Welcome to autumn! This season is when Medicare Beneficiaries are going to receive valuable and pertinent information in the mail about their benefits and upcoming changes in preparation for the Part D Open Enrollment period. The Open Enrollment Period is an important opportunity that is provided to Medicare beneficiaries annually to evaluate their prescription drug coverage and to make changes if they desire. It occurs from October 15 to December 7 annually.
Medicare and You Handbook. Each Medicare beneficiary can expect to receive an updated copy of the Medicare and You handbook. This handbook is an overview of the benefits that you have through Medicare. It also includes a list of the upcoming year’s prescription drug plans for you to review. If you do not receive a Medicare and You handbook, you can order one by calling 1-800-MEDICARE or online at http://www.medicare.gov.
ANOCs and EOVs. If you are receiving prescription drug coverage through Medicare, you should receive from your plan publications called the Annual Notice of Change (ANOC) and Evidence of Coverage (EOV). These should arrive by September 30. The ANOC publication informs you of the changes that this plan will be making for the next year beginning January 1. The EOV is a much more comprehensive version of the ANOC. Changes can include cost modifications such as: the premium; the amount you pay to belong to the plan, the deductible; the amount you pay out-of-pocket before the plan begins to pay, and co-payments or co-insurance; the share you pay at the pharmacy after the plan has paid their portion. You will also be warned of Formulary Changes. The Formulary is the list of medications that the plan covers. The EOV provides a formulary so that you can verify that your medications will continue to be covered. Medications covered this year may not be covered next year. The Open Enrollment period (October 15 to December 7) is the perfect time to change plans if you are not satisfied with the changes being made by your plan. If you do not receive the ANOC/EOV publications, contact your plan and request one.
Plan Non-Renewal Notices. The plan that you are on may not be offered in the upcoming year. Plans not renewing must send out a Plan Non-Renewal Notice in October. If you receive this letter, you will want to be proactive in selecting a new plan for 2018. You may choose a new plan during the Open Enrollment period and up to February in the new year. But be careful! If you wait until after December 31 to enroll in a new plan, you may experience a gap in coverage because you will be disenrolled from your current plan.
Consistent Poor Performance Rating. If your prescription drug plan is given a low performance rating (three stars or less) for more than three years in succession, you will receive a Consistent Poor Performance Rating notice. You are encouraged to look at alternative plans and make a change during Medicare’s Open Enrollment Period. You can also change your plan at any time if you are enrolled in a plan with a low performance rating.
Extra Help Notifications
Medicare beneficiaries with lower incomes and assets qualify for the Extra Help program, also known as the Limited Income Subsidy (LIS) program. This program assists beneficiaries pay for their prescription drug coverage. Some of the color coded notices that are sent out to beneficiaries receiving Extra Help are:
Loss of Deemed Status Notice. This grey letter lets you know that you will no longer receive Extra Help as of January 1 of next year. If your income has not changed and you feel that you are receiving this letter by mistake, you can re-apply for this program through the Social Security Administration at 1-800-772-1218 or by contacting the Medicare Information office at 1-800-478-6064 (toll free in Alaska) for assistance.
Change in Extra Help Copayments Notice. This orange notice will inform you of the co-pays for next year. This letter usually arrives in October.
Reassignment Notice. This blue notice is sent if your current plan is not going to be offered next year. The notice informs you that you are being reassigned to a new plan. If you would prefer to choose your plan, you must be proactive. You can call the Medicare Information Office for assistance.
Reassignment Notice. This is a different reassignment notice (also blue) that you will receive if the premium of the plan you are currently on is going to rise above the benchmark amount, the amount that Medicare will cover under the Extra Help program. If you receive this notice, you will be reassigned to a new plan unless you actively change plans by December 31.
Low-Income Subsidy Choosers Notice. This grey notice will inform you that the premium is rising to above the Extra Help benchmark amount and if you stay on this plan, you will pay the difference between what Extra Help covers and what the plan charges. You must be proactive to change to a new plan.
Medicare Beneficiaries that receive their prescription drug coverage through a current or former employer should receive a Notice of Creditable Coverage annually. This letter informs you that the coverage you have is creditable, or, as good as or better than Medicare prescription drug coverage. This is important information because if at some point you choose to switch to Medicare Part D, you can do so without penalty. You should retain these notices for proof should you decide at a later date to apply for Part D. If you get notice that your prescription drug coverage is no longer creditable, you may want to sign up for a Part D plan to avoid accumulating a penalty.
If you receive any of these notices in the mail and are uncertain how to respond, you can contact the Medicare Information Office with your questions and receive guidance.
Nila Morgan is a Certified Medicare Counselor and Medicare Fraud Education Coordinator who works at the Anchorage Senior Activity Center.
Nila Morgan is a Certified Medicare Counselor who works at the Anchorage Senior Activity Center.
