Medicare Part C Medicare Advantage

Help, I Missed the Medicare Deadline!

October 15 through December 7 (Annual Enrollment Period) is when individuals enrolled in Medicare may change their Medicare Advantage or Part D Prescription drug plan selection. This is a good time to share some of the questions I have been receiving in case you, a neighbor or family member missed that deadline:

Q: I missed the deadline to make a change. Is there another way for me to choose a new plan for next year?
A: Maybe. Separate from the Annual Enrollment Period, some Medicare participants are eligible for what’s called a Special Election Period during which you can make a change to your Medicare Advantage or Part D Prescription drug plan.

Q: Am I eligible for this Special Election Period?
A: Possibly. If you have recently changed your address or are eligible for New York State EPIC or Social Security Extra Help you may be eligible for a plan change during the Special Election Period.

1) In New York State, the EPIC program is what Medicare refers to as a State Pharmaceutical Assistance program (SPAP) EPIC members have one Special Election Period per calendar year.
2) Medicare participants enrolled in the Part D Extra Help program have the Special Election Period benefit, too.

Q: Sounds great, Dan. But why would I want to take advantage of this Special Election Period?
A: There doesn’t have to be a specific reason. Still, the most common situations I see are:

  1. If your preferred provider or hospital does not participate in the Medicare Advantage plan you enrolled in, using the Special Election Period to change your plan could mean being able to use your preferred provider and usually see lower copays.
  2. If your health changes requiring more frequent specialist visits, using the Special Election Period to change your plan could mean being able to reduce or eliminate hospitalization and / or specialist copays.
Use Medicare Special Election Period to Change Medicare Advantage Plan <<< Click on Monopoly Man(TM) and listen to my short interview with Bob Foxworth. Bob used his Special Election Period to change plans after his HMO refused approval to see a cancer specialist of his choice.

Q: I’m not sure of my eligibility status, Dan, can you help me with my questions?
A: Yes, just call me at (518) 346-2115 or send me a note and we’ll discuss your options.

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