Dear Editor:
New rules for when and how often people can switch Medicare health plans are being phased in over the next two years.
“Medicare now will operate like most other health insurance programs and allow people to change health plans only during certain times of the year,” Yvonne Bryant, Social Security manager in Jersey City, said.
More than 38 million Americans are enrolled in various Medicare health plans. These plans include the original Medicare plan, Medicare managed care plans (HMOs and similar organizations) and Medicare private fee-for-service health care plans.
“Until the end of last year, people could leave a Medicare health plan at any time, for any reason,” Ms. Bryant said.
Now, people will be able to leave a Medicare health plan and join another plan only once between January 1 and June 30, 2002. Their coverage will begin the first day of the month following the change in Medicare plans. In November 2002, they will have another opportunity to switch plans. If they switch plans then, the change will be effective January 1, 2003.
The rules will change again starting January 1, 2003. People can leave a Medicare health plan and join another plan only once between January 1 and March 31, 2003. Their coverage will begin the first day of the month following the change. Just like in 2002, they will have another opportunity to switch plans during the annual election period between November 1 and November 30 every year. Any change made in November will be effective the following January.
“The new rules are being put in place to help Medicare plan providers manage their health care costs and payments and plan for enrollee care, ” Ms. Bryant said.
Ms. Bryant noted that people also will be able to leave or join a Medicare health plan if:
Their health plan leaves Medicare;
They move out of their plan’s service area; or
They are in another situation that Medicare decides is an exception.
Different rules also apply for people who are turning 65 years old and are new to Medicare, and for people who just became eligible to join a Medicare-managed care plan or private fee-for-service plan.
“If people are in a Medicare health plan or are thinking about joining one, they need to know how the new rules will affect them,” Ms. Bryant said. “They can talk to the plan representative or membership office.”
If anyone wants more information, they should call Medicare at 1-800-633-4227 (TTY/TDD 1-877-486-2048 if they are deaf or hard of hearing) to ask for publication CMS-02241, New Rules For Switching Medicare Plans, or visit www.hcfa.gov/pubforms/ on the Internet to read, print or order a copy.
Social Security