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How Caregivers Can Help with Medicare Plan Options During the Annual Election Period

The Annual Election Period (AEP) occurs every year from October 15 to December 7. During this time, Medicare beneficiaries have a host of plan options, from enrolling in a private Medicare Advantage plan to switching from one Medicare Advantage plan to another to adding or removing prescription drug coverage.

If you’re a caregiver, you may want to take this opportunity to have an in-depth conversation with the Medicare beneficiary you’re helping. Is she happy with her doctors? What health concerns does he worry about? Is she up to date with her Medicare benefits? Would he like to make any coverage changes?

Because a beneficiary’s health and medication needs may change, we always recommend that you take some time ahead of AEP to make sure the person in your care is getting the most from his or her Medicare coverage.

Switching Medicare plans during the AEP isn’t as difficult as it might sound. The most common private plan options are described here, broken out by Medicare plan type.

Medicare Advantage (Medicare Part C)

Perhaps the person you’re caring for has Original Medicare, Part A and Part B, but would like to have additional coverage benefits, such as vision, dental, and prescription drug coverage. In this case, joining a Medicare Advantage plan may be a worthwhile option.

Most Medicare Advantage plans cover prescription drugs, but you might want to make sure by asking the plan or reviewing its policy before you switch. Medicare Advantage Prescription Drug plans offer health and drug coverage in a single plan.

Joining a Medicare Advantage plan during AEP means that coverage takes effect on January 1 of the following year. If the beneficiary already has a Medicare Advantage plan and would like to join a different one, then the beneficiary is automatically disenrolled from the old plan when the new coverage begins. No additional action is necessary when it comes to switching plans. The beneficiary should receive a letter from the new plan after enrollment, stating when the plan’s coverage will begin.

Conversely, you can drop a Medicare Advantage plan and return to Original Medicare coverage during the AEP. You have another chance to do this during the Medicare Advantage Disenrollment Period, from January 1 to February 14 every year. Original Medicare doesn’t include prescription drug coverage, so you can add a stand-alone Medicare Prescription Drug Plan during this period as well.

As a member of a Medicare Advantage plan, the beneficiary continues paying the Part B premium in addition to any premium the Medicare Advantage plan may charge.

Medicare Part D (prescription drug coverage)

The AEP also allows Medicare beneficiaries to switch prescription drug plans, whether it’s a stand-alone Medicare Part D Prescription Drug Plan that works with Original Medicare or a Medicare Advantage Prescription Drug plan. The beneficiary doesn’t have to cancel his or her existing prescription drug plan, as it will cover him or her until the end of the year. The new prescription drug plan’s coverage begins on January 1 of the following year.

If the beneficiary didn’t sign up for Medicare drug coverage when first eligible for Medicare, or if he or she went for 63 days or longer without creditable drug coverage (coverage that’s expected to pay, on average, at least as much as Medicare’s standard drug coverage), it’s possible he or she will have to pay a late enrollment penalty.

Switching Medicare plans

Here are some ways that you, as a caregiver, can help a Medicare beneficiary find a more suitable Medicare plan option.

Review his or her current coverage. A person’s needs change and may continue to change over time. Ask the beneficiary if the current plan will cover all his or her health and drug needs for next year while remaining an affordable option. If not, it may be worth switching plans.

Compare Medicare plans in your area. There may be several plan options available in the beneficiary’s area. To find out more about available plans, you can:

  • Contact the Medicare plan directly.
  • Call 1-800-MEDICARE (1-800-633-4227), TTY users 1-877-486-2048; 24 hours a day, 7 days a week.
  • Contact a licensed insurance agency such as eHealth.
  • Call eHealth licensed insurance agents at 1-888-296-0117, TTY users 711; Monday through Friday, 8AM to 8PM ET, Saturday, 9AM to 6PM ET.
  • Or visit eHealthMedicarePlans.com and enter your zip code where requested to see a quote.

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The purpose of this communication is the solicitation of insurance. Contact may be made by an insurance agent/producer or insurance company. eHealthInsurance Services, Inc. is not connected with or endorsed by the U.S. government or the federal Medicare program.

eHealth's Medicare website is operated by eHealthInsurance Services, Inc., a licensed health insurance agency.