Medicare Advantage Open Enrollment Offers One-Time Chance to Change Your Mind: Allsup Outlines Rules for Switching Plans

January through March, open enrollment helps Medicare recipients make sure
they`ve made the right choice
BELLEVILLE, Ill.--(Business Wire)--
Although annual Medicare enrollment has ended, some Medicare Advantage
beneficiaries can still switch their coverage during the current Medicare open
enrollment period. That information comes from Allsup, a leading provider of
Social Security disability, financial and healthcare-related services to people
with disabilities.

"Most people think the Medicare Advantage choice they make during annual
enrollment, which runs Nov. 15 to Dec. 31, is written in stone for the next
year," said Paul Gada, personal financial planning director and product manager
for Allsup Medicare AdvisorSM. "But under certain circumstances, beneficiaries
can change their plan by March 31, and they should take advantage of this if
they don`t think the plan they have is going to best fit their needs." The
Allsup Medicare Advisor service helps people with disabilities choose the best,
most affordable Medicare plan to meet their specific needs.

During the open enrollment period, Jan. 1 through March 31, some individuals
have an opportunity to switch plans, but there are limitations. Specifically,
they must continue to keep prescription drug coverage if they had it as of Dec.
31. Or, if they did not have prescription drug coverage as of Dec. 31, they
cannot add it to their plan.

For example, someone could switch from a traditional Medicare plan with Part D
(prescription drug) coverage to a Medicare Advantage plan with prescription drug
coverage included, but cannot switch from a Medicare Advantage plan with
prescription drug coverage to a traditional Medicare plan without also adding
Part D coverage. Additionally, while individuals can switch from one Medicare
Advantage plan to another, so long as both either cover or do not cover
prescription drugs, they cannot switch from one Part D plan to another. (See
chartfor an outline of scenarios.)

"If you have second thoughts, your financial situation has changed or your
health needs have changed, open enrollment gives you a chance to make changes to
help improve your situation," said Gada.

For example, Gada explained, an individual with Medicare Part D coverage who has
been prescribed a costly medication may want to consider finding a Medicare
Advantage plan with prescription drug coverage that provides benefits during the
gap. For 2009, the gap in Medicare Part D prescription drug coverage occurs once
a Medicare beneficiary`s prescription drugs, including what the plan pays and
the patient`s own deductibles and co-pays, has reached $2,700. The individual
then is responsible for paying the next $3,453.75 himself or herself.

Eligible individuals also may want to consider switching plans because of the
cost. In addition to the premium, traditional Medicare requires an individual to
pay 20 percent of the Medicare-approved amount out of their own pocket, while
Medicare Advantage plans tend to have lower, flat-fee co-pays or none, depending
upon the plan; Medicare Advantage plans also tend to offer lower costs for
prescription drug coverage.

Overall coverage is another factor, particularly for individuals with
disabilities. Because of limited coverage under traditional Medicare, many
individuals buy Medigap supplemental coverage; however, this may preclude
individuals from filing claims related to pre-existing conditions during the
six-month waiting period. Medicare Advantage plans are required to cover
pre-existing conditions.

After Open Enrollment, Switching Options Are Limited

Between the end of open enrollment on March 31 and the start of the next annual
enrollment in November, individuals can join or change their plans for only a
few specific reasons. These include:

* Disability - individuals can join a plan three months before or three months
after their 25th month of disability as determined by the Social Security
Administration.
* Turning 65 - three months before or after the month that beneficiaries turn
65, they can enroll in a new plan.
* Moving out of the plan`s service area - people moving permanently out of their
plan`s service area are allowed to switch plans at anytime during the year.
* Nursing home residents - a person that moves into, lives in or is leaving a
nursing home can enroll in a new plan at anytime during the year.
* Fraud - if a person learns they were enrolled in a plan without their
knowledge, they can contact their state health insurance program (SHIP) at
anytime during the year for assistance in switching plans.
* Recipients receiving "extra help" can switch plans as needed to ensure they
are getting the most cost-effective, appropriate coverage possible. People who
get extra help include those with income and assets under a certain threshold
(Low-Income Subsidy/LIS), those who are eligible for Medicare and Medicaid
(dual-eligible) and people receiving Supplemental Security Income (SSI)
benefits.

About Allsup

Allsup, Belleville, Ill., is a leading nationwide provider of financial and
healthcare-related services to people with disabilities. Founded in 1984, Allsup
has helped more than 110,000 people receive their entitled Social Security
Disability Insurance and Medicare benefits. Allsup employs more than 550
professionals who deliver services directly to consumers and their families, or
through their employers and long-term disability insurance carriers.

The Allsup Medicare Advisor service provides customized, objective support to
help individuals with disabilities navigate the complexities of Medicare and
Medicare Advantage programs, analyze the best plan coverage and provider options
based on individual preferences, better understand healthcare cost information,
and simplify the confusing process of enrolling in a Medicare Advantage plan.

For more information, visit www.Allsup.com.

The information provided is not intended as a substitute for legal or other
professional services. Legal or other expert assistance should be sought before
making any decision that may affect your situation.

Allsup
Mary Jung, (773) 429-0940, mtjung@msn.com
or
Dan Allsup, (800) 854-1418 ext 5760, djallsup@allsupinc.com

Copyright Business Wire 2009