Dear Toni:
I’ve been told that I have to wait until Medicare’s Open Enrollment time to change my Medicare Advantage plan. I have just received a letter from my doctor saying they are no longer in the network for the Medicare Advantage plan I have and that I need to change to another plan if I want to continue using him.
I don’t know what to do. I’ve been on this plan for years. Now I have to change and make sure all of my prescriptions are covered. Please advise. James…Memorial area
Hello James:
I know how troubling it is when you find out that your doctor is not accepting your Medicare Advantage Plan.
You will have some decisions to make.
- Do you want to keep your doctor?
- Do you want to keep your Medicare Advantage Plan or change to a plan your doctor accepts?
Which of the two questions is most important to you? That is a decision you have to make for yourself.
Medicare Advantage Plans may change their physician networks as well as their prescription drug formulary each year. James you are lucky your doctor informed you before Medicare’s Open Enrollment, so that you can make a change.
Medicare’s Open Enrollment involves only enrolling in a Part C Medicare Advantage plan and/or a stand alone Part D Medicare Prescription Drug plan. Open Enrollment does not involve changing or enrolling in a Medicare Supplement.* Open enrollment time period is only for Medicare Part C and Part D.
This year Medicare’s Open Enrollment starts on Wednesday, October 15, and it will end at midnight on Sunday, December 7th (Pearl Harbor Day). Making enrollment earlier helps the insurance companies and Medicare approve your application earlier and get your new insurance cards to you by January 1st. All plans will have January 1st as their start date.
Below are the changes that a Medicare beneficiary can make during OEP (open enrollment period):
- Enroll in a new Part D Medicare Prescription Drug Plan.
- Change from one Part D Medicare Prescription Drug Plan to a new Part D Medicare Prescription Drug Plan.
- Enroll in a Part C Medicare Advantage Plan with Prescription Drugs
- Change from one Part C Medicare Advantage Plan to a new Part C
Medicare Advantage Plan.
- Return to Original Medicare and purchase a Medicare Supplement and enroll in a Part D Medicare Prescription Drug Plan.
- Return to Original Medicare only and enroll in a Part D Medicare Prescription Drug Plan
- Or Return to Original Medicare with no Part D plan. Don’t forget there is a penalty for not enrolling in a Part D Medicare Prescription Drug plan when first eligible. .
To see what Medicare Advantage plans are in your zip code, visit Medicare’s website at www.medicare.gov and click on health & drug plans. There you can check factors like deductibles, co pays, co insurance and also premiums. You can compare up to three (3) Medicare Advantage or Part D Prescription drug plans at a time.
**Toni Says: Always call your doctor or health care professional and be sure he/she is still accepting whatever Medicare Advantage plan you are currently on or thinking of enrolling in.
Confused about Medicare Workshops in your area:
- Thursday, October 16th– Understand the Rules of Medicare for HR Departments: 5:00PM-8:00PM located at the BBVA Compass Tower,2200 Post Oak Blvd,18th Floor Room 18S, Houston, TX 77056. RSVP as Space is limited
- Tuesday, October 21, Sugar Creek Baptist Church-Chapel-6:30-8:30- 13213 Southwest Frwy.
RSVP: Both events by calling 832/800-4674
Toni King, author of the new Medicare Survival Guide®, which is a simple guide explaining Medicare is on sale at www.tonisays.com. Email questions to www.tonisays.com/ask-toni.
