A large chunk of baby boomers was eligible for Medicare last year and many boomer parents and grandparents are already receiving Medicare benefits.

Unless you love wading through insurance ins and outs, the paperwork can drive you crazy. There was confusion about people wanting to make last minute changes to their drug coverage who missed Medicare’s 2012 Annual Enrollment Period (AEP) in 2011. According to a survey of Medicare recipients conducted by PlanPrescriber, Inc., one-in-five Medicare recipients were unaware of the new enrollment dates.

For those procrastinators, it can be difficult, but not impossible, to change Part C or D coverage outside of AEP which was designated to allow people to review and change their coverage, if necessary. These plans often change prices and benefits from year to year. Don’t panic, but prepare to do some hard work.

Ross Blair, President/CEO of PlanPrescriber, Inc., (which provides senior-friendly Internet comparison tools and resources for Medicare) created the following short list of tips to help maximize your drug and health benefits in 2012. And, if you desperately need to change plans, there are some strategies for doing that here as well.

  1. Look for Other Drugs. If you missed AEP and you can¹t change your coverage, try to optimize the drugs you¹re taking to fit your current plan. Among the ten largest drug plans in the country, no single plan covers more than 79 percent of all available prescription drugs in 2012. The Medicare Modernization Act (MMA) requires every Medicare plan with prescription drug coverage to include at least two drugs in each category and class. Talk to your doctor to find what other drugs exist to treat your illness and discuss the possibility of switching.
  2. Ask about Medicare Supplement (MediGap) open enrollment periods. If your MediGap plan isn¹t working for you any longer, and you can¹t enroll in a Medicare Advantage plan outside of AEP, you may be able to change your MediGap plan during select MediGap open enrollment periods. Some states and insurance companies have created open enrollment periods for MediGap plans as well. Investigate the MediGap open enrollment rules in your state by contacting a licensed agent.
  3. Ask an expert about Special Needs Plans (SNPs). Special Needs Plans (SNPs) are available for people who are low-income, disabled and under the age of 65. There are also fifteen types of SNPs designed specifically for folks with chronic health problems. And, if you qualify for a SNP you can enroll at any time, provided one is available in your area.
  4. Investigate 5 Star Medicare Advantage plans. New this year, you don¹t have to wait for AEP to enroll in a 5-Star Medicare Advantage plan. The 2010 Health Care Reform law created a new ratings system for Medicare Advantage plans that begins this year. Plans with the highest rating of 5 stars can enroll people at any time, even after AEP is over. To find one near, use a Medicare plan search engine, like PlanPrescriber.com or Medicare.gov.
  5. Investigate Medicare Annual Disenrollment Period (MADP) which started January 1. Medicare¹s ADP lets you disenroll (cancel) from a Medicare Advantage plan if it fails to meet your needs and add drug coverage at the same time. ADP ends on February 14, 2012 so don’t miss this deadline. Before you disenroll, do some homework to be sure you¹ll still have the coverage you need in 2012.
  6. Investigate Medicare Special Enrollment Periods (SEPs). Medicare also provides SEPs for people who need to change their coverage outside of AEP. A person may qualify for an SEP if they move permanently outside of their plan¹s service area; become eligible for a low-income subsidy due to a loss of income; receive incomplete information about what qualifies as creditable prescription drug coverage or lose that coverage through no action of their own; if they become eligible for Medicare and Medicaid (“dual eligible”) but lose their dual eligibility status; if they live in, are moving into, or are moving out of certain types of skilled nursing facilities; if they receive a retroactive Medicare entitlement determination; or if they qualify for other special enrollment periods that may be authorized by the Federal Government.

If you missed the Annual Enrollment Period, don¹t feel trapped in a plan that doesn¹t meet your needs. Baby boomers know the key is to be proactive, reach out to experts who can help figure out what those opportunities are, and how to take advantage of them.

One of the best resources for staying on top of healthcare news is the Henry J. Kaiser Family Foundation’s Kaiser Health News (KHN). Please feel free to share our resources with your own loved ones to help them age gracefully and safely in place. You can comment here, or connect and converse with us on Facebook.

 

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