by Carl Dye, Independent Insurance Broker
Let’s address those opportunities when we can make changes in our Medicare coverage. As discussed last month, OEP (Open Enrollment Period) is the time one either ages into Medicare due to turning 65 or the effective date of Part B, if delayed due to having insurance through employment, and AEP (Annual Election Period) which is currently October 15 through December 7. OEP applies to both Supplemental coverage and Medicare Advantage Plans, while AEP applies only to Medicare Advantage Plans, including MA-PDs and PDPs.
Supplements can be written at any time, providing the applicant qualifies health wise. Only during OEP or a Guaranteed Issue (loss of other insurance due to relocation or the withdrawal of a plan by a company) can one avoid the health questions. Many have the misunderstanding that AEP is the same as OEP due to continuous advertising by many sources that call AEP OEP! Do not be misled by these advertisements, but consult your agent to determine your specific situation.
Medicare Advantage Plans, in addition to AEP, have what is known as Special Election Periods or SEPs. There are seven such periods when you can change your Medicare Advantage Plans that is important to understand.
- MOV — This is particularly important in the White Mountains due to the continuous influx of people moving up from the Valley or other states where most MA-PDs cannot transfer. Upon notification of a new address, it is highly likely that a cancellation notice will be sent. It is important that you retain this notification as it not only gives you 63 days to obtain other insurance, but this is one of the times that you can obtain a Guaranteed Issue.
- LIS—You receive help paying your Part B premium and/or assistance paying for your prescription drug plan and/or prescriptions.
- LLS—You no longer qualify for for financial assistance for your prescription drugs.
- LEC—You are losing coverage from an employer or union and have lost such coverage within 63 days.
- LOC—You lost your creditable prescription drug coverage in the last 63 days.
- MDE—You have BOTH Medicare and Medicaid (AHCCCS in Arizona) or you will be losing AHCCCS in the next few months.
- LTC—You are moving into or out of a Long Term Care facility within the past two months.
What all this means is that there may be instances when you can make a substantial change in your existing Medicare Advantage Plan should your health and/or financial situation deem it desirable that, previously, you may not have been aware Talk to your agent whenever you have questions or concerns. In fact, you should have your Medicare coverage and expenses reviewed every two to three years at a minimum. This actually holds true for for all insurance and financial plans held by you and your family. Change is not all that fun, but you may be able to afford a vacation or that special something you have been wanting by a simple review of how effective your coverage is and how well your money is being spent. If you have not been doing this over the years, now is an excellent time to begin.
While I attempt to keep these articles short and to the point, it does not mean that questions do not arise that you may feel apply only to yourself. There are few, if any, new questions that pop up on a regular basis. It is just that so much of this topic is clouded by poor communication and a continued barrage of advertisements and company direct solicitation that we become immune to to the message that everyone needs to hear. “Medicare can and does provide each of us excellent health insurance at affordable prices!” However, it is up to each of us to seek out the best coverage that fits our needs and our checkbook.
Hopefully this short narrative has created an interest in learning more about this excellent health insurance coverage. While I have a basic game plan on what we will be covering, I truly hope you readers feel free to email/call in specific questions and/or concerns that have bothered you either recently or in the past that you would like clarifications on in following write ups. I can be reached at:email@example.com or by phone at (928) 245-1388.
I look forward to hearing from many of you in the coming months and truly believe that, together, we can overcome some, if not all, of the myths and mysteries of Medicare.