Is your 2017 Medicare Part D prescription drug plan or Medicare Advantage plan still being offered in 2018?
Each year, Medicare plans have the option of not renewing
their Medicare contract. When this happens, the Medicare plan can be discontinued across the country
or in a specific service area (state or ZIP code). If a Medicare beneficiary is enrolled in a non-renewing Medicare plan, they may be without Medicare plan coverage for the entire year (all of 2018) unless they enroll into another Medicare plan during the annual Open Enrollment Period (starting October 15th and continuing through December 7th) or have access to a
Special Enrollment Period.
Your discontinued (non-renewing) 2017 Medicare plan may be due to a:
- Plan Consolidation: When multiple plans from one company are brought together into one plan, or a
Medicare Part D plan from one company may be merged together with a
Medicare Part D plan from another company.
Members in the non-renewing 2017 plan are automatically "crosswalked" to the new 2018 Medicare plan.
- Service Area Reduction: Members in some areas will remain in the Medicare plan and the plan will be discontinued in other areas. The service area may be an entire state, specific counties, or ZIP codes.
In some cases, members are crosswalked to a new plan, but, in other cases, the members will be without coverage if they do not select a new 2018 Medicare Part D or Medicare Advantage plan. Remember there is a Service Area Reduction Special Enrollment Period (SAR SEP) starting on December 8 and continuing through the end of February allowing you the possibility of enrolling in a 2018 Medicare plan after the December 7th close of the annual Open Enrollment Period.
- Terminated Plan: All members will need to choose a new Medicare plan or be without coverage in 2018.
In these situations, members
of
a Medicare Part D plan will be notified in their Annual Notice of Change
(ANOC) letter about the termination or consolidation and be given the option to
join another plan during the annual Open Enrollment Period.
If members
do not join another Medicare plan, they may find themselves
automatically moved (or crosswalked) into
another Medicare plan at the start of the next plan year, or they will be without coverage.
We will first look at stand-alone Medicare Part D plans (PDPs) and further down in this article, we will discuss Medicare Advantage plans (MAs and MAPDs).
Members of all discontinued 2017 stand-alone Medicare Part D prescription drug plans (PDPs)
are slated to be crosswalked to a new plan in 2018. This will affect
79,046 members, unless they choose a new 2018 plan. For more information, please see the chart below:
Examples of 2017 stand-alone Prescription Drug plans that are being crosswalked into other plans in 2018.
Crosswalked Stand-Alone Medicare Prescription Drug Plans (PDPs)
(with the number of plan members impacted)
|
Plan Name |
States |
Members Affected |
First Health Part D Premier Plus (PDP)
members crosswalked to First Health Part D Value Plus (PDP) |
in 28 states
|
74,172 |
Express Scripts Medicare - Choice (PDP)
members crosswalked to Express Scripts Medicare - Value (PDP) |
PR
|
125 |
WellCare Extra (PDP)
members crosswalked to WellCare Classic (PDP) |
AZ
LA
OR
WA
WI
|
4,749 |
Note: Members of the AARP MedicareRx Walgreens (PDP)
will be crosswalked to the same plan, but with a new Plan Id - and some plan members may notice the plan id change on their 2018 Member Id cards.
What about 2018 Medicare Advantage plan (MA and MAPD) mergers and terminations?
Important Points:
- 268 Medicare Advantage plans will be discontinued in 2018 without crosswalking members to other plans. These people will need to select another 2018 Medicare plan or possibly be without Medicare plan coverage through 2018.
- How many people are affected?
1,264,802 Medicare Advantage plan members in the 268 Medicare Advantage plans terminating in 2018, will find that their 2017 Medicare Advantage plan
will not be offered in 2018. And many counties across the country will see significant
changes in their Medicare Advantage plan landscape. You
can review 2018 Medicare Advantage plan changes using our MA-Compare
tool found here: MA-Compare.com/2018.
- In addition, 121,946 plan members in 38 Medicare Advantage plans will be crosswalked to a new Medicare Advantage plan in 2018. Below is a chart highlighting some of the Medicare Advantage plan "crosswalks" for 2018.
Examples of Medicare Advantage plan Reassignments |
2017 Medicare Advantage Plan |
New 2018 Medicare Advantage Plan |
State(s) |
Members Affected |
HumanaChoice Texas H6609-151 (PPO) |
HumanaChoice H5216-043 (PPO) |
Counties in TX |
41,193 |
Peoples Health Choices Platinum #009 (HMO) |
Peoples Health Choices 65 #14 (HMO) |
4 Parishes in LA |
11,467 |
WellCare Essential (HMO-POS) |
WellCare Value (HMO) |
Counties in GA |
8,296 |
Golden State Medicare Health Plan, Golden (HMO) |
Golden State Medicare Gold (HMO) |
6 Counties in CA |
8,248 |
Health Net Ruby Select (HMO) |
Allwell Medicare Essentials II (HMO) |
2 Counties in AZ |
6,180 |
Rocky Mountain Standard Plan + Rx (Cost) |
Rocky Mountain Standard Plan (Cost) |
Counties in CO |
5,566 |
Need a faster way to see if your Medicare Part D or Medicare Advantage plan is changing in 2018?
Our
PDP-Compare
and
MA-Compare
tools allow you to compare annual 2017/2018 changes in
all stand-alone Medicare Part D prescription drug plans (PDPs) or Medicare Advantage plans (MAs or MAPDs) across the country showing changes in monthly premiums and plan design changes, as well as changes in co-payments or co-insurance rates for different drug tiers along with the most recent Medicare quality Star ratings.
Both the
PDP-Compare
and
MA-Compare also show the Medicare Part D plans or Medicare Advantage plans that will be
merged,
discontinued, or
added in 2018.
Not sure where to begin with all this information?
Medicare beneficiaries can telephone Medicare at 1-800-633-4227, speak with a Medicare representative, and learn more about their 2018 Medicare Part D and Medicare Advantage plan options.