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Do I Need to Renew My Medicare Plan?


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In most cases you don’t have to renew your Medicare coverage, but it’s always a good idea to review your coverage every year to make sure it still fits your needs. This is true whether you are in Original Medicare, a Medicare Advantage plan, or a Medicare Prescription Drug Plan. You may want to review your coverage annually with a licensed insurance agent.

Are you enrolled in Original Medicare, Part A and Part B?

This is the government-sponsored health program that you automatically get when you turn 65 if you’re already receiving Social Security (SSA) or Railroad Retirement Board (RRB) benefits. You’re also automatically enrolled if you’ve been receiving SSA or RRB disability benefits for 24 months in a row or if you qualify because of a health condition like End Stage Renal Disease (permanent kidney failure requiring a kidney transplant or continuous dialysis treatments) or amyotrophic lateral sclerosis (also known as Lou Gehrig’s disease).

You may qualify for Medicare if you have end-stage renal disease (permanent kidney failure requiring a kidney transplant or continuous dialysis treatments), but you need to enroll manually if you’re under 65.

If you’re enrolled in Original Medicare, you don’t need to renew your coverage, but you need to pay your Medicare Part B premium every month, along with your Part A premium if applicable. (Most people don’t pay a Part A premium – Part A is premium-free if you’ve worked at least 10 years while paying Medicare taxes.) Many beneficiaries’ premiums are automatically deducted from their Social Security retirement benefits. Note that some beneficiaries decide not to enroll in Medicare Part B, in which case you wouldn’t have to pay the premium.

Not sure whether you’re enrolled in Original Medicare? Medicare sends you a red, white, and blue card when you’re enrolled, and the card tells you what type of Medicare coverage you have. You can call Medicare to review your coverage (contact information is at the end of this article).

Are you enrolled in a Medicare Advantage plan or a Medicare Part D Prescription Drug Plan?

These Medicare plan options are available from private insurance companies that contract with Medicare to provide your benefits. If you have either type of plan, you should have a member card that shows the plan’s name and contact information, and in most cases you’d be paying a monthly premium (and in most cases your Medicare Part B premium). If you’re not sure, you can call your Medicare plan or contact Medicare to review your coverage (contact information is at the end of this article).

Your Medicare plan sends you an Annual Notice of Change every fall. Read this notice carefully, because it tells you about any coverage changes, such as costs, that your plan may be putting into effect (typically as of January 1 the following year). If you have a Medicare Prescription Drug Plan, the Annual Notice of Change includes any changes to the plan’s drug formulary, or list of covered prescription drugs. A plan’s formulary may change at any time. You will receive notice from your plan when necessary.

When you review your Annual Notice of Change, you may want to take a close look at your personal health situation and your Medicare coverage, considering questions like:

  • Does your Medicare plan include benefits you use or need?
  • Medicare Advantage plans include your Medicare Part A and Part B benefits (except hospice care, which is still covered under Medicare Part A), but they often include extra benefits as well, such as routine dental or vision services. Many Medicare Advantage plans also cover prescription drug coverage.
  • You might want to compare Medicare Advantage plans available where you live to see whether any other plan within your service area meets your needs more closely, or has lower costs.
  • Did you know that Original Medicare covers prescription drugs only in certain situations?
  • Medicare Part A and Part B don’t generally cover most of the medications you take at home. So, if your doctor prescribes medications for you, you might want to consider enrolling in a Medicare Part D Prescription Drug Plan. Alternatively, you may want to look into Medicare Part C (Medicare Advantage); you may be able to get your prescription coverage through a Medicare Advantage Prescription Drug plan (MA-PD).
  • Does your Medicare plan cover your prescriptions?
  • Remember that every Medicare plan that includes prescription drug coverage has a formulary listing the drugs it covers and what your costs are (such as copayments). A plan’s formulary may change at any time. You will receive notice from your plan when necessary.
  • Do you have frequent medical services or visits to the doctor?
  • If you do, you might want to consider enrolling in a Medicare Supplement (Medigap) plan. Doctor visits and medical services usually require copayments or coinsurance, not to mention deductibles; this is usually true whether you’re enrolled in Original Medicare or a Medicare Advantage plan.
  • Medigap plans are designed to help pay your Medicare Part A and Part B out-of-pocket costs (such as copayments and deductibles). Different Medigap plans cover different portions of these costs. You generally can’t enroll in both a Medicare Advantage plan and a Medicare Supplement plan. Read more about Medigap plans.

Suppose you do want to make some changes to your Medicare plans.

You can’t generally make changes anytime you’d like; you need to be aware of the enrollment and election periods for the various types of Medicare plans.

Two of the most popular and useful periods when you can make coverage changes are your Initial Enrollment Period (IEP) and the Annual Election Period, also known as Fall Open Enrollment for Medicare.

  • Your Initial Enrollment Period (IEP) takes place when you’re first eligible for Medicare, typically a seven-month period that starts three months before you turn 65 or the 25th month of disability benefits. During that time, you can decide what type of Medicare plan to enroll in.
  • The Annual Election Period (October 15 through December 7) lets you:
    • Sign up for a Medicare Advantage plan.
    • Change from one Medicare Advantage plan to another.
    • Leave a Medicare Advantage plan and return to Original Medicare.
    • Sign up for a stand-alone Medicare Part D Prescription Drug Plan.
    • Change from one Medicare Prescription Drug Plan to another.
    • Drop your Medicare Prescription Drug Plan.

In some situations, often involving a change in or loss of coverage, you may qualify for a Special Election Period for enrolling in Medicare Advantage plans or Medicare Prescription Drug Plans.

If you want to drop your Medicare Advantage plan and return to Original Medicare, you can do so during the Medicare Advantage Disenrollment Period (January 1 through February 14 each year). You can also add a stand-alone Medicare Prescription Drug Plan during this time.

You can easily compare the Medicare plan options available in your area by entering your zip code where shown on this page.

This website and its contents are for informational purposes only. Nothing on the website should ever be used as a substitute for professional medical advice. You should always consult with your medical provider regarding diagnosis or treatment for a health condition, including decisions about the correct medication for your condition, as well as prior to undertaking any specific exercise or dietary routine.

 

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