Is It Too Late To Change My Drug Plan?

Q: Is it too late to change my drug plan? I know the date is Dec. 7, but what do I do if I missed that?

A: The media coverage for this year’s Annual Open Enrollment Period (AEP) of Oct. 15 to Dec. 7 has been extensive. It is hard to imagine missing all the ads in the newspaper, magazines and TV. I know that some of you have not done anything yet. I know that because my phone is still ringing.

You have until midnight Dec. 7 to make your insurance change. If you have already made a choice and now have changed your mind, you can do a new enrollment. The last enrollment you do before Dec. 7 is the plan enrollment that you will have. You should still get your information prior to Jan. 1. If you need to fill a prescription in January before you get your ID card, you can call the company you chose and see if they have you on file yet. If you call your new 2014 company and they give you your ID numbers, you can take this information to your pharmacist and he/she can fill your prescriptions using your new plan.

If they don’t have you in the system yet, you may need to fill the prescription anyway, pay full price and then file a claim with the company to get back any money you are due.

If it gets to be close to the end of December and you haven’t heard from your chosen company, please call them. That will give you and the company enough time to figure out the problem, in order to get you enrolled and processed by Jan. 1.

Remember that most people complete their enrollment through the Center for Medicare & Medicaid Services (CMS). Most people use the website or the 1-800-medicare phone number to facilitate their enrollment (1-800-633-4227). This means that Medicare is collecting the enrollment, but sending it on to the insurance company to process. This communication takes time. Yes, computers are fast, but there are many thousands of Medicare recipients making these changes right now.

Medicare will then communicate the disenrollment to your 2013 insurance plan. It may take them a while to get this information to take you out of their computers. You may continue to get information from your old company for a number of months, which you ignore. You usually do not need to contact your old plan and disenroll. In fact you shouldn’t contact most plans to dis-enroll, Medicare does that for you. There are some exceptions to that rule. One exception is if you have a PFFS plan or a Medicare Supplement Plan (Medigap). These plans are not tied to your prescription drug plan. If you have one of these plans and wish to change your coverage you must write a letter to cancel those policies, in addition to joining a new plan.

I don’t recommend waiting until the last week, but sometimes our situations fall in such a manner that you can’t help waiting until the last week or even the last day.

Please don’t fill your prescriptions using your 2013 plan if you in fact switched plans for 2014. If you do this, the old company will then come back to your pharmacy for the money it paid on your behalf. Then your pharmacists will have to contact you to get your new information and re-bill the correct plan. This makes extra work for the pharmacists (who have enough work already). This also really confuses the insurance companies about your actual intentions. Did you mean to switch plans for the new year? Do you want to stay with your 2013 plan?

As with any change we need to make, I don’t recommend procrastinating until the last moment, so if you can, make the change early.

You may also have special enrollment periods open to you to make a switch later on in 2013 and 2014. There are not as many Special Enrollment Periods available to us in 2014 as there were in 2013, so be sure your choice is the best you can make with the information you have available to you. I will be writing another article soon on Special Enrollment Periods.

Happy insurance season to all and to all good health!