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the resource BLOG

Your clients can make a change to their Medicare Advantage plan January - March.

12/8/2021

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The Medicare Advantage Enrollment Period runs from January 1st - March 31st. ​​

If your client is unhappy with their current Medicare Advantage plan, they can make a switch to another Medicare Advantage Plan (with or without drug coverage). They can also dis-enroll from their Medicare Advantage Plan and return to original Medicare. If they choose to do so, they'll be able to join a Medicare Prescription Drug Plan as well (Part D).

​If they enrolled in a Medicare Advantage Plan during their Initial Enrollment Period, they can change to another Medicare Advantage Plan (with or without drug coverage) or go back to Original Medicare (with or without drug coverage) within the first three months they have Medicare.
Medicare client
If your client switches to a different Medicare Advantage Plan or goes back to original Medicare with or without a drug plan, their new coverage will start the first day of the month after their new plan gets the request for coverage. An important detail to remember though, if your client decides to go back to original Medicare, they may not be able to buy a Medicare Supplement policy.

​The best time for your client to get a Medicare Supplement policy is during their six month Medigap Open Enrollment Period. During that time they can purchase any Medicare Supplement policy sold in their state, even if they have health problems. This period starts the first month they have enrolled in Medicare Part B and they're age 65 or older.

There are many details to consider, before jumping off their current coverage. However, there are options if their current plan is not a good fit.
By Carolyn Portanova
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What can your clients do during the Medicare Annual Enrollment Period?

10/16/2019

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Every year between October 15th and December 7th Medicare beneficiaries have the opportunity to make changes to their existing policies and change their benefits with regard to Medicare Supplement plans, Medicare Advantage plans and Prescription Drug plans. It can be an overwhelming time for seniors as they sift through all the literature that has been mailed to them, and all the plans they've been researching online.

​Your clients should have received their 'Annual Notice of Change' from their insurance company. This notice will list any changes in their policy, such as possible increase in costs or coverage. The notice should compare the benefits they currently have and what they will be in 2020. Their prescription drug plans should also be reviewed at this time of year to ensure that their medications will still be covered.

​As their insurance agent, you can assist them with making the best decision regarding their policies for the next year or even longer. We've laid out everything your clients can do during this enrollment period below.
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So what exactly can your clients do? ​

  1. They can change from original Medicare to a Medicare Advantage plan, or vice versa. (If they switch to original Medicare they'll likely need a Medicare Supplement plan, and unless they happen to be in their Initial Enrollment period, they'll have to answer health questions. Learn more about the Initial Enrollment period and Guaranteed Issue rights.)
  2. They can switch from one Medicare Advantage plan to another Medicare Advantage plan.
  3. They can switch from a Medicare Advantage plan that doesn't have drug coverage to one that does offer drug coverage, or vice versa.
  4. They can join a Medicare Prescription Drug Plan (PDP).
  5. They can switch from one Prescription Drug Plan (PDP) to another PDP.
  6. They can drop Medicare Prescription Drug coverage completely.
Source: CMS.gov
​There are so many options for your clients, and it can be a daunting process to assist them with their choices, but utilizing our tools and resources will help make the process smoother. Some of these tools include using our rate and underwriting tool which will allow you to cost compare Medicare Supplement and Medicare Advantage plans for them. If you don't have access to our Resource for Rates tool, you can request access and receive a 30 day trial. Our contracted agents always have full access to this tool. It's also available as an app in the App Store and on Google Play. Use your login credentials for the desktop version to access quotes on the go.

Reviewing our new Medicare & Part D Plan Finder guide will help you if you're not AHIP certified and selling prescription drug plans to your clients. It's a step-by-step guide to the newly launched site on Medicare.gov. The new plan finder has a much simpler, and user-friendly interface; however, it does encourage Medicare beneficiaries to create a My Medicare account and to login with their credentials so they can save their prescriptions. It is not necessary to have them create an account if they do not wish to; you'll still be able to assist them with their drug choices.

In some cases, your clients may already have the best plans, and they won't need to do a thing. However, this is your opportunity to review their policies and determine if they'd be better off with another plan. It also provides the opportunity to open up the discussion about other types of insurance they may need.
By Carolyn Portanova
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Questions About Open Enrollment vs. Guaranteed Issue Rights?

9/20/2017

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Medicare Open Enrollment vs Guaranteed Issue Rights
Medicare Supplements (Medigap policies) have two different types of enrollment periods that don’t require you to answer health (medical) questions.  These different periods of time are called a few different names which can be obscure.  Here is a break down to better understand the different terms and their specific rules.

Medicare Supplement (Medigap) Open Enrollment
This period is considered your “initial enrollment period”.  Thus the reason it is called your “initial enrollment period” is that many confuse the Medigap Open Enrollment period with the Medicare Open Enrollment period.  Medicare Open Enrollment permits someone to change their Medicare Drug or Medicare Advantage plan each year, whereas Medigap’s Open Enrollment normally only allows you ONE guaranteed enrollment period, regardless of preexisting conditions.This period lasts six months and begins the first day of the month in which you are 65 or older and enrolled in Medicare Part B. So if you turn 65 on April 3 but don’t join Medicare B until May 25, your Medigap Open Enrollment Period will start on June 1, which is the first day of the month in which you are both 65 and enrolled in Part B.  (Some States such as CA, have a 30 day Medigap Birthday rule that allows you to switch Medigap plans to an equal or lesser value than your current Medigap plan during your birth month-without answering health questions).

Medigap Guaranteed Issue Rights
The chart below describes the situations, under federal law, that give you a right to buy a policy, the kind of policy you can buy, and when you can or must apply for it.  States may provide additional Medigap guaranteed issue rights.
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You have a guaranteed issue right if…
You have the right to buy…
You can/must apply for a Medigap policy…
​You’re in a Medicare Advantage Plan (like an HMO or PPO), and your plan is leaving Medicare or stops giving care in your area, or
you move out of the plan’s service area.
Medigap Plan A, B, C, F, K, or L that’s sold in your state by any insurance company.
You only have this right if you
switch to Original Medicare
rather than join another
Medicare Advantage Plan.
​As early as 60 calendar days before the date your health care coverage will end, but no later than 63 calendar days after your health care coverage ends. Medigap coverage can’t start until your Medicare Advantage Plan coverage ends.
You have Original Medicare and an employer group health plan (including retiree or COBRA coverage) or union coverage that pays after Medicare pays and that plan is ending.
 
Note: In this situation, you may have additional rights under state law.
Medigap Plan A, B, C, F, K, or L that’s sold in your state by any insurance company.
If you have COBRA coverage,
you can either buy a Medigap
policy right away or wait until
the COBRA coverage ends.
No later than 63 calendar days after the latest of these three dates:
1. Date the coverage ends
2. Date on the notice you get telling you that coverage is ending (if you get one)
3. Date on a claim denial, if this is the only way you know that your coverage ended.
You have Original Medicare and a Medicare SELECT policy. You move out of the Medicare SELECT policy’s service area. Call the Medicare SELECT insurer for more information about your options.
Medigap Plan A, B, C, F, K, or L that’s sold by any insurance company in your state or the state you’re moving to.
​As early as 60 calendar days before the date your Medicare SELECT coverage will end, but no later than 63 calendar days after your Medicare SELECT coverage ends.
(Trial right) You joined a Medicare Advantage Plan (like an HMO or PPO) or Programs of All-inclusive
Care for the Elderly (PACE) when you were first eligible for Medicare Part A at 65, and within
the first year of joining, you decide you want to switch to Original
Medicare.
Any Medigap policy that’s sold
in your state by any insurance
company.
As early as 60 calendar days before the date your coverage will end, but no later than 63 calendar days after your coverage ends.
 
Note: Your rights may last
for an extra 12 months
under certain circumstances.
(Trial right) You dropped a
Medigap policy to join a Medicare Advantage Plan (or to switch to a Medicare SELECT policy) for the first time, you’ve been in the plan
less than a year, and you want to switch back.
The Medigap policy you had before you joined the Medicare Advantage Plan or Medicare SELECT policy, if the same insurance company you had before still sells it.
If your former Medigap policy isn’t available, you can buy Medigap Plan A, B, C, F, K, or L that’s sold in your state by any insurance company.
As early as 60 calendar days before the date your coverage will end, but no later than 63 calendar days after your coverage ends.
 
Note: Your rights may last
for an extra 12 months
under certain circumstances.
Your Medigap insurance company goes bankrupt and you lose your coverage, or your Medigap policy coverage otherwise ends through
no fault of your own.
Medigap Plan A, B, C, F, K, or L that’s sold in your state by any insurance company. Medigap.
No later than 63 calendar days from the date your coverage ends.
You leave a Medicare Advantage Plan or drop a Medigap policy because the company hasn’t followed the rules, or it misled you.
Medigap Plan A, B, C, F, K, or L that’s sold in your state by any insurance company.
​No later than 63 calendar days from the date your coverage ends.
Source: 2017 Choosing A Medigap Policy
By Cassandra Bennett
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    Author

    Carolyn Portanova is the Director of Marketing at The Brokerage Resource and has been with the firm since 2012. 

    She oversees all marketing and communications for the organization and works closely with the firm's independent agents and advisors to help them promote their own brands.

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