Department of Human Services

Making Healthcare Make Sense April 2013

Answers To Some Of The Most Commonly Asked Medicare Questions

April 1, 2013 | 2 min reading time

Q:  I recently got a notice from Medicare about my new Part D plan, allowing me to change to a higher-rated plan if I want to.  I thought the Medicare Prescription Drug and Health Plan Open Enrollment Period were over.  What does this mean?

A:  Medicare has sent these letters to Medicare beneficiaries who have decided to enroll in what are called "low performing plans" – that is, plans which have scored less than three stars on the Medicare five-star rating system for the last three or more years.  This is the second such mailing.  The first one, sent last fall, went to people who were enrolled last year in a low performing plan.  This new mailing went to Medicare beneficiaries who enrolled in a low performing plan during the most recent Open Enrollment Period.

If you got either letter, you have a one-time opportunity to change your enrollment to a higher rated plan, right away, without waiting for the next Open Enrollment Period in October. You can also change to a plan which does not yet have a rating, because it is too new to have received one.  But you don't have to make any change at all if you don't want to.

If you decide to make a change, it will take place on the first day of the month following your election.  It will not change the plan you are in this month. You may also change from a low performing Medicare Advantage health plan to a Medicare Advantage health plan in your coverage area with a higher rating or to Original Medicare, if you want to; in the latter case, you will also be allowed to enroll in a separate Part D plan at the same time, to make sure your prescription medication needs are also covered, as the Medicare advantage health plan may have provided your prescription drug coverage, too.

For more information about your plan choices, to compare them side-by-side, and to find one that fits your needs, you can go to the Medicare Plan Finder tool:

https://www.medicare.gov/find-a-plan/questions/home.aspxor, you can call Medicare 24 hours a day at 1-800-MEDICARE which is-1-800-633-4227.

You can also get assistance, in your state, from the State Health Insurance Assistance Program or SHIP program; their number is on the back page of your Medicare & You handbook.Note, however that under this special enrollment opportunity, the SHIP volunteers can help you compare the Medicare health and drug plan options, but they are not able to actually change your plan for you.  To enroll, you must call 1-800-MEDICARE.

For more information, call 1-800-MEDICARE, which is, 1-800-633-4227.Medicare's national toll-free helpline is available 24 hours a day, seven days a week, or visit www.medicare.gov.

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  • Department:
    Department of Human Services
  • Topic:
    Federal and State Government Services

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