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, Medicare Cost plans are not available in 66 Minnesota counties starting Jan. 1, 2019. The Centers for Medicare & Medicaid Services (CMS) did 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 where Cost plans are available. Cost plans are available in 2019 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, Where Cost plans are available. The Centers for Medicare & Medicaid Services (CMS) and/or your health plan sent letters in August and September 2018 to Medicare Cost plan members who are affected.
If your Cost plan is not available in 2019, you can still enroll in a new plan. Use one of the following enrollment periods.
- 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. Generally, your plan will be effective the first of the month after we receive your enrollment.
- 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 began the date you received notice of Cost plan termination and lasts through March 5, 2019. If you elect this option, you’ll want to enroll in a separate Medicare Prescription Drug Plan during the SEP, if you need one.
- Jan. 1 – March 31, 2019: This is the Medicare Advantage Open Enrollment Period. If you have a Medicare Advantage plan, you can switch to a different Medicare Advantage plan or add or drop Part D prescription drug coverage.
Based on guidelines from The Centers for Medicare and Medicaid Services (CMS), health plans can automatically enroll some members in a Medicare Advantage plan for 2019. 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 would have sent you information explaining that they automatically enrolled you in a Medicare Advantage plan for 2019. You don’t need to take any action if you like the plan.
- If you are not automatically enrolled into a new plan, you’ll have to choose a new Medicare plan for coverage in 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 medical 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.
A Medicare Supplement plan provides medical coverage only. It doesn’t include coverage for Part D outpatient prescription drugs. If you want this coverage, you’ll need to enroll in a separate Medicare Prescription Drug Plan. That’s important because there’s a late enrollment penalty if you don’t have Part D or similar drug coverage for more than 63 days in a row. Visit medicare.gov and click the “Drug Coverage (Part D)” tab at the top to learn about your enrollment opportunities.
Some Cost plan members who had both medical and prescription drug coverage were automatically enrolled in a Medicare Advantage plan starting Jan. 1, 2019. If you change to a different plan, you may need to cancel the Medicare Advantage plan.
You need to take action if you switched to a Medicare Supplement plan and did not enroll in a separate Medicare Prescription Drug Plan. Enrolling in a Medicare Supplement plan will not automatically cancel your Medicare Advantage plan. Contact your Medicare plan’s Member Services at the phone number on the back of your current I.D. card for help. It’s important to do this by Dec. 31, 2018 so you don’t have duplicate coverage starting Jan. 1, 2019.
If you made the plan changes below, the Centers for Medicare & Medicaid Services (CMS) automatically cancels your Medicare Advantage plan for you:
- You switched to a Medicare Supplement plan and a separate Medicare Prescription Drug Plan
- You switched to a different Medicare Advantage plan
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. HealthPartners Care Group includes clinics like Park Nicollet, Entira Family Clinics, Stillwater Medical Group, North Memorial Health Care, CentraCare Health and HealthPartners
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.
Keeping your doctor or switching to a new one is a personal choice. If you want to change providers, call your health plan’s member services at the phone number on the back of your ID card. If you want information about your HealthPartners plan, we’ll help you understand in-network and out-of-network benefits and your provider choices. We can also explain how your plan works if you want to keep your doctor(s). Remember, when you use providers in the network, you pay less 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.