During this period, a Medicare beneficiary can make any of the following changes, which will be effective on January 1, 2021:
- Join a Part D plan (if not already enrolled)
- Drop a Part D plan
- Switch to a new Part D plan
- Drop a Medicare Advantage plan and return to Original Medicare
- Join or switch a Medicare Advantage plan with or without drug coverage.
Even if you are satisfied with your 2020 Medicare Advantage Plan, you should still reevaluate the plan if it will best meet your needs for 2021. Most Medicare Advantage plans can change the terms of coverage each year, which means new plans might become available and some plans might stop offering coverage. Even if a plan continues to offer coverage into the following year, its monthly premium, formulary, network providers, deductible, and copay amounts could change so it is important that you consult with a Medicare insurance agent.
Medicare Advantage Plans (Part C)
Medicare Advantage Plans cover more at a lower cost than original Medicare with Medicare Supplement Plans in many cases. Instead of paying for Medicare Part A, B, and D coverage, Medicare Advantage Plans cover all of these and may even include other services. The beneficiary usually pays a Medicare Advantage plan premium as well as their Part B premium. In Southern California, many Medicare Advantage plans offer $0 premiums with extra ancillary benefits.
These plans work much like private health insurance plans, where most services have a small co-pay. HMO and PPO network plans are also available, depending on your location. Whatever you choose, Medicare Advantage plans can have very different rules and coverage options. Most offer some degree of prescription coverage. Some may require a referral to see a specialist and may or may not cover out-of-network care.
Drug Plans (Part D)
Medicare Part D is prescription drug coverage. You can get Medicare Part D coverage through a stand-alone Medicare prescription drug plan or a Medicare Advantage prescription drug plan. Both are available from Medicare-approved private insurance companies. Medicare Part D coverage is optional, but if you don’t enroll in Medicare Part D as soon as you’re eligible, you might pay a late-enrollment penalty if you enroll later. Your monthly plan premium and out-of-pocket expenses for prescription drugs will vary from plan to plan.
Like Medicare Advantage plans, experts caution about choosing a plan based solely on the price. You need to make sure to check whether your prescription drugs are covered and at what cost. If you have any questions about your Medicare Advantage plan or drug plan, Skyline Benefit’s Medicare team is here for you. You can call us at (714) 888-5116 or click here to make an appointment today.