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Medicare Advantage 2015 – Changing Plans

Before you enroll – what you need to know about Medicare Advantage 2015 Plan Changes2015 Medicare Advantage

Whether you are new to Medicare or have been enrolled in Medicare for some time it’s important to keep up to date on any changes. Although Medicare Advantage for 2015 avoided any catastrophic change related to the budget debate there are still important changes that you should be aware of before you enroll in a 2015 Medicare Advantage Plan.

Medicare Advantage Plans for 2015 on the whole look similar to plans from previous years.  Options for private fee-for-service (PFFS) plans will remain scarce with a greater emphasis on network based plans such as HMO Medicare and PPOs.

Rural Counties have fewer plans whereas more populated Counties have many choices due to insurance companies having an easier time setting up credible networks. This disparity is due to insurance companies offering plans being able to market plans County by County.

Finding Medicare Advantage plans by State is not always possible. Even though a plan may be available in all Counties State wide, the features, benefits and premiums may differ.

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Annual Enrollment Period not the only time to enroll

The Annual Enrollment Period takes place each year from October 15th to December 7th. Enrolling during this period will ensure that your new Advantage Plan is effective January 1st of the following year. If you are enrolled in a  Medicare Advantage Plan and do nothing during the Annual Enrollment Period you will automatically be enrolled in the plan for the following year assuming the plan is still offered.

It’s important to keep in mind that plans are annual plans with all benefits ending December 31st of each plan year. Insurance companies have the option of:

  • Renewing a plan for the following year
  • Discontinuing a plan
  • Renewing but making changes to plan benefits and/or premium

This is why it’s vitally important to at least take the opportunity to review your plan documents and compare available Medicare Advantage plans each year.

If you are new to Medicare you do not have to wait until the Annual Enrollment Period to join a plan. You can submit an application up to 3 months prior to the first day of the month you are eligible for Medicare, the month you become eligible and up to three months after the month you become eligible.

It’s best to submit an application prior to the month you are eligible so you can enjoy the benefits and protect yourself from the unpredictable costs of original Medicare including deductibles and coinsurance.

Changing your 2015 Medicare Advantage Plan

The Centers for Medicare and Medicaid Services (CMS) have included a change that will allow for a new Special Enrollment Period. This enrollment relates to Medicare plans rated 5 stars.

People enrolled in a Medicare Advantage plan that is rated at 4.5 stars or less will be able to enroll in a 5 star plan at any time during the year. The good news is that most all people are enrolled (or will be enrolled) in a plan rated at 4.5 stars or less. The bad news is there are few 5 star plans and many Counties will have no 5 star plans available.


If you are lucky enough to have 5 star plans available you will have greater flexibility to make changes if you are unhappy with your current plan. It’s important to note that just because a plan is rated 5 stars you shouldn’t jump into it without first considering whether the plan will meet your needs. The provider network and the plan’s Part D formulary are probably the most important aspects to explore.

Other options to make changes to your 2014 Medicare Advantage Plan include the standard Special Enrollment Periods that are triggered by some change in circumstance and related to receiving extra help financially.

These changes detailed for 2015 Medicare Advantage Plans and the Medicare Advantage program in general are most important for you to be knowledgeable about so you can enroll in the best plan for your circumstances as well as explore any options to make changes if the need arises.

 

One comment

  1. The info you provide is quite helpful.
    Thank you

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