Medicare Med-plans, May15+: Options After the Deadline

Based on content from Medicare.gov
Edited Article and Commentary by Dr. Don Rose, Writer, Life Alert

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The initial enrollment period for the new Medicare prescription drug coverage ran from January 1, 2006 to May 15, 2006. While millions signed up, many seniors may have forgotten to do so, or decided to put it off. This article discusses what one should know and do after the May 15 deadline. The main thing to know is that you CAN still sign up for a new prescription drug plan after that date. However, many seniors who do are likely to face coverage delays, and may pay more. Read below for more details. --Dr. Don Rose

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May I Get My Plan After May 15?

Many are pondering this question. Many rumors abound. Let’s check the main source. The official Medicare website (more specifically, the subsite questions.medicare.gov) provides several Q&A pairs, including this one:
  • Question: What happens if I choose not to join a Medicare drug plan by May 15, 2006? Can I join later?
  • Answer: If you don’t join a plan by May 15, 2006, and you don’t currently have a drug plan that, on average, covers at least as much as standard Medicare prescription drug coverage, you will have to wait until November 15, 2006 to join. When you do join, your premium cost will go up at least 1% per month for every month that you wait to join. Like other insurance, you will have to pay this penalty as long as you have Medicare prescription drug coverage. If you join after May 15, 2006, the next open enrollment period is November 15, 2006 to December 31, 2006. However, coverage for people who enroll during this period will not take effect until January 1, 2007.
So, it appears that most folks who didn’t enroll by May 15 must wait an extra 6 months to join, and 7.5 months to be covered – at a higher price (i.e., higher monthly premium). For example, if you wait 8 extra months to sign up (that is, if you could have been in a plan for 8 months but you weren’t in one), your monthly premium would be 8 percent higher than if you had signed up before May 15 – and, you’d have to pay this higher amount for as long as you had coverage.

Such a permanent premium penalty has riled some seniors and interest groups. However, there are some rays of hope. First, for many, the penalty would not be a huge dent to a monthly budget (for instance, waiting till this November to sign up would likely add under $4 per month to your premium). Second, not everyone will be affected. Low income seniors (with income below $15,000 per year) can take extra time to enroll, and will not face penalties for signing up after May 15. There have also been rumors that an extension for all seniors may be enacted; given this election year, that wouldn’t be a surprise, since the move would surely please many. However, a general extension has not yet happened at the time of this writing.

Getting More Information

Medicare has been working with thousands of national and local partner organizations to get information to seniors -- including Area Agencies on Aging, the National Council on Aging, the NAACP, the AARP, disability organizations, church groups, pharmacists and physicians. More than 1,000 enrollment seminars were held in the weeks leading up to May 15, and some of these organizations can still provide useful information if you contact them. Many have websites as well, so you can access their info 24/7, right from home.

The Medicare.gov website is one of the best resources. Here it addresses the information issue:
  • Question: Is there information and help available to compare Medicare drug plans?
  • Answer: Look for information about plans in your area in the “Medicare & You 2006” handbook. You can use our new search tool, the Medicare Prescription Drug Plan Finder, on this website for detailed information about the plans available in your area; or call 1-800-MEDICARE (800-633-4227). TTY users should call 1-877-486-2048.

Closing Thoughts

As many of you know (given the extensive media coverage), May 15, 2006 was the deadline to sign up for the new Medicare Prescription Drug Benefit.  But there is some good news: most seniors can still sign up for coverage, even after May 15.

The passing of the deadline does, however, mean that most seniors signing up after May 15 will incur a penalty. This penalty may take the form of time (possible coverage delays) and/or money (higher cost). Info provided on Medicare.gov indicates that most folks who didn’t enroll by May 15 must wait an extra 6 months to join, and 7.5 months to be covered – at a higher price.

To find out the available options, seniors and their relatives can call 1-800-MEDICARE or visit the Medicare website at www.medicare.gov. The Medicare website has easy-to-use tools to help seniors find the plan that best fits their needs. Children of eligible beneficiaries are encouraged to help their parents find out what options are available, and at what cost.

Resources

Official U.S. Government site for people with Medicare: www.medicare.gov  ; a list of common questions and answers can be found at questions.medicare.gov.

Official website for HHS (the U.S. Department of Health and Human Services): www.hhs.gov

Article on “Strengthening Medicare”, from the official White House website: Medicare and new drug plan - White House page.

Document summarizing what seniors should know and do regarding the new Medicare drug program:  Link to Full PDF Document Five Simple Steps: "A National Day of Conversation - Friends and Family First".

The “Secretary’s Progress Report III on the Medicare Prescription Drug Benefit”: http://www.hhs.gov/secretaryspage.html.

The article above is based on one or more pages from the Medicare website (www.medicare.gov). Medicare.gov content is in the public domain and is, to the best of our knowledge, reliable and accurate. However, Life Alert -- while always striving to provide true, precise and consistent information -- cannot guarantee 100 percent accuracy; hence, readers are encouraged to use the resources provided to gather more information before drawing conclusions and making decisions.

Dr. Don Rose writes books, papers and articles about computers, the Internet, AI, science and technology, and issues related to seniors.

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