Is your 2018 Medicare Part D prescription drug plan or Medicare Advantage plan still being offered in 2019?
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 2019) unless they enroll in a different 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) 2018 Medicare plan may be due to a:
How many 2018 plan members will be affected?
- 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 will be automatically crosswalked to a new 2019 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 2019 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 2019 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 2019.
- One Million members being crosswalked to a new Medicare plan: Approximately 800,000 members in non-renewing 2018 stand-alone Medicare prescription drug plans and an additional 200,000 members in non-renewing Medicare Advantage plans will be automatically "crosswalked" to new 2019 Medicare plans.
- Over 1.5 Million members loosing their coverage if they do not select a new Medicare plan: Approximately 1.44 million members are currently enrolled in 2018 Medicare Advantage plans that will be terminated in 2019. These members will NOT be crosswalked and will be without 2019 coverage if they do not actively enroll in a new Medicare Advantage plan. An additional 87,000 stand-alone Medicare prescription drug plan members also need to actively select a new 2019 Medicare plans.
In these situations, members
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.
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).
Stand-alone Medicare Part D plans (PDP) Important Points:
Examples of 2018 stand-alone Prescription Drug plans that are being either crosswalked into other plans in 2018.
- 21 Medicare Part D Prescription Drug plans will be discontinued in 2019 without crosswalking members to other plans. These people will need to select another 2019 Medicare plan or possibly be without Medicare plan coverage through 2019.
- How many people are affected?
87,874 members in the 21 PDPs terminating in 2019, will find that their 2018 plan will not be offered in 2019. You can review 2019 Medicare Prescription Drug only plan changes using our PDP-Compare tool found here: PDP-Compare.com/2019.
- In addition, 836,614 plan members in 57 Medicare Advantage plans will be crosswalked to a new PDP in 2019. Below is a chart highlighting some of the stand-alone Medicare Prescription Drug plan "crosswalks" for 2019.
|Crosswalked Stand-Alone Medicare Prescription Drug Plans (PDPs)
(with the number of plan members impacted)
|Symphonix Value Rx (PDP) members crosswalked to AARP MedicareRx Saver Plus (PDP)
in all states
|First Health Part D Premier Plus (PDP) members crosswalked to Aetna Medicare Rx Value Plus (PDP)
in 23 states
|Blue MedicareRx Premier (PDP)
members crosswalked to Blue MedicareRx Standard (PDP)
||in 12 states
|Anthem Blue Cross MedicareRx Gold (PDP)
members crosswalked to Anthem Blue Cross MedicareRx Standard (PDP)
What about 2018 Medicare Advantage plan (MA and MAPD) mergers and terminations?
|Discontinued Stand-Alone Medicare Prescription Drug Plans (PDPs)
Members must select a new prescription drug plan
|Magellan Rx Medicare Basic (PDP)
in all states
|Educators Rx Advantage (PDP) & Educators Rx Basic (PDP)
|Senior Care Plus: Medicare Rx Standard (PDP)
|TakeCare RX Plus (PDP)
- 324 Medicare Advantage plans will be discontinued in 2019 without crosswalking members to other plans. These people will need to select another 2019 Medicare plan or possibly be without Medicare plan coverage through 2019.
- How many people are affected?
1,440,088 Medicare Advantage plan members in the 324 Medicare Advantage plans terminating in 2019, will find that their 2018 Medicare Advantage plan
will not be offered in 2019. And many counties across the country will see significant
changes in their Medicare Advantage plan landscape. You
can review 2019 Medicare Advantage plan changes using our MA-Compare
tool found here: MA-Compare.com/2019.
- In addition, 200,230 plan members in 67 Medicare Advantage plans will be crosswalked to a new Medicare Advantage plan in 2019. Below is a chart highlighting some of the Medicare Advantage plan "crosswalks" for 2019.
Need a faster way to see if your Medicare Part D or Medicare Advantage plan is changing in 2019?
|Examples of Medicare Advantage plan Reassignments
|2018 Medicare Advantage Plan
||New 2019 Medicare Advantage Plan
|Senior Dimensions Southern Nevada (HMO)
|UnitedHealthcare Medicare Focus (HMO) H0609-032
||2 Counties in NV
|MMM - Elite Ultra (HMO-POS)
||MMM Elite (HMO-POS) H4003-034
||Counties in PR
|AARP MedicareComplete SecureHorizons Plan 1 (HMO)
||AARP MedicareComplete SecureHorizons Plan 2 (HMO) H0543-144
||4 Counties in CA
|UCare for Seniors Value Plus (HMO-POS)
||UCare Classic (HMO-POS) H2459-021
||Counties in MN
|WellCare Choice (HMO-POS)
||WellCare Choice (HMO) H4868-012
||5 Counties in NY
|Cigna-HealthSpring Preferred SMS (HMO)
||Cigna-HealthSpring Preferred (HMO) H4407-026
||Counties in MS
|WellCare Dividend (HMO)
||WellCare Value (HMO-POS) H0174-005
||11 Counties in TX
tools allow you to compare annual 2018/2019 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
also show the Medicare Part D plans or Medicare Advantage plans that will be merged
, or added
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 2019 Medicare Part D and Medicare Advantage plan options.