PART 2: POSSIBLE CHANGES IN MEDICARE

Medicare Annual Enrollment Period (AEP)

As you may know, the Annual Enrollment Period for Medicare beneficiaries will be October 15 through December 7.  This is the period during which you may make certain changes in the way you want to receive your Medicare benefits in 2016, including the following:

  • A beneficiary enrolled in Original Medicare (Parts A and B) may enroll in any Medicare Advantage Plan or stand-alone Part D Prescription Drug Plan offered in the service area – with no medical underwriting.
  • A beneficiary enrolled in a Medicare Advantage plan may choose a different plan or return to Original Medicare.
  • A beneficiary enrolled in a Medicare Part D Prescription Drug Plan may choose a different plan.

Note:  The Annual Enrollment Period does not apply to Medicare Supplement policies, which are usually renewed on the anniversary date of the beginning of coverage.  Open enrollment in such coverage applies only when a beneficiary first enrolls in Medicare Part B.  Guaranteed issue (without medical underwriting) applies only at that time and when a beneficiary qualifies for a Special Enrollment Period, e.g., upon the loss of employment-based coverage.

Any beneficiary currently enrolled in a Medicare Advantage plan or Part D Prescription Drug Plan should have already received information from the current plan about any changes to be effective January 1.  No action is needed if the beneficiary is satisfied with the current plan and the scheduled changes.

Effects of provisions of the Affordable Care Act (ACA) continue to impact health insurers who offer Medicare Advantage and Prescription Drug Plans and, in turn, the Medicare beneficiaries enrolled in such plans.  In response to changes in reimbursement from the Centers for Medicare and Medicaid Services (CMS) and benefits costs, most insurers are implementing changes effective January 2016.  Such changes may be in the form of premiums, out-of-pocket costs or both.

The purpose of this notice is only to remind you of your annual options and is not a recommendation that you make any changes.  However, this is a good time to review alternative plans, particularly if your prescription drugs have changed.  If you are affected by Medicare plan changes announced for 2016, you should review them carefully – first of all to ensure you understand them, and then to decide whether you are satisfied with the changes or whether you should consider an alternative plan for 2016.

Even with any changes announced for next year, your current plan may still be the right one for you.

Factors to Consider in Evaluating a Medicare Advantage or Prescription Drug Plan

  • Amount of monthly premium
  • Out-of-pocket costs for services you anticipate receiving
  • Participation of your physicians and other health care providers in plan networks
  • Inclusion of your prescription drugs in Part D plans’ formularies and the tiers/copays to which your products are assigned
  • Your experience with plan administration and customer service
  • CMS Star Rating
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