Dear Tom and Alan:
My wife turns 65 the day before Christmas!
I’m already on Medicare and have a drug plan. I want to get ready for her getting on Medicare, but I want to make sure her medications are covered as well as they are under her present plan.
I’m also a little mixed up as to the open enrollment time for her.
Medicare.gov has been a good place to look to shop for prescription plans, but how do they compare with the government drug plans?
Tom: OK, Jeff, you’re right in our bailiwick.
All agents who intend to sell drug plans (and get paid) are now taking the AHIP required course.
AHIP stands for America’s Health Insurance Plans. I don’t know how they managed it, but AHIP is the Center for Medicare & Medicaid Services’ (CMS) “…exclusively approved vendor for Federal Marketplace Training.”
So, each year, agents complete AHIP then go to each individual insurance company to re-certify to sell their particular plans.
Al: And…speaking of too much information, there are no “government drug plans.”
Each year, the government sets a minimum standard for a “creditable” drug plan.
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Each insurance company is required to offer a plan that meets this minimum standard. Of course, they all offer plans that go beyond the minimum and set their own prices.
Essentially, the government says, “Here’s the least you can do, so you do it, but we’ll be looking over your shoulder.”
What can be confusing to people is that the monthly cost of a drug plan can range from $20.40 to $169.80.
Tom: You’re on the right track searching Medicare.gov for different companies and what they offer.
As to your question about open enrollment, it’s called the Annual Enrollment Period (AEP), and it starts Oct. 15 each year and ends on Dec. 7.
Al: However, your wife is in a very special position because her birthday is coming up and reaching age 65 brings some extra privileges.
Unless she’s still working and has good medical and prescription coverage through her job, she’ll want to go to Social Security and arrange to receive her Medicare card.
Her Medicare A and B will begin Dec. 1, the first day of her birth month.
Because she is entitled to Medicare Part A and/or enrolled in Part B, she is in a “guaranteed issue” time frame where she can sign up for any drug plan and/or any Medicare Supplement Plan.
Tom: Specifically on her drug plan, a.k.a., Medicare Part D, your wife can choose whatever she wants beginning three months before her birthday, the month of her birthday, or three months after her birthday.
So … her “open enrollment” period starts Sept. 1 this year and ends March 31 next year.
Another little kicker in all this is that if she signs up for a plan to begin Dec. 1, as most people would, she’ll have a somewhat different plan to begin 2019!