Q1Group 2017 PDP Analysis: Is your 2016 Medicare Part D prescription drug plan or Medicare Advantage plan still being offered in 2017?
Each plan year, Medicare Part D and Medicare Advantage plans have the option of not renewing their Medicare contract and their Medicare plans can be discontinued across the country or in a specific service area (state or ZIP code).
This means that, if a 2016 Medicare plan provider does not offer any alternative plans for their existing members - then the 2016 members of the discontinued Medicare plan must find a new Medicare Part D or Medicare Advantage plan - or be without 2017 Medicare Part D or Medicare Advantage plan coverage.
The following chart shows examples of 2016 stand-alone
Medicare Part D prescription drug plans (PDPs) that will no longer be available in
2017, along with the number of people who will be affected:
Discontinued 2016 Stand-Alone Prescription Drug Plans
with Membership
|
Plan Name |
States |
Members Affected |
Advantage-Plus Meridian (PDP) |
IL IN KY MI OH |
2288 |
SilverSelect Rx (PDP) |
AR |
323 |
SmartSaver Rx PDP Value (PDP) |
NY |
1,057 |
Transamerica MedicareRx Classic (PDP) |
all states |
6,686 |
What if your 2016 Medicare Part D plan or Medicare
Advantage plan is not offered in 2017?
If your Medicare Advantage plan or Medicare Part D plan is discontinued in 2017,
you may choose to join a new Medicare Advantage plan or Medicare Part D plan
during the
annual Open Enrollment Period.
However, if you do not enroll in a new Medicare Advantage
plan or Medicare Part D plan by December 7th, you will be provided a Special
Enrollment Period to join a 2017 Medicare plan from December 8, 2016 through
February 28, 2017 (also called the Service Area Reduction Special Enrollment Period or
SAR SEP).
Remember, if your current Medicare plan was discontinued in 2017, your 2016 Medicare prescription drug coverage ended on December 31, 2016.
Remember that coverage begins on the first day of the month following enrollment.
If you waited until January to enroll in a 2017 plan, your new prescription drug coverage
will take effect on February 1st, so you will have no prescription drug
coverage for the month of January. And it continues that if you wait until
February to enroll in a 2017 plan, your coverage will take effect on March 1st,
so you will have no prescription drug coverage for January or February, 2017.
Our
PDP-Compare
and
MA-Compare
tools show the 2016 stand-alone Medicare Part D prescription drug plans (PDPs) and Medicare
Advantage plans (MAs or MAPDs) across the country that will be
merged,
discontinued, or
added in 2017.
How
many people are affected by having their 2016 Medicare plan discontinued?
Around 350,000 Medicare beneficiaries. Each plan year, Medicare
Part D and Medicare Advantage plans have the option of not renewing their Medicare
contract and their Medicare plans can be discontinued across the country or in a
specific service area (state or ZIP code). Again, this means that these 2016 members of the discontinued Medicare
plan must find a new Medicare Part D or Medicare Advantage plan - or be without
2017 Medicare Part D or Medicare Advantage plan coverage – and may be liable
for a
late-enrollment
penalty.
So how
do I join a Medicare plan using the SAR SEP?
Call Medicare at 1-800-633-4227. If your Medicare plan was
discontinued at the end of 2016, you can call a Medicare representative
before the end of February 2017 and join a 2017 Medicare
Part D and Medicare Advantage plans.
A few notes on Medicare plan that are being merged into another Medicare plan.
Each year, Medicare plans can consolidate multiple plans (meaning two
Medicare Part D plans 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. In these situations, members of
a Medicare Part D plan will be notified in their Annual Notice of Change
(ANOC) letter about the merger or consolidation and given the option to
join another plan during the annual Open Enrollment Period. If people
do not join another Medicare plan, they may find themselves
automatically moved (or cross-walked) into
another Medicare plan at the start of the next plan year.
Examples of 2016 stand-alone Prescription Drug plans that are being merged (cross-walked) into other plans in 2017.
Crosswalked Stand-Alone Prescription Drug Plans
(with the number of plan members impacted by the merger or consolidation)
|
Plan Name |
States |
Members Affected |
EnvisionRx Plus Clear Choice (PDP) members crosswalked to EnvisionRxPlus (PDP) |
PA
OR
MI
RI
SC and a few other states |
49,052 |
United American - Essential and Select (PDPs) members crosswalked to SilverScript Choice (PDP) |
all states |
114,741 |
First United American - Enhanced, Select, and Essential (PDP) crosswalked to SilverScript Plus (PDP) |
NY |
7,117 |
What about 2017 Medicare Advantage plan (MA and MAPD) mergers and terminations?
A large number of Medicare Advantage plan members will find that their
2016 Medicare Advantage plan will not be offered in 2017. And many
counties across the country will see significant changes in their
Medicare Advantage plan landscape. You
can review 2017 Medicare Advantage plan changes using our MA-Compare
tool found here:
MA-Compare.com/2017.
To read more about 2016 Medicare plan mergers and consolidation, please see out Blog "
Are you being reassigned to another Medicare Part D plan in 2017?"
Q1News.com/605