Medicare Part D Cost-Sharing
When you go to the pharmacy to pick up your prescriptions, you will pay your share of the costs. Some plans have a deductible and then there are the copays that you pay for the medication itself.
Medicare Advantage plans have lock-in periods. You can enroll in one during Initial Enrollment Period (IEP) when you first turn 65. After that, you may enroll or dis-enroll only during certain times of year. Once you enroll in Medicare Advantage, you must stay enrolled in the plan for the rest of the calendar year. You may only dis-enroll from an Advantage plan during certain times of the year unless you qualify for a Special Election Period (SEP) due to a specific circumstance.
The Annual Election Period (AEP) in the fall is the most common time to change your Medicare Advantage plan. This period runs from October 15th – December 7th each fall. Changes made to your enrollment will take effect January 1 of the next year. If you decide to leave a Medicare Advantage plan and return back to Original Medicare, you must notify your Medicare Advantage plan carrier, normal in writing. Otherwise Medicare will continue to show that you are enrolled in the Advantage plan instead of Original Medicare.
Some people join Medicare Advantage plans without doing any research about how these plans work or speaking with an agent who can advise them. Therefore they don’t know about all of these rules. They may find themselves enrolled into a plan that their doctor doesn’t accept or that doesn’t include one of their medications. This happens most often in January after a person has used the Annual Election Period to join a Medicare Advantage plan. For this reason, Congress designed the Medicare Advantage Open Enrollment Period that runs from January 1st – March 31st each year. During this period, if you’re in a Medicare Advantage Plan (with or without drug coverage), you can switch to another Medicare Advantage Plan (with or without drug coverage). You can drop your Medicare Advantage Plan and return to Original Medicare. You'll also be able to join a Medicare drug plan. During this period you cannot switch from Original Medicare to a Medicare Advantage Plan, Join a Medicare drug plan if you're in Original Medicare, or switch from one Medicare drug plan to another if you're in Original Medicare.
Unfortunately, this does not guarantee that you can return to the Medigap plan you had before. Unless this was your first time ever in a Medicare Advantage plan, then you will usually have to answer health questions and go through medical underwriting to get re-approved for Medigap. Consider this before dropping any Medigap plan to go to Medicare Advantage.