It's that time of year again -- no, not the time for college basketball's March Madness, but the Open Enrollment Period (OEP) for people on Medicare.
Even though someone may have enrolled in a Medicare plan prior to January 1, those who are eligible can still make one change to their medical benefits for 2007. A "change" can mean they can add, drop or switch certain types of Medicare health plan coverage. Whatever change a beneficiary wants to make though, it must be consistent with whether they have Prescription Drug coverage as of January 1. Medicare beneficiaries are not permitted to change from one PDP to another PDP plan during this time.
Confused? Here are some examples that help illustrate the rules.
The OEP, which began January 1, allows just one of the following types of plan changes through March 31:
Enrollees in a Medicare Advantage plan with prescription drug coverage (MAPD). These beneficiaries may change to a different MAPD plan, or may go back to Original Medicare plus a stand-alone prescription drug plan (PDP).
Enrollees in a stand-alone PDP may choose to enroll in an MAPD plan but they cannot change from one PDP plan to another.
Medicare Advantage (MA) members enrolled in a plan that does not cover prescription drugs may switch to another plan that does not include drug coverage, or may go back to Original Medicare.
Beneficiaries who are not enrolled in an MA plan or a PDP plan can elect to enroll in an MA plan without drug coverage.
After March 31, Medicare beneficiaries are "locked in" through the end of the year to whichever type of PDP or MAPD plan is selected. So, it's important to be comfortable with the plan you choose.
According to the Centers for Medicare and Medicaid Services (CMS), 251,200 beneficiaries in Washington are participating in the Medicare Part D program.
"People who are happy with the choice they made for 2007 benefits do not need to take any action," said Debbie Smith, regional president of Senior Products for Humana, a nationwide health benefits company with offerings in Washington. "However, beneficiaries may be continuing to take stock of how their plan has worked for them so far, or they may have received additional information that leads them to want to make a change. The OEP is designed to allow for one change."
"Humana offers competitive Medicare Advantage medical and prescription drug plans which offer an excellent value to Medicare recipients in our markets," she added.
"We are often asked how this is possible," she continued. "It is because the federal government pays health benefits companies offering Medicare coverage to provide these benefits. This government partnership allows insurers to offer extra benefits such as free physical fitness memberships, mental fitness exercisers, and special programs such as those designed to promote healthy weight."
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