Categorized | Opinion

Are you eligible for the Medicare Special Election Period?

Joe Tompkins is the West Texas Medicare sales director for Humana.

Joe Tompkins is the West Texas Medicare sales director for Humana.

Even though the Medicare Advantage and Prescription Drug Plan Annual Election Period ended Dec. 7, some people with Medicare still might be eligible for what is known as a Special Enrollment Period, or SEP.

There are many reasons why Medicare beneficiaries might be eligible for a Special Election Period. Some SEPs have a fixed deadline, while others depend on the date you became eligible for the SEP.

Some people with Medicare qualify for an SEP that ends Feb. 28, 2019, because:

• Their current plan did not renew in 2019 or their retirement benefits were discontinued as of Dec. 31, 2018. People whose current plans did not renew for 2019 should have been notified of these changes by their plan by Oct. 2, 2018.

• Their 2018 plan received a 2.5 or below STAR quality rating for three consecutive years. STAR ratings judge the quality of plans in several categories, including preventive care, managing chronic conditions, member experience, member complaints, and customer service. STAR ratings are based on a five-star scale and can change each year. STAR ratings for 2019 Medicare plans are available at medicare.gov.

Even though beneficiaries in this category have until Feb. 28 to choose a plan, those who want coverage beyond original Medicare to start Jan. 1, 2019, must select a plan by Dec. 31.

When choosing a plan, Medicare beneficiaries should:

• Learn the monthly costs of the plan (premium), costs to use the plan (deductibles and copayments), and the maximum you might have to pay in case of a serious health event (maximum out of pocket).

• Learn about the doctor and hospital networks included in each plan.

• If you take medication, it’s important to know that Original Medicare does not cover most prescription drugs. Many Medicare Advantage plans include prescription drug coverage, or you can sign up for a stand-alone Part D Prescription Drug Plan. Be sure to check the estimated cost of your medication on each of these plan options.

• Also, review your records to see how much you spent this past year on health care and what you anticipate your health care needs to be for the coming year.

To learn more about Special Enrollment Periods, visit medicare.gov or call 1-800-MEDICARE (633-4227) 24 hours a day, seven days a week. You can also visit humana.com/medicare or call 1-877-877-0714 from 8 a.m. to 8 p.m. local time, seven days a week.

Humana is a Medicare Advantage HMO, PPO, and PFFS organization, and stand-alone prescription drug plan, with a Medicare contract. Enrollment in any Humana plan depends on plan renewal.

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