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Use Caution When Reviewing Prescription Drug Benefits and Medicare Choices

Use Caution When Reviewing Prescription Drug Benefits and Medicare Choices

Each year, the Medicare Annual Enrollment Period, beginning on October 15 and ending on December 7, (also known as AEP), gives participants an opportunity change their Medicare benefits. This period is a good time to think about current and future needs. It's also a good time to consider new choices.

Participants may receive information in the mail from private companies that sponsor Medicare Advantage Plans (Medicare Part C) and Medicare Prescription Drug Plans (Medicare Part D) in the weeks leading up to open enrollment. Television, radio and online advertisements will also be common. Although new information can be helpful, it can also be overwhelming and confusing.

A common mistake with big consequences

Each person has to decide which options for receiving Medicare benefits best fit specific needs. But, there is one common mistake that people make that can have big consequences- buying a stand-alone Medicare Prescription Drug Plan when they already have prescription drug coverage, or access to it through their Medicare Advantage Plan.

Many Medicare Advantage plans are Medicare Advantage-Prescription Drug (MA-PD) plans. MA-PD plans include both medical and prescription drug coverage, and these plans have a pharmacy network for filling prescriptions.

What happens if you are in an MA-PD plan and by mistake also enroll in a stand-alone Medicare Part D plan?

Companies that sponsor stand-alone Medicare Prescription Drug Plans (PDPs) also work closely with Medicare and Social Security. When a company enrolls a participant in a PDP, the participant is automatically removed from his or her existing plan that has prescription drug coverage. This is intended to make sure no one is covered by and paying for more than one plan at one time.

This can result in someone with an existing MA-PD plan being "un-enrolled" or "voided" from the entire Medicare Advantage-Prescription Drug plan. Once a participant is no longer enrolled in his or her Medicare Advantage plan, that participant is thought to be receiving hospital and medical coverage benefits through Original Medicare. If that was not your plan, you may be in for some additional or unexpected changes in your coverage and in your out-of-pocket expenses.

If you are enrolled in a Medicare Advantage-Prescription Drug Plan, DO NOT buy a stand-alone Medicare Part D plan unless you want to switch to Original Medicare. It can be difficult to correct this mistake until the following year's open enrollment period.

Learning as much as possible is one way to avoid mistakes

Learn which Anthem plans are available in your area and compare your options. Anthem has online tools to help you decide the best medical coverage plan and prescription drug plans for your needs and your budget.

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