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Thursday, December 28, 2017

Making changes to Medicare coverage

If the person you’re caring for already has Medicare, it’s a good idea to make sure the current coverage is still meeting his or her health, financial, and coverage needs. A Medicare health or prescription drug plan can change how much it costs and what it covers each year. Each fall, there’s an opportunity to change Medicare coverage options, so you should help the person review his or her current health and prescription drug coverage.

If he or she is satisfied with the current plan’s cost and coverage for the coming year, do nothing. However, if the person wants to make a change, it can be done during certain times depending on the type of coverage. 

Fall Open Enrollment Period 
Between October 15–December 7 each year, a person with Medicare can join, switch, or drop a Medicare Advantage Plan (like an HMO or PPO) or a Medicare drug plan. The coverage will begin on January 1 of the following year.  

Medicare Advantage Disenrollment Period

Between January 1–February 14 each year, if someone is in a Medicare Advantage Plan, he or she can leave that plan and switch to Original Medicare. If the person switches to Original Medicare during this period, he or she will have until February 14 to also join a Medicare Prescription Drug Plan to add drug coverage. The coverage will begin the first day of the month after the plan gets the enrollment form. 

During this period, a person can’t do any of these: 
• Switch from Original Medicare to a Medicare Advantage Plan. 
• Switch from one Medicare Advantage Plan to another. 
• Switch from one Medicare Prescription Drug Plan to another. 
• Join, switch, or drop a Medicare Medical Savings Account Plan.

In most cases, a person must stay enrolled in a Medicare Advantage or Medicare Prescription Drug Plan for a whole calendar year. However, there are exceptions, like: 
• Moving out of the plan’s service area
• Having both Medicare and Medicaid 
• Qualifying for Extra Help to pay for prescription drugs 
• Living in an institution (like a nursing home)

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