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A "do-over" chance for Medicare open enrollment

Tips for driving down medical bills
Tips for driving down medical bills 06:38

You probably thought you were finished thinking about Medicare when the 2018 open enrollment period ended on Dec. 7. Not so fast: Medicare has another limited open enrollment that runs from Jan. 1 through March 31, 2019, for Medicare Advantage plans. Here's a brief review to help you understand your options.

You face a fundamental decision regarding how you receive medical treatment under Medicare:

  • Original Medicare usually gives you the most flexibility to choose your health care providers, but it's also the most complicated way to receive benefits. It's recommended that you supplement original Medicare with a Medicare Supplement Plan to help cover Medicare's substantial deductibles and copayments and that you buy a Part D prescription drug plan to pay for prescription drugs.
  • A Medicare Advantage (MA) plan offers one-stop shopping, typically combining all parts of Medicare and prescription drug coverage. However, MA Plans usually limit you to seeing only the health care providers in the plan's network.

You do have the opportunity to change your mind if you elected an MA plan during the 2018 open enrollment period or if you simply allowed your 2018 MA plan to remain effective for 2019. During the 2019 Medicare Advantage open enrollment period, you can:

  • Change from one MA plan to another
  • Opt out of your MA plan and switch to original Medicare
  • Elect a stand-alone Part D prescription drug plan if you lose prescription drug coverage due to opting out of your MA plan

Your election becomes effective the month after you make the switch.

Why would you want to move from one MA plan to another or to original Medicare? Here are a few possible reasons:

  • Many MA plans change their benefits and coverage from year to year, and you may not have noticed until you tried to make a claim in 2019. Often, changes are made to the prescription drug formulary, which can have a significant impact on your out-of-pocket costs.
  • You might have incurred a serious medical condition and want more flexibility in choosing your providers under original Medicare.
  • You might discover an MA plan that better meets your needs. For example, some offer limited vision or dental benefits that aren't covered by original Medicare.

"If you're new to an MA plan this year, try it out before March 31," recommended Diane Omdahl, president of Sixty-Five Incorporated, an independent Medicare consultancy. That way, you can test whether you like it and still have time to change if you don't.

Note that if you opt out of your MA plan and switch to original Medicare, you may have a challenge purchasing a Medicare Supplement plan. Most states allow insurance companies to require that you satisfy medical underwriting requirements to obtain coverage (insurance companies are prohibited from applying medical underwriting only when you're first eligible to enroll in Medicare at age 65). So if you have a preexisting condition, you may not be able to elect a Medicare Supplement Plan.

Here are a few things you can't do during 2019 Medicare Advantage open enrollment:

  • Switch from original Medicare to an MA Plan
  • Switch from one prescription drug plan to another, if you're in original Medicare
  • Join a prescription drug plan if you're in original Medicare and previously declined to enroll in such a plan.

There's a lot to keep track of with Medicare and all its various parts and features. If you're confused, which is understandable, it's a good idea to find a professional who can help you. It's part of your "retirement job" to spend time learning about your options. Smart choices can save you thousands of dollars and help keep you healthy.

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