Due to federal law, you may have to choose a different Medicare plan for 2019. You’ll get plenty of notice about changes and options this fall. But many people like to plan ahead. So here are five tips to get ready now for Medicare Cost plan changes.
Frequently Asked Questions
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Based on a federal law that starts Jan. 1, 2019, Medicare Cost plans won’t continue in 66 Minnesota counties. The Centers for Medicare & Medicaid Services (CMS) will not renew Medicare Cost plans in counties where there are two or more Medicare Advantage plans with a certain number of members. Use the county lookup tool on this website to see if you live in a county that’s affected. Cost plans will continue in 21 Minnesota counties and in surrounding states. This includes Wisconsin, North Dakota and South Dakota.
See if your county is included; just enter your county in the tool on this website with the heading, How will this affect my plan? The Centers for Medicare & Medicaid Services (CMS) and/or your health plan sent letters in August and September to Medicare Cost plan members who are affected.
Your 2018 Medicare Cost plan covers you through the end of the year, as long as you continue to live in Minnesota and pay your plan premiums.
It’s important to review your Medicare plan options during the Annual Election Period (AEP) from Oct. 15 to Dec. 7. If your Cost plan will be ending, you can enroll in a new plan for Jan. 1, 2019 during the AEP. Check out these tips to help you in the article, Tips to prepare, compare and enroll in a 2019 Medicare plan.
Your health plan can automatically enroll you in a Medicare Advantage plan if you meet certain guidelines. (See question, Am I automatically enrolled in a Medicare Advantage plan?)
Based on guidelines from The Centers for Medicare & Medicaid Services (CMS), health plans can automatically enroll some members in a Medicare Advantage plan. The plan must offer comparable coverage to your 2018 plan; you need to have both health and prescription drug coverage with the same company; and you must live in a county where Medicare Advantage plans are offered.
- If you meet these guidelines, your health plan can automatically enroll you in a 2019 Medicare Advantage plan. You don’t need to take any action if you like this plan for 2019.
- If you are not automatically enrolled into a new plan, you’ll have to choose a new Medicare plan for coverage starting Jan. 1, 2019. If you don’t choose a new plan, you’ll have Original Medicare only.
You can get more coverage than just Original Medicare Parts A and B with these types of plans: Medicare Advantage, Medicare Supplement and Part D drug plans. Learn how these plans work in the article, Other Medicare options if my Cost plan goes away.
Both plans provide extra coverage to fill the cost-sharing gaps in Original Medicare. Here’s a general description of their differences.
- Medicare Advantage plans include your health and Part D outpatient prescription drug benefits in one plan, with one number to call if you have a question. You pay less when you use providers in the plan’s network.
- Medicare Supplement plans provide health coverage only. They don’t have Part D prescription drug coverage, which you can purchase separately if you need drug coverage. You can get your care from any U.S. provider that accepts Medicare and get the same covered services.
Medicare Advantage plans have certain doctors, clinics and hospitals in the network. It’s always important to use providers in the network because you pay less for covered services. Medicare plans have different networks, so check the network list to see if your doctor is included. With Medicare Supplement plans, you can see any U.S. provider that accepts Medicare.
If your doctor is a HealthPartners Care Group provider, you can absolutely continue to see your doctor with a HealthPartners Medicare plan.
The HealthPartners Journey network provides access to 3,500 primary care physicians, 17,000 specialty care physicians and 98 hospitals and outpatient surgical centers and clinics like Park Nicollet, Entira Family Clinics, Stillwater Medical Group, North Memorial Health Care, CentraCare Health and HealthPartners. To find more providers, visit healthpartners.com/journeydoc
Note: When you use the providers in network, you pay less for covered services. You can use providers not in the network, but you may pay more for covered services.
You can call or chat with a HealthPartners sales team member (see blue box for information).You may find this article helpful, too: Where to go for info about Medicare Cost plan changes. It includes a handy reference sheet of resources you can call or go to online for more information.
Keep these important dates in mind so you get the coverage you want:
- Oct. 15 – Dec. 7, 2018: This is the Medicare Annual Election Period (AEP) when you can review 2019 options and enroll in a plan for Jan. 1, 2019. The AEP is for enrollment in Medicare Advantage and Medicare prescription drug plans.
- Now – March 5, 2019: You can enroll in a Medicare Supplement plan without providing your health history. This is called a “guaranteed issue right.” Your eligibility begins the date you received notice of Cost plan termination and lasts through March 5, 2019. If you elect this option, you’ll also be able to sign up for a separate Part D prescription drug plan if you need one.
- Dec. 8, 2018 – Feb. 28, 2019: During this one-time Special Election Period (SEP), you can enroll in a different Medicare plan or choose Original Medicare due to the Cost plan closing.
- Jan. 1 – March 31, 2019: This is the Medicare Advantage Open Enrollment Period. If you enrolled in a Medicare Advantage plan you can switch to a different Medicare Advantage plan, or add or drop Part D prescription drug coverage.