By Sheila Curtis
Are you happy with the health insurance you have?
Well, now is the time to evaluate your coverage. The new drug program went into effect January 1, but there were many other changes to Medicare as well.
Insurance companies who offer non-group Medigaps (Medicare supplements) no longer can offer plans with drug coverage. But if you have a Medigap with drug coverage now, you are grandfathered and therefore may keep it.
AARP’s United HealthCare and Blue Cross/Blue Shield presently are the only companies selling non-group Medigaps in Massachusetts with two plans available, Supplement Core and Supplement 1 (Medex Bronze). Massachusetts law mandates that all policies are standardized, so Medicare beneficiaries can make their choices based on price alone.
AARP provides continuous open enrollment for its Medigap plans, but you only can purchase a BCBS policy during a limited window from February 1 to March 31 each year.
Blue Cross can be reached at 1-800-678-2265; United HealthCare at 1-800-523-5800.
There also are changes to the Medicare Advantage plans (HMOs, PPOs). Previously you were allowed to enroll or disenroll from your Medicare HMO at any time. But now you can make only one change from January 1 to May 15. From May 15 to June 30, only lateral changes are allowed, which means you can only switch to the same kind of policy. For instance, you cannot change from a policy that does not include a drug benefit to one that does offer this coverage. There is also something called an “annual coordination” period November 15 to December 31 when you’re allowed to change plans.
Tufts and Blue Cross now are offering PPOs (Preferred Provider Organization plans), which allow you to go outside their network of doctors, but at higher cost-sharing.
For information on HMOs and PPOs available on the Cape, call Tufts at 1-800-246-2400 or BCBS at 1-800-678-2265.
As you know, the new Medicare Drug Program went into effect January 1. If you joined a plan last year and don’t feel it meets your needs, you may make one change until May 15.
Those people on both Medicare and MassHealth can change plans smoothly.
If you have not joined a Medicare Drug plan yet, you have until May 15 to do so, after which you may have to pay a penalty.
Prescription Advantage, the state’s drug assistance program, also is holding an open enrollment from March 15 to April 28. For those eligible, Prescription Advantage will act as a second support to assist with some Medicare Part D drug costs.
If you would like more information on your options, you may call me at 1-800-334-9999 or contact you local senior center to make an appointment with a SHINE counselor.
(Ms. Curtis is regional director for SHINE, a state agency Serving the Health Information Needs of Elders.)