Autumn is Busy, and September is Here

During the coming weeks Medicare beneficiaries will begin to receive a flurry of mail and advertisements. Here’s a quick guide to some of the mail that many will begin to receive.

Annual Notice of Change (ANOC)

Every year, both Medicare Advantage plans and standalone prescription Plan (Part D) beneficiaries will begin to receive an annual notice of change, a regulatory requirement mandated by the CMS. The ANOC will contain detailed information regarding coverage you have received in 2015, and will display how it will change in 2016. For example, the ANOC will display changes in premiums, deductibles, and copays, which may vary from year to year, depending on the services that you receive.

It cannot be overstated: beneficiaries should read these ANOCs when received. Too often, beneficiaries discard this document, and learn, after the fact, that their out-of-pocket costs change at a time they least expect. A very important feature about ALL Medicare Advantage and Medicare Part D plans is that they are annual contracts, these plans are approved by the CMS on an annual basis, and can be greatly affected by a large number of factors. Last (and not least), the carriers of Medicare Advantage Plans and Part D plans are actively competing against one another. The result is that the terms and conditions of your Medicare Advantage or Medicare Part D are likely to change. For Medigap policyholders, this is not an issue, because the terms and conditions do not change from year to year, other than the premium. By definition, Medigap plans are standardized (for example, Plan N from carrier #1 is identical to Plan N from carrier #2). In addition, they are guaranteed renewable, which means that the language will remain the same over time.

Extra Help for Prescriptions

The Extra Help program (which has also been known as the Low Income Subsidy), is administered by the federal government. For those that receive Medicaid, enrollment is automatic. However, for those that do not qualify for Medicaid, it is entirely different. For non-Medicaid recipients of Extra Help assistance, renewal is not guaranteed. The federal government may ask for you to verify certain financial data, in order to confirm your eligibility. You will be notified during the month of September. Again, this is a very important letter. In addition to receiving financial assistance towards premiums and copays, qualifying for the Extra Help program also automatically provides a Medicare beneficiary the ability to change Part D or Medicare Advantage plans throughout the year. Finally, if you qualify for the Extra Help program, and if you have a Medicare Advantage Prescription Drug (MAPD) plan, then the financial assistance can result in lower monthly premiums for your Medicare Advantage Prescription Drug plan. In other words, there are many implications to qualifying for the Extra Help program.