This year’s Medicare Annual Enrollment Period (October 15 through December 7) was a busy time and we are grateful for the scores of individuals and couples who permitted our team of agent advisors to help with their 2021 Part C Medicare Advantage or Part D Prescription drug plan selection. (The December 7 deadline did not apply to a Medicare Supplement plan selection.)
Q: But I missed that deadline. Is there another option for me to choose a new plan for 2021?
A: Possibly. Some Medicare participants are eligible for what is called a Special Enrollment Period during which you can make a change to your Part D prescription drug or Medicare Advantage Plan. This is separate from the October 15 – December 7 Annual Enrollment Period.
Q: Am I eligible for a Special Enrollment Period?
A: Let’s look at three Special Circumstances that may apply to you. If one does, you can make changes to your Medicare Advantage and Medicare prescription drug coverage outside of the normal Annual Enrollment Period:
- Are you a veteran? Many veterans may not be aware of a valid Special Election Period available by having their prescriptions filled through the Veterans Administration (VA.) Vets can use that Special Enrollment Period to enroll in a “MA only” plan – a Medicare Advantage plan with no drug benefits. Click here for more information on MA Only plans.
- In New York State the State Pharmaceutical Assistance Program (*) known as EPIC can help with a portion of your drug plan’s premium and reduce prescription co-payments. EPIC members also have one Special Enrollment Period per calendar year to enroll in a new Medicare Advantage or Part D prescription drug plan. [Download the 2020 EPIC application here.]
- Social Security Extra Help – Eligibility for this program is based on your income and assets. Extra Help subsidizes part or all of your drug plan’s premium and deductible and reduce prescription co-payments. With Extra Help, you may be able to make changes to your coverage one time during each of these periods:
- January – March
- April – June
- July – September
Q: Do any of these Special Circumstances apply to Medicare Supplement plans?
A: No. However three states (New York, Massachusetts and Connecticut) do require Medicare Supplement plan insurers to offer policies to Medicare beneficiaries age 65 and older through continuous open enrollment, with guaranteed issue rights throughout the year.
That means if you want to drop a Medicare Advantage plan (which includes prescription drug coverage) and return to Original Medicare with a Medicare Supplement plan; you need a Special Enrollment Period to add the third piece, your Part D prescription drug coverage.
Q: I’m not sure of my eligibility status, can you help me with my questions?
A: Yes. Simply use the form below and send a note to an agent advisor or call (518) 346-2115. We’ll discuss your options by telephone, web conference or an in person visit. And, during your Special Enrollment Period, we may be able to identify a Medicare Advantage, Medigap or Prescription Drug Plan more suited to your needs – even though the December 7 deadline has passed.
(*) In Massachusetts, the SPAP is Prescription Advantage.
(*) In New Jersey, the SPAP is PAAD and Senior Gold