
- Switch from Original Medicare (Medicare Parts A and B) to Medicare Advantage (Medicare Part C)
- Switch from a Medicare Advantage plan back to Original Medicare
- Switch from one Medicare Advantage plan to another. This might involve switching from a plan without Medicare Part D prescription drug coverage to one that has it, or vice-versa
- Make changes to your Medicare Part D prescription drug plan, like joining a Part D plan, switching from one Part D plan to another, or dropping a Part D plan altogether
Enrollment changes take effect on January 1. The Open Enrollment Period is important because once it closes, you cannot make any changes to your plan until the following year.
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What are my new co-pays? Some plans have a co-pay for chiropractic that may be higher than the charge for theservice itself. These excessive co-pays effectively eliminate the chiropractic benefit.
- What limits are there on access to care? Managed care plans attempt to lower costs by limiting access and fees paid to providers. Will you be able to continue to seek care from your current chiropractic physician when you feel you need to? Will you need a referral? Can you go to an out-of-network provider, and, if so, at what cost?
- Are there added costs? While the marketers of these new plans will emphasize areas where you can save, there may be hidden costs. The plan could include higher deductibles and/or co-pays for “specialty” services, out-of-network providers, non-covered diagnostic tests, second opinions, etc. And, you may find that if you go outside the managed care network, you may be responsible for all costs.
- What are the plan’s special rules? Is there an appeal process? All plans will have rules and procedures that must be followed. You need to understand these rules and learn how potential coverage and payment disputes will be handled.
- Will you have control over your own care? You need to know if needed care is limited, if referrals are required, or if there are any other restrictions that will affect you.
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