Phil called our office in a panic. He had chosen a Medicare Advantage Plan four years ago and was very happy with his plan. He had contacted his primary care physician in October and asked the staff if his doctor was going to be on the same Advantage plan network for the coming new year.
They had replied, “Yes, the doctor has been on that network for a long time”. So, Phil did nothing as his enrollment in his Advantage plan would just roll over and continue into the new year. Then a strange thing happened. He called his doctor’s office to get an appointment in February, and the appointment staff member stated that his doctor was no longer in Phil’s Advantage plan network and that Phil would have to pick a new primary care doctor that was still in his plan. Phil was dumbfounded, and was even somewhat angry, in that he had called the doctor’s office back in October just to make sure he didn’t need to switch plans to keep his doctor. Now he was stuck with a medical plan and had lost his doctor of many years.
His next call was to American Retirement Advisors, where he knew we could help him get some answers and see if there was a solution to his predicament.
“I like my plan but I’m losing my doctor,” he lamented when we met with him.
There was, of course, good news that we were able to help. There is a new Medicare enrollment period called “Open Enrollment Period” (OEP) that starts Jan 1 and ends March 31, each year. This is a new enrollment period that just went into effect for 2019. It’s exactly for folks just like Phil, who picked a plan only to find out their primary care physician wasn’t on the plan. This OEP allows a one-time switch for the new plan year.
We researched all the available Advantage plans in his geographic area and found that his primary care doctor was on three ttherAdvantage networks. One of the plans even had more appropriate co-pays for services then the plan that Phil was currently on.
“So, I get to keep my Doctor and I have lower co-pays”? Phil could not believe his good luck! If you find out that you’ve selected a new Advantage plan for the new year only to find out that your doctor that was supposed to be on the plan, is not, you get a do-over!
Don’t confuse this new OEP with the Annual Election Period (AEP) where you get to research plans and select a new plan each October 15th through December 7th. This is a completely new enrollment period that allows a one-time change if you selected the wrong plan.
So, if you have questions? Call us! We can help!