More about Medicare’s Part D prescription drug plans
Question: I currently have a Part D drug plan and would like to know when I can change to another plan. Do I have that option at any time?
Answer: In general, someone who has Part D plan can only choose another plan during Medicare’s Annual Enrollment Period (AEP) October 15-December 7. Selections made during the AEP go into effect January 1 the following year. Appointments are available each fall with ARC SHIP counselors to help those with Part D select the best plan for the following year. This annual option to change is also available to anyone who has a Medicare Advantage plan that includes Pt D. However, there are a number of special circumstances when someone could qualify for a Special Enrollment Period (SEP) and could switch plans outside the outside the annual period. A few examples included moving outside a plan’s service area, qualifying for Social Security “Extra Help”, or residing in a long-term care facility. A SEP may also be available for someone who believes they were provided incorrect or misleading information when they enrolled in their current plan. Please contact SHIP if you would like to change plans and feel a special circumstance may apply.
Disclaimer: The questions and answers in this column are intended to provide additional understanding on relevant Medicare topics. For additional explanations specific to your situation, please call ARC and request that a SHIP counselor contact you. You may also utilize SHIP walk-in hours on the 2nd Thursday and 4th Monday at 1:00.
SHIP counselors are trained, certified, and experienced in offering one-on-one information for all aspects of Medicare, health insurance and drug plans. A program of ARC, SHIP provides assistance, explanations, and plan comparisons. There is never a cost, sales, or any insurance affiliations.
SHIP is especially helpful for those new to Medicare who are trying to navigate the system and meet deadlines or to anyone wanting to lower current insurance costs and understand options. Help is available by individual appointment at various times each month. Call ARC at 309-888-9099, and a counselor will return your call to set an appointment.
Walk-in hours are available on the 2nd Thursday and 4th Monday of each month ONLY. Walk-ins start at 1 PM with no appointment needed. First come, first served. SHIP is a program of the Illinois Department on Aging.
COVID 19 - SHIP & Medicare
SHIP remains available through ARC and will follow any COVID protocols currently in place for the ARC facility. In addition to in-person sessions and dependent on your circumstances, the counseling sessions may involve a computer (ZOOM) meeting or a phone conversation. Please call ARC and leave a message on the SHIP line.
Medicare and the Coronavirus. Here is a summary of the coverage provided by Medicare:
· Medicare covers the lab tests for COVID-19. You pay no out-of-pocket costs.
· Medicare covers all medically necessary hospitalizations. This includes if you're diagnosed with COVID-19 and might otherwise have been discharged from the hospital after an inpatient stay, but instead you need to stay in the hospital under quarantine.
·Vaccine distribution is underway across the United States. Specifics regarding local access are available from the Mclean County Health Department. Medicare insurance plans will cover vaccine costs, if any.
· If you have a Medicare Advantage Plan, you have access to these same benefits. Medicare allows these plans to waive cost-sharing for COVID-19 lab tests. Many plans offer additional telehealth benefits beyond the ones described below. Check with your plan about your coverage and costs.
· Scammers may use the coronavirus national emergency to take advantage of people while they’re distracted. As always, guard your Medicare card like a credit card, check Medicare claims summary forms for errors, and if someone calls asking for your Medicare Number, hang up! More information is available from the official website https://www.medicare.gov
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