April 1 is the deadline for changing Medicare health plans. After April Fool’s Day, you will be locked in to your current plan for the rest of the calendar year.
Judging by the ads on TV and in the newspaper, private insurers are making one last big push to sign on enrollees. Don’t give in to pressure. Do your homework, but don’t procrastinate, if you are not satisfied with your current plan.
Medicare is complicated, even the pros admit that, but there are places you can go to get help.
The Medicare Rights Center, a national non-profit consumer service organization that works to ensure access to affordable health care for older adults and people with disabilities, is a good place to start.
The center offers Medicare Interactive Counselor, an independent, online resource that provides easy-to-understand answers to questions about Medicare. To learn more, go to Medicare Interactive Counselor at www.medicare interactive.org.
Paul Precht, the center’s director of policy and communications advises seniors to not sign up for coverage they don’t understand.
For starters Precht offered some general rules about the types of changes Medicare recipients can make before April 1:
A person who is enrolled in a Medicare private health plan with drug coverage (like an HMO or PPO) can switch to another that also offers drug coverage. They can also switch to Original Medicare with a stand-alone drug plan. If someone has Original Medicare with a stand-alone drug plan, they can switch to a Medicare private health plan with drug coverage. They cannot, however, add or drop the Medicare drug benefit (Part D) and they cannot switch from one stand-alone prescription drug plan to another one. Most people with Medicare will not be able to change their health plan again until 2010.
If you are considering changing plans, Precht recommends asking the following:
n How much is the premium?
n Does the plan have an annual limit on how much you would pay out of pocket for medical care? How much is the limit and does it cover all services?
n Will I be able to use the doctors, hospital and other medical providers I want?
n Does the plan cover the prescription drugs I take at a cost I can afford without restrictions?
Keep in mind that benefits offered through private health plans are not standardized. Some plans can leave you on the hook for higher bills if you get sick, Precht warns.
If you have questions, don’t try to work this conundrum out by yourself. Ask for help.
Donna Wright, health and social services reporter, can be reached at 745-7049.