Medicare Advantage plans are annual plans. When you enroll in an Advantage plan you should be aware that things can change the following year, including having your plan not renew. 2010 is going to prove to be a unique year because there will be a larger number of plan disruptions than previous years.
These plan disruptions will be primary caused by one of two circumstances.
■Medicare Improvement Act for Patients and Providers (MIPPA) legislation made changes to the Private Fee-For-Service product (PFFS) which resulted in many carries deciding to exit several plan service areas.
■Carriers deciding to exit plan service areas and terminate plans based on bottom line considerations.
MIIPA legislation is mandating that beginning in 2011, PFFS plans will be required to allow members access to a provider network if there are at least two provider networks in that service area. Many carries offer only PFFS plans in many service areas across the US and developing a network, especially in more rural areas, is cost prohibitive.
Your Special Enrollment Period (SEP)
If your Medicare Advantage plan is not renewing for 2011, CMS requires carriers to notify you by mail no later than October 2. You may receive a notification as early as September 10.
The SEP for the members who are impacted by plans not renewing will be from October 1 2010 through January 31 2011. During this time you have some options.
■Your current carrier may have another plan that you find suitable.
■You can enroll in an Advantage plan offered by another carrier.
■You can return to original Medicare and purchase a stand-alone Part D drug plan.
■You can enroll in a Medigap policy on a guaranteed issue basis and purchase a stand-alone Part D drug plan.
If your Advantage plan is not renewing for 2011, you are afforded some protections for the remainder of the year. Your carrier is required to honor their contract and provide coverage through December 31 2010.
■You will still be able to use your plan during this time.
■Claims for services will continue to be paid.
■Customer service will still assist you with any problems or concerns.
If you receive a notice that your Medicare Advantage plan is not renewing for 2011, there is no need to panic. Now is the time to start shopping for another Advantage plan or start to explore Medicare supplement options. Just because you have had an Advantage plan, there’s no reason not to look at a Medicare supplement. Medicare Supplement Plan N is a good alternative to an Advantage plan.
It is easiest to compare 2011 Medicare advantage plans online or visit the Medicare site and take the time to navigate to plans available in your area. Which ever way you decide to go, don’t let your Medicare Advantage plan non-renewal discourage you. After all it was an annual plan when you enrolled. Contact us at 1-800-247-9889 and we can discuss your options with you.