|Vol. 16, Issue 3 – February 6, 2017|
|Do I qualify for a Special Enrollment Period if I have a problem with my private insurance plan?||Dear Marci,While I am not anticipating any problems with my private insurance plan, I would like to be prepared for the worst. If difficulties arise, am I allowed to change plans at any time?
– Ronald (Bowman, ND)
The short answer to your question is that it depends on the specific difficulties that you are facing with the plan. Under certain circumstances, you may be eligible for a Special Enrollment Period (SEP) to change your Medicare Advantage Plan and/or Part D prescription drug plan outside of the usual enrollment or disenrollment periods. If you get an SEP, your new coverage will usually start the first of the month after your sign up for or disenroll from your plan.
An SEP allows you to change your Medicare Advantage Plan or your stand-alone Part D plan that works with Original Medicare. Here are three common difficulties you might encounter with your plan to warrant an SEP:
Ronald, click here to access a chart on Special Enrollment Periods that will help you determine whether or not you qualify for an SEP under these and other circumstances.
Valentine’s Day is fast approaching – and here is a reminder that February is also American Heart Month. The American Heart Association has developed a My Life Check ® program that uses a seven-step list to help everyone live longer, more productive, and healthier lives. Combat the health risk factors that lead to heart disease and stroke, and you will also lessen their impact on dementia, Alzheimer’s disease, memory loss, and cognitive dysfunction. The seven steps are relatively easy and inexpensive to follow. Click on each link below to learn more.
|The Centers for Medicare & Medicaid Services (CMS) has joined with the Consumer Financial Protection Bureau to provide tips to people enrolled in the Qualified Medicare Beneficiary (QMB) Program who have been wrongfully billed.The QMB Program is one of three Medicare Savings Programs (MSPs) that helps to pay people’s Medicare costs if they have limited finances. QMB pays Medicare Part A and B premiums, deductibles, and coinsurances or copays.
Federal law prohibits providers from billing people enrolled in the QMB program for any Medicare cost-sharing. This means that Medicare providers should not bill people who have QMB for any Medicare-covered services they receive.
To learn your rights as a Qualified Medicare Beneficiary, read the CMS and CFPB blog post.
To find out more about providers inappropriately billing a beneficiary for Medicare cost-sharing, see QMB Balance Billing on Medicare Interactive.
Dear Marci is a biweekly e-newsletter designed to keep you — people with Medicare, social workers, health care providers and other professionals — in the loop about health care benefits, rights and options for older Americans and people with disabilities.
For reprint rights, contact Mitchell Clark.