Q- What is the Medigap Free Look Period?
A- You have 30 days to decide if you want to keep the new Medigap policy. This is called your “free look period.” The 30-day free look period starts when you get your new Medigap policy. You’ll need to pay both premiums for one month.
Don’t cancel your first Medigap policy until you’ve decided to keep the second Medigap policy. On the application for the new Medigap policy, you’ll have to promise that you’ll cancel your first policy.
Q- What is the Part D late enrollment penalty ?
A- The late enrollment penalty is an amount that’s added to your Part D premium. You may owe a late enrollment penalty if at any time after your initial enrollment period is over, there’s a period of 63 or more days in a row when you don’t have Part d or other creditable prescription drug coverage.
(Ref: Medicare & You Handbook 2019 pg 77 and 78)
Q- When am I going to hit the doughnut hole?
A- The doughnut hole refers to a gap in prescription drug coverage under Medicare Part D. In 2019, once you reach $4,020 in prescription drug costs, which include both your share of covered drugs and the amount paid by your insurance, you will be in the coverage gap. In 2019, you will get a 70% discount on brand name prescription drugs. When your total out-of-pocket costs reach $6,350, you qualify for “catastrophic coverage”. At that point, you are responsible for only 5% of your prescription drug costs for the rest of the year (or $8.95 for brands and $3.60 for generics, whichever is greater). However, if you receive “Extra Help” you do not have a coverage gap.
(Ref: www.medicare.gov )
Q- What is I am losing my Health Insurance?
A- This qualifies you for a Special Enrollment Period (SEP) of 60 days to get new health insurance. If you miss that window, you will have to wait until the next year’s Open Enrollment Period (OEP).
Q- I don’t take any or just a few medications. Do I need a Medicare Prescription Drug Plan?
A- Even if you don’t take many prescriptions now, you should consider joining a Medicare drug plan. If you decide not to join a Medicare drug plan when you’re first eligible, and you don’t have other creditable prescription coverage, or you don’t get Extra Help, you will likely pay a late enrollment penalty if you join a plan later.
( Ref: Medicare & You Handbook 2019 pg 77 and 78)
Q- Can I get help with my Part D premium?
A- If you have limited income and resources, you may qualify for help to pay for some health care and prescription drug costs. Extra help, also called Low Income Subsidy, is available if your yearly income for a single person is less than $18,210 and resources less than $14,390 per year. For a married person with no dependents the income limit is $24,690 and resources less than $28,720 per year. You may apply for Extra Help at www.socialsecurity.gov keyword “Extra Help” or call your local social security office.
(Ref: Medicare & You Handbook 2019 pg 83 and www.socialsecurity.gov )
Q- If I retire, how long do I have to take Part D?
A- Don’t go 63 days or more in a row without a Medicare drug plan or other creditable coverage.
(Ref: Medicare & You Handbook pg 77 and 78)
Q- What if Healthcare.gov has me confused?
A- Call us and let us help you navigate through the process.
Q- What if I have a life changing event?
A- If you are lose employer coverage, retire, get married, have a baby, adopt a baby, have an income change, or are denied Medicaid, you will have a Special Enrollment Period to get new coverage.
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