Medicare Advantage plans (MAPD) have different service areas available to those who live within that area. Service areas are typically based on geographic regions, such as counties or states, depending on the plan. If you have clients that are moving to an area outside their current MAPD service area, you should inform them about the three coverage options changes they can make when they move:
1. Move to a new Medicare Advantage Prescription Drug Plan (MAPD)
2. Return to Original Medicare and add a Drug Plan (PDP)
3. Return to Original Medicare and add a Drug Plan (PDP) and a Medicare Supplement.
Move to a New Medicare Advantage Plan
If a beneficiary is moving outside of their plan’s service area, they’ll need to enroll in a new Medicare Advantage plan. You can help a Medicare beneficiary research plans in their area by identifying their healthcare needs, researching plans, comparing costs and benefits, and explaining the enrollment process. This involves using online resources to search for plans, comparing premiums, deductibles, copayments, and out-of-pocket maximums, and explaining the benefits and costs associated with each plan. You can also assist with enrollment by completing the enrollment application and providing necessary documentation.
Return to Original Medicare and add a Drug Plan.
If a beneficiary is moving outside of their plan’s service area and doesn’t want to enroll in a new Medicare Advantage plan, they can return to Original Medicare. Beneficiaries can enroll in a Medicare Part D prescription drug plan to supplement their coverage. As an agent you should educate beneficiaries on the requirements for prescription drug plan coverage and assist them in finding a plan that fits their need as well as help them enroll.
Return to Original Medicare and add a Drug Plan and a Medicare Supplement
A beneficiary will be eligible for guaranteed issue into a Medicare Supplement Plan when moving out of their current MAPD plan service area. They will have Guaranteed Issue rights to enroll in a Medicare Supplement plan without medical underwriting for 63 days after they move out of their current plan service area. The rules for Guaranteed Issue into a Medicare Supplement can vary and the plan depends on when they turned 65. People who turned 65 prior to January 1, 2020, can choose Plan F as their Guaranteed Issue choice while people who turned 65 after January 1, 2020 can choose Plan G since Plan F is not available for them.
Conclusion
In conclusion, moving with a Medicare Advantage plan can be a complicated process, but there are steps beneficiaries can take to ensure they have uninterrupted coverage. As a Medicare agent, it’s your responsibility to help beneficiaries understand their options and make informed decisions about their healthcare coverage. By providing them with the information and guidance they need, you can help make the transition as smooth as possible.
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