Open Enrollment Period Offered for Medicare Advantage Plans

Iowans had until December 31 to enroll in, or change Medicare prescription drug coverage. Now they have another opportunity to make a decision about their Medicare benefits. "Every year from January 1 to March 31 people on Medicare can decide if they want to enroll in, change or disenroll from a Medicare Advantage plan," says Kris Gross from the Senior Health Insurance Information Program (SHIIP). She adds, "We have 59 Medicare Advantage options offered in the state and Iowans will be seeing and hearing a lot of advertising for these products. It's important they understand what changes they can make during this three month period."

Medicare Advantage plans are another way to get your Medicare benefits. When you enroll in one of these plans you are choosing to get all of your Medicare benefits through this plan, rather than through the traditional Medicare program. The plans must cover all the same medical and hospital services you get under Medicare Part A and Part B, and may provide Medicare drug coverage and other benefits such as eye exams and routine physicals. The types of plans offered in Iowa are health maintenance organizations (HMO), preferred provider organizations (PPO), point of service organizations (POS), private fee-for-service plans (PFFS), medical savings accounts (MSA), cost contracts and special needs plans.
From January through March individuals can enroll in a plan, change to a different Medicare Advantage plan or disenroll and return to original Medicare. You can't add or drop Medicare prescription drug coverage during this time. Basically, you have to go from like to like. You can only join or change to another Medicare Advantage plan with drug coverage if you now have drug coverage OR change to Original Medicare and enroll in a Medicare prescription drug plan. If you don't have Medicare drug coverage or have a Medicare Advantage plan without drug coverage you can only join a plan that doesn't include drug coverage OR return to Original Medicare without drug coverage.

After March 31 there are limited situations when you can disenroll from a Medicare Advantage plan and return to original Medicare. Individuals who enrolled in a Medicare Advantage plan for the first time and dropped their Medicare supplement when they enrolled, can disenroll anytime in the first 12 months of coverage. Someone new to Medicare can enroll in a Medicare Advantage plan when they go on Medicare and can also disenroll anytime in the first 12 months of coverage. The other situations involve individuals who have Medicare Advantage plans with Part D drug coverage and are allowed to change drug plans monthly. This involves those in nursing homes, on Medicaid and those who are in programs which help pay the Medicare Part B premium (QMB, SLMB and QI).

For more information about the Medicare Advantage plans available in Iowa call SHIIP at 1-800-351-4664 (TTY 1-800-735-2942). Local SHIIP counselors are also available to explain the plans. Call the SHIIP 800# for the site nearest you. SHIIP services are free, confidential and objective.