Feb. 14 is another D-Day to change Medicare plans


Sometimes, it’s hard to know which thing to apologize for: Should I apologize for not having called out some Medicare “stuff” sooner, or should I apologize for calling out some Medicare stuff?

It probably doesn’t matter, so I apologize! – But you’ll note that doesn’t stop me…

OK, here’s the deal: If you have a Medicare Advantage Plan, or an Advantage Plan that has a Part D “component” (which simply means an Advantage Plan that includes prescription drug coverage) you have until Valentine’s Day (which seems a cruel irony) to get out – if you want to. “Get out” means that you can switch to “original” Medicare, which means Part A, Part B, a MediGAP plan (if you want one) and a Part D plan (if you want one).

And we remember that a “Medigap” plan is a private plan that you can purchase to pay some part of what Parts A and B don’t pay, right? Good – I thought so.

Let’s try this another way: If you have an Advantage Plan, you can switch to original Medicare, enroll in a Medigap plan and enroll in a Part D plan. You canNOT switch to a different Advantage Plan or an Advantage Plan with a Part D component – I don’t know why.

If you have an Advantage Plan that has a part D component (known affectionately as a MAPD) you can switch to original Medicare, enroll in a Medigap plan and enroll in a Part D plan. You canNOT switch to a different MAPD plan or switch to a stand-alone Part D plan. I don’t know why, and seriously suspect that I don’t want to.

If you want to do any of that, call the Plan directly to disenroll, call 1-800 MEDICARE to enroll or enroll in a Part D plan, which automatically disenrolls you from the Advantage Plan. Yes, a smart person would read that again – Slowly.

If you’re perfectly happy with your Advantage Plan, don’t do anything and spend your time planning what to get someone special for Valentine’s Day, which could have a longer effect on your life than Medicare.

If you decide to do something, and “something” includes a Medigap plan, remember that this is not “guaranteed issue,” which means that your Medigap plan-of-choice doesn’t have to accept you and could, thus, require you to complete a health questionnaire, which would then be scrutinized – at length; or, maybe, said Plan will smile sweetly and welcome you into the fold with open arms, as well as your premium check.

Life is full of surprises.

Medigap plans are “standardized,” meaning that all “A” plans cover the same stuff, all “F” plans cover the same stuff, etc. but their premiums could vary dramatically. Medigaps “travel,” which means that it doesn’t matter where in the good ole’ US of A you are, as long as you’re using a provider who accepts Medicare.

See why I apologized?

Care to have a little help with this? I get it: Call any of the numbers at the end of the column and decent people will help you, without trying to sell you anything.

A couple of other Medicare “quickies” (an unfortunate choice of words, perhaps, but…):

*No, it isn’t you – your Medicare “summary of benefits” (think “EOB”) has changed. It’s supposed to be simpler and actually include definitions, which could take some of the fun out of it — at least the font will be larger;

*If you have a Part D and hit the “donut hole” this year, you’ll get a 21% discount on generics and a 52.5% discount on brand-name drugs, and…

*…our coinsurance for outpatient mental health treatment has actually decreased.

If you’ve been at this “Medicare game” for a while, you’ll note that, with the exception of the “quickies” (sorry), nothing has really changed. It’s the same game that we’ve been playing for a while. I mention this because there is still a tremendous amount of fear and misunderstanding about what the “Affordable Care Act” (“ACA,” “ObamaCare,” whatever) will do/is doing to us Medicare-types – answer: Not much.

So we’ll have to find something else to be afraid of, like what will happen if we forget to remember Valentine’s Day; personally, I’ll choose Medicare any day.

HEADS UP! If you have a “chronic condition” (diabetes, heart disease, chronic pain, arthritis – you get it: Something unpleasant that doesn’t go away), here’s another chance to change your life – and I mean that.

Living well workshop

Olympic Area Agency on Aging and the Grays Harbor County Health Department are teaming up to present another round of “Living Well with Chronic Conditions.” Free.

This was developed at Stanford and it works. It’ll run every Tuesday, from 1-3:30 p.m., beginning Feb. 12 and going through March 19. It’ll happen in the first floor conference room of the Health Department (2109 Sumner), which is “accessible.”

I’m not kidding: This will change your life and, yes – I said “free.”

Call Paulette at 538-2457 (1-866-582-1487) to sign up, or email her at dodgepj@dshs.wa.gov because these “slots” go quickly.

There’s a reason for that.

Mark Harvey is the director of Senior Information and Assistance for Olympic Area Agency on Aging. He can be reached at harvemb@dshs.wa.gov or 532-0520 in Aberdeen, (360) 942-2177 in Raymond or (360) 642-3634. FACEBOOK: Olympic Area Agency on Aging-Information & Assistance.