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Top ten questions about enrolling in a 2024 Medicare Part D plan, Medicare Advantage plan, or Medicare Supplement.

Category: Enrollment Topics
Published: Nov, 07 2023 03:11:19

(1) Question:  How do I change my Medicare Part D or Medicare Advantage plan?

You simply enroll in your selected 2024 Medicare plan. Your current 2023 Medicare plan will be automatically notified about your plan change. As noted in the last Newsletter, you can enroll into a 2024 Medicare Part D or Medicare Advantage plan by: (1) calling a Medicare representative at 1-800-Medicare, (2) visiting the Medicare.gov website, (3) contacting a local SHIP volunteer, (4) working with a local insurance agent representing your chosen plan, or (5) telephoning a Medicare plan Member Services or Customer Services representative.

(2) Question:  Can I join a Medicare drug plan if I have VA drug coverage?

Yes. If you currently receive your prescription drug coverage through the Veterans Administration (VA), you have the option to also join a stand-alone Medicare prescription drug plan (PDP) or Medicare Advantage plan with drug coverage (MAPD).

You can then use either your VA drug benefit or Medicare drug coverage to purchase your medications – whichever is more economical or convenient. However, you cannot use your VA drug benefit together with your Medicare drug plan to pay for the same prescription. You can read more in our Frequently Asked Question (FAQ) about VA benefits and Part D coverage.

(3) Question:  Can I join a stand-alone Medicare Part D prescription drug plan if I have employer coverage?

Probably not.
 Most people cannot enroll in both an employer health plan that includes prescription coverage and a separate Medicare Part D prescription drug plan. If you have prescription coverage through your employer health plan, and you enroll in a Medicare Part D plan ( PDP), you risk losing your employer health coverage. You can click here to read more.

Important:  Ask before enrolling. Before enrolling in a Medicare prescription drug plan, be sure to contact your employer health plan administrator for further information or you may be without 2024 healthcare coverage. You can click here to see more FAQs about Medicare plans and your employer coverage.

(4) Question:  Can I join a stand-alone Medicare Part D drug plan if I have a Medicare Advantage (MA) plan that does not have drug coverage?

Yes, but only if . . .
 You can add separate Medicare rug coverage to a Medicare Advantage plan – but only if you have a Medicare Advantage Private-Fee-For-Service ( PFFS) plan that does not include prescription coverage, a Cost plan, or a Medicare Medical Savings Account ( MSA) plan. Remember, there are only a limited number of 2024 Medicare Advantage PFFS plans, Cost plans, and MSA plans available.

Important: You cannot add a separate Medicare prescription drug plan if you have a Medicare Advantage HMO or PPO plan that does not provide drug coverage ( MA). In fact, enrolling in a “stand-alone” Medicare Part D drug plan ( PDP), when you are already enrolled in an HMO or PPO, will automatically disenroll you from your Medicare Advantage HMO or PPO plan.  You can click here to read more.

(5) Question:  Can anyone enroll in a Medicare Advantage Special Needs Plan?

No. Medicare Advantage Special Needs Plans (SNPs) are designed to provide a balance of benefits that meet the needs of a particular group of Medicare beneficiaries – such as people who are institutionalized (I-SNP) or have limited financial resources (dually eligible Medicare/Medicaid, D-SNP) or have a specific chronic condition (like diabetes or heart disease, C-SNP). If you wish to join a SNP, you will be required to show evidence that you meet the eligibility requirements of the plan – such as economic need or a specific chronic condition.

(6) Question:  Can I join any Medicare drug plan if I qualify for the Medicare Part D Low-Income Subsidy?

Yes. If you qualify for the Medicare Part D Low-Income Subsidy (LIS) or Extra Help program, you can join any Medicare Part D or Medicare Advantage plan in your Service Area (state or ZIP code area).

However, you will only qualify for the $0 monthly premium if your Medicare drug plan qualifies for your state’s $0 LIS Benchmark premiumunless, you enroll into a Medicare Part D plan or Medicare Advantage plan that already offers a $0 premium – such as the 2024 Florida WellCare Value Script plan or the 2024 AARP Medicare Advantage (HMO-POS) plan found in Los Angeles.

(7) Question:  Can I join a stand-alone Medicare Part D drug plan if I have a Medicare Supplement?

Yes. You can enroll in a Medicare Supplement and join a separate Medicare Part D plan (PDP). You can click here to read more about adding a PDP to a Medicare Supplement plan. And you can click here to review the stand-alone Medicare Part D plan options in your area.

(8) Question:  Can I join a Medicare Advantage (MA or MAPD) plan if I have a Medicare Supplement?

Surprisingly, yes. But you can no longer use your Medicare Supplement when you join a Medicare Advantage plan. Although you are permitted to join a Medicare Advantage plan when already enrolled in a Medicare Supplement, your Medicare Supplement will no longer provide any healthcare coverage benefits.  Click here to read more…

(9) Question:  Can anyone who is Medicare eligible join a Medicare Supplement?

Yes – when you are initially eligible for Medicare (turn 65). 
Although Medicare Supplement rules vary by state, in general you will have a “guaranteed issue” right to join any Medicare Supplement when you first become eligible for Medicare. After your 6-month Medigap Open Enrollment Period, you may be subject to medical underwriting, pay a higher premium, or be denied coverage.

Important: Some states have more generous enrollment rules allowing people to join or change Medigap policies outside of their initial Open Enrollment Period and still have a guaranteed issue right. For more information, you can contact a local insurance agent or SHIP volunteer and ask about your rights to join a Medicare Supplement. You can click here for an overview of the benefits offered by different Medigap policies.

A note to under-65 Medicare beneficiaries: If you are an under-65 Medicare beneficiary due to a disability or ESRD, your right to join a Medicare Supplement will depend on the state where you live. The Centers for Medicare and Medicaid Services (CMS) currently shows 33 states giving under-65 Medicare beneficiaries the right to join at least one type of Medigap policy – with insurance companies in other states voluntarily allowing Medicare beneficiaries under 65 to join their Medicare Supplement plans. However, no matter where you live, once you turn 65, you can participate in the Medigap Open Enrollment Period and have the same guaranteed-issue right to join any Medigap policy available within your state.

(10) Question:  Are there many differences between a Medicare Supplement and a Medicare Advantage plan?

Yes. A few key differences are:

What the plan covers
A Medicare Supplement (Medigap policy) works with your Original Medicare Part A and Medicare Part B – filling “gaps” in Medicare coverage. A Medicare Advantage plan administers your Medicare Part A and Medicare Part B benefits and must provide coverage that is at least as good as Original Medicare – may include prescription drug coverage and also offer additional health-related and non-health-related supplemental benefits.

Term of Coverage
A Medicare Supplement continues unchanged from year-to-year and may raise premiums over time. A Medicare Advantage plan is only for a single calendar year and can change coverage features and premiums each year. Medicare Advantage plan members will be automatically re-enrolled each year unless they actively choose another plan or the plan does not renew its contract with Medicare.

Guaranteed Issue and Renewal Rights
After your 6-month initial Medigap Open Enrollment Period with guaranteed issue rights, you can enroll in a Medicare Supplement at any time, but depending on your state, you may be subject to medical underwriting, pay a higher premium, or have your Medigap enrollment denied based on your health.

Medicare Advantage plans are always guaranteed issue without any health questions – with the exception that, as noted above, chronic illness Special Needs Plans (C-SNPs) can confirm your health-related condition with an enrollment question such as: “Do you have one of the following conditions: Cardiovascular Disorder, Diabetes, Chronic Heart Failure?”

Healthcare Provider Access
Medicare Supplements do not have a fixed network of healthcare providers and in most cases, plan members can visit any healthcare provider that participates in Medicare. Medigap policies are very portable for domestic travelers – and may include some coverage for international travel. Medicare Advantage plans often have a fixed network of doctors and hospitals with higher costs and possible restrictions for people who are seeking benefits outside of a plan’s healthcare network.

Click here for more examples of how Medicare Advantage plans differ from Medicare Supplements.

Related Article: Example of choosing between a Medicare Advantage plan and a Medicare Supplement.

Bottom Line: Do not confuse Medicare Advantage plans with Medicare Supplements. When in doubt, telephone a Medicare representative at 1-800-633-4227 or contact a local SHIP volunteer for assistance.

Tips & Disclaimers
  • Q1Medicare®, Q1Rx®, and Q1Group® are registered Service Marks of Q1Group LLC and may not be used in any advertising, publicity, or for commercial purposes without the express authorization of Q1Group.
  • The Medicare Advantage and Medicare Part D prescription drug plan data on our site comes directly from Medicare and is subject to change.
  • Medicare has neither reviewed nor endorsed the information on our site.
  • We provide our Q1Medicare.com site for educational purposes and strive to present unbiased and accurate information. However, Q1Medicare is not intended as a substitute for your lawyer, doctor, healthcare provider, financial advisor, or pharmacist. For more information on your Medicare coverage, please be sure to seek legal, medical, pharmaceutical, or financial advice from a licensed professional or telephone Medicare at 1-800-633-4227.
  • We are an independent education, research, and technology company. We are not affiliated with any Medicare plan, plan carrier, healthcare provider, or insurance company. We are not compensated for Medicare plan enrollments. We do not sell leads or share your personal information.
  • Benefits, formulary, pharmacy network, provider network, premium and/or co-payments/co-insurance may change on January 1 of each year. Our PDPCompare.com and MACompare.com provide highlights of annual plan benefit changes.
  • The benefit information provided is a brief summary, not a complete description of benefits. For more information contact the plan.
  • Limitations, copayments, and restrictions may apply.
  • We make every effort to show all available Medicare Part D or Medicare Advantage plans in your service area. However, since our data is provided by Medicare, it is possible that this may not be a complete listing of plans available in your service area. For a complete listing please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov.
    Statement required by Medicare:
    "We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options."
  • When enrolling in a Medicare Advantage plan, you must continue to pay your Medicare Part B premium.
  • Medicare beneficiaries with higher incomes may be required to pay both a Medicare Part B and Medicare Part D Income Related Monthly Adjustment Amount (IRMAA). Read more on IRMAA.
  • Medicare Advantage plans that include prescription drug coverage (MAPDs) are considered Medicare Part D plans and members with higher incomes may be subject to the Medicare Part D Income Related Monthly Adjustment Amount (IRMAA), just as members in stand-alone Part D plans. In certain situations, you can appeal IRMAA.
  • You must be enrolled in both Medicare Part A and Part B to enroll in a Medicare Advantage plan. Members may enroll in a Medicare Advantage plan only during specific times of the year. Contact the Medicare plan for more information.
  • If you are enrolled in a Medicare plan with Part D prescription drug coverage, you may be eligible for financial Extra Help to assist with the payment of your prescription drug premiums and drug purchases. To see if you qualify for Extra Help, call: 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048, 24 hours a day/ 7 days a week or consult www.medicare.gov; the Social Security Office at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY users should call, 1-800-325-0778; or your state Medicaid Office.
  • Medicare evaluates plans based on a 5-Star rating system. Star Ratings are calculated each year and may change from one year to the next.
  • A Medicare Advantage Private Fee-for-Service plan (PFFS) is not a Medicare supplement plan. Providers who do not contract with the plan are not required to see you except in an emergency.
  • Disclaimer for Institutional Special Needs Plan (SNP): This plan is available to anyone with Medicare who meets the Skilled Nursing Facility (SNF) level of care and resides in a nursing home.
  • Disclaimer for Dual Eligible (Medicare/Medicaid) Special Needs Plan (SNP): This plan is available to anyone who has both Medical Assistance from the State and Medicare. Premiums, co-pays, co-insurance, and deductibles may vary based on the level of Extra Help you receive. Please contact the plan for further details.
  • Disclaimer for Chronic Condition Special Needs Plan (SNP): This plan is available to anyone with Medicare who has been diagnosed with the plan specific Chronic Condition.
  • Medicare MSA Plans combine a high deductible Medicare Advantage Plan and a trust or custodial savings account (as defined and/or approved by the IRS). The plan deposits money from Medicare into the account. You can use this money to pay for your health care costs, but only Medicare-covered expenses count toward your deductible. The amount deposited is usually less than your deductible amount, so you generally have to pay out-of-pocket before your coverage begins.
  • Medicare MSA Plans do not cover prescription drugs. If you join a Medicare MSA Plan, you can also join any separate (stand-alone) Medicare Part D prescription drug plan
  • There are additional restrictions to join an MSA plan, and enrollment is generally for a full calendar year unless you meet certain exceptions. Those who disenroll during the calendar year will owe a portion of the account deposit back to the plan. Contact the plan provider for additional information.
  • Medicare beneficiaries may enroll through the CMS Medicare Online Enrollment Center located at www.medicare.gov.
  • Medicare beneficiaries can file a complaint with the Centers for Medicare & Medicaid Services by calling 1-800-MEDICARE 24 hours a day/7 days or using the medicare.gov site. Beneficiaries can appoint a representative by submitting CMS Form-1696.