I Changed My Prescription Drug Plan, What Now?

Beginning January 1, you will no longer be on your old plan and your new plan begins. You will want to discard your old plan’s insurance card and put your new one in its place. You will want to give your drug store/provider your new insurance card information for billing.

Those people who chose to pay their premiums via coupon book can pay monthly or make as many payments as they want by sending in the amount required. Those that chose to have their premiums taken out of their Social Security check or Railroad Retirement may have lag time depending on when they switched plans. Its best to make sure premiums are paid and not assume it will come out of your Social Security check. IT IS BENEFICIAL TO REVIEW AND CHANGE PLANS EARLY IN OPEN ENROLLMENT.

In some instances, individuals have gotten letters from the Social Security stating: "We will no longer deduct money for your Medicare prescription drug plan costs from your monthly benefits." What does this mean?

When you enrolled in your new Medicare Part D prescription drug plan you may have selected the option to have your monthly plan premiums automatically deducted from your Social Security check.

The Social Security letter may note, "If you have any questions about your Medicare prescription drug plan costs, please contact your Medicare prescription drug plan".

You then may have contacted your Medicare plan and a Member Services representative asked you to either pay your monthly premiums by sending in a check (possibly with a coupon) or to set up an automatic electronic funds transfer from your bank (or use a debit card).

What happened to your chosen option of premium payment by Social Security deduction?

In short, your newly-chosen Medicare plan may not have had time to organize the automatic Social Security deductions and so your plan will ask you to use another form of premium payment (such as being issued a coupon book, where you will send a check for the premium amount along with one of your coupons).

Then, after the start of your new Medicare plan coverage (January 1st), you will be able to contact your Medicare plan again and change how your monthly premiums are paid and you may be able to, once again, elect to have your monthly premiums deducted automatically from your Social Security check.  (To contact your Medicare plan's Member Services department, please use the toll-free number found on your Member ID card.) Please remember that it can take the Social Security Administration up to three (3) months to process your premium change.

What is the source of this premium-payment policy?

The Centers for Medicare and Medicaid Services (CMS) published revised guidance in May 2019 entitled, "Withholding Medicare Prescription Drug Premium from Your Social Security Payment" that outlines why some people are being denied automatic Social Security check deductions as their chosen form of premium payment.

The CMS document states that if you make a Medicare plan change, "depending on when you made your enrollment decision, you may be asked to pay your new plan directly for a while. If that happens, you will get a bill or payment book from your new drug plan telling you the amount you owe. Your new plan will expect you to pay premiums directly until premium withhold begins with your new plan. You may need to contact the plan to let them know you still want to have your premiums withheld."

The CMS document continues with an example: “You enrolled at the end of Open Enrollment and chose to have your premiums withheld from your Social Security payment. However, you just got a payment book from your drug plan saying you owe $36.50 each month, starting in January. You call the plan, and the plan says that it did not get your request for enrollment in time to arrange for your January premium to be withheld. The plan says it will request to have the premiums withheld from your Social Security payment starting in February. You’ll need to send your premium payment for January directly to your plan.” Some Medicare plans may not allow Social Security check premium deduction at the start of the year, although this was the chosen payment option on their enrollment application. Instead, Medicare plan members are told to either send the first premium payment by check or submit the Electronic Funds Transfer request. When contacted, the Medicare plan Member Services representatives said that they would be send the forms to request the Social Security payment option - as per the CMS guidance.

(sources included:"Withholding Medicare Prescription Drug Premium from Your Social Security Payment" (Revised May 2019), CMS Product N 1400)

Special Enrollment Periods (SEP)

Circumstances beyond your control may force you to change your Part D plan outside the Annual Enrollment Period (Oct. 15 – Dec. 7). For example, you might move, and your plan does not serve your new area, or you may have moved back into the U.S. Alternately, you might lose your current plan because its contract with Medicare changes or is cancelled, or your carrier simply decides to discontinue offering your plan in your area. Other special circumstances related to your financial or medical situation, as well as administrative errors by federal employees, may qualify you for an SEP.

5-Star Special Enrollment Periods

The Centers for Medicare Services review the quality of service provided by each plan, including Part D plans, and assign them 1 to 5 stars. If a 5-star Part D plan is available in your area, you may hange to it from your current plan from December 8 to the following November 30. You can exercise this option only once per year.

If you have questions about paying your Medicare drug plan premiums, call the customer service number listed on your drug plan card. If your drug plan cannot help or you have additional questions about your premium or enrollment, call 1-800-MEDICARE (1-800-633-4227). TTY users can call 1-877-486-2048.