Advantage plan may have a different network of doctors and that drug plan formularies differ from plan to plan and may be more costly than your current plan. HICAP can also assist you with plan comparisons based on your drug regimen and other factors to avoid choosing a plan that isn’t best for your individual needs.