Senior Life Matters

Question: Is it too late to change my drug plan? I know the date is December 7th, and that is Friday of this week, but is it too late? What do I do if I missed that?

Question: Is it too late to change my drug plan? I know the date is December 7th, and that is Friday of this week, but is it too late? What do I do if I missed that?


Answer: The media coverage for the Annual Open Enrollment Period (AEP) of October 15thto December 7this intensive. It is hard to imagine missing all the ads and the mail that you get from the companies, wanting you to take their product over the others available.  I know that some of you have not done anything yet. I know that because the Senior Life Matters phones are still ringing.

You have until midnight 12-7-18 to make your insurance change! Whether you make your change on October 15that 11am or on December 7th at 11PM, your coverage begins 1-1-19.

If you have already made a choice and now have changed your mind, you can do a NEW enrollment. The last enrollment you do before 12-7-18 is the plan enrollment that you will have. I never recommend waiting until the last day, but sometimes our situations fall in such a manner that you can’t help waiting until the last day.

Even if you do your enrollment choice at the last minute, you should still get your information prior to 1-1-19. If haven’t heard from the new company, or you need to fill a prescription in January before you get your ID card, you can call the company you chose and see if they have you on file yet. If you call your new 2019 company and they give you your ID #’s, you can take this information to your pharmacist and he/she can fill your prescriptions using your new plan.

If they do not have you in the system yet, you may need to fill the prescription anyway, pay full price and then file a claim with the company to get back any money you are due.

Most people complete their enrollment through the Center for Medicare & Medicaid Services (CMS). These people use the website or the 1-800-medicare phone number to facilitate their enrollment (1-800-633-4227). This means that Medicare is collecting the enrollment, but sending it on to the insurance company to process. This communication takes time. Yes, computers are fast, but there are many thousands of Medicare recipients making these changes right now.

Medicare will then communicate the disenrollment to your 2018 insurance plan. It may take them a while to get this information to take you out of their computers. You may continue to get information from your old company for a number of months, which you can ignore. You usually do NOT need to contact your old plan and dis-enroll. In fact you shouldn’t contact most plans to dis-enroll, Medicare does that for you. There are some exceptions to that rule. Two exceptions to that rule are if you have a PFFS plan, or a Medicare Supplement Plan (Medigap). These plans are NOT tied to your Prescription Drug plan. If you have one of these plans and wish to change your coverage you must write a letter to cancel those types of insurance, in addition to joining a new plan.

Do NOT use your old (2018) insurance cards after January 1, 2019. If you do this, the old company will then come back to your pharmacy for the money it paid on your behalf. Then your pharmacists will have to contact you to get your new information and re-bill the correct plan. This makes extra work for the pharmacists (who have enough work already!). This also really confuses the insurance companies about your actual intentions. Did you mean to switch plans for the new year? Do you want to stay with your 2018 plan? So switch out your old insurance cards with the new insurance cards so they are not in your wallet to use by mistake after 1-1-19.

As with any change we need to make, I do not recommend procrastinating until the last moment. You may also have special enrollment periods open to you to make a switch later on in 2018 & 2019. There are Special Enrollment Periods (SEP) available to use throughout the year, but be sure your choice is the best you can make with the information you have available to you.

The ideal time to make a new choice if you do not get it done by the 12-7-18 Annual Enrollment Period deadline & you have an SEP to use, would be to make your choice by the end of December. If you enroll in a new plan by 12-31-18, your new coverage would begin 1-1-19, so there would be no gap in coverage at all. So some of you may have some extra time.

An SEP that we can commonly use once each year is if ‘you are enrolled in EPIC’. EPIC is the New York State Pharmacy Assistance Product that gives you extra coverage for your Prescription Drugs. This SEP can be used later in December or anytime during 2019. I will be writing another article soon on Special Enrollment Periods.

Happy Insurance Season to all and to all Good Health!

To contact Janell Sluga, GCMC with questions or concerns, please call 716-720-9797 or e-mail her at