retired couple researching Medicare Advantage

  1. Make sure you have a current copy of Medicare-and-You. This handbook has details about what Medicare covers and provides website and phone numbers where you can get additional information.
  2. The number for Medicare is 1 800 633 4227 and they are opened 24 hours per day, seven days per week. 
  3. During Open Enrollment, which is from October 15th through December 7th, you can change Medicare Advantage plans.
  4. Another change you can make during Open Enrollment is from a Medicare Advantage to a Medicare Supplement plan. According to page 23 of Choosing-A-Medigap, you have a one-year Trial right for Medicare Advantage plans. This means that during the first year, you can return to Original Medicare and enroll in a Medicare Supplement without going through medical underwriting. When an applicant is required to go through medical underwriting the insurance company can decline them or charge them a higher premium. According to page 22 of Choosing-A-Medigap, you can also enroll in a Medicare Supplement without medical underwriting if your Medicare Advantage policy is terminated. You can enroll in a Medicare Supplement as early as 60 days before your coverage ends, but no later than 63 days after your coverage ends. After your one-year Trial Right, most Medicare Supplement insurance companies will require you to go through medical underwriting unless your Medicare Advantage policy has been and will be terminated. BlueCross BlueShield is exception to this. They have the Blue-to-Blue Rule which allows their Medicare Advantage Policy holders to switch to one of their Medicare Supplements during Open Enrollment without medical underwriting.
  5. To ensure you pay the lowest amount for your prescription drugs make sure you use one of your plans preferred pharmacies or their preferred mail order. 
  6. If your doctor recommends you take a new drug that is not in the formulary of your current Medicare Advantage plan, you can contact their customer service and request an exception. Also, you can shop around for the best price. Online applications like GoodRx.com and Singlecare.com often have coupons that offer significant savings. You may be able to get a lower cost through discounts at a local pharmacy, an on-line pharmacy like Mark Cuban’s pharmacy, Costplusdrugs.com or Marley Drugs (https://www.marleydrug.com, 1 866-997-2871). From this website: www.needymeds.org, people often find huge savings on expensive drugs. This organization helps them connect with the manufacturers of expensive drugs to obtain them at no cost or a low cost. Their number is 1 800-503-6897. Another option is to order your drug from a Canadian pharmacy like Canadian Prescriptions Plus (1-866-779-7587, www.canadianprescriptionsplus.com).
  7. If you are traveling outside of the United States, make sure your contact your Medicare Advantage insurance company to determine if your coverage will be sufficient. You may need to purchase travel insurance.
  8. Unlike Medicare Supplements, Medicare Advantage plans are regional. If you move out of your plan’s service area you will have a Special Election Period which begins 1 month before your move and 2 months after the move to enroll in a new plan.

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