NEWSLETTER
2022 • Quarter 1 • Issue 1
Robert Dumais
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LBA 911
Early in December we met a lovely lady who told us she had just switched from a Medicare Supplement plan to a Medicare Advantage plan (MA). She was excited and surprised that the new plan had a $0 premium. She went on to say that she had an elective surgical procedure planned in January at a Boston Hospital. When we dug a bit deeper, we found out that her surgeon and the hospital were both out of network with the MA plan she selected. Thankfully we were able to switch her to another $0 premium MA plan where the providers were in network. We found out that the surgery went well and she is recovering nicely.
MEDICARE IS COMPLICATED, AND THERE IS NO COST FOR A CONSULT WITH AN LBA ADVISOR. THE STAKES ARE HIGH, DON’T GO IT ALONE.

GOOD TO KNOW
MEDICARE OPEN ENROLLMENT, RULES WITH EXCEPTIONS!
Besides the October 15 through December 7 Medicare Annual Open Enrollment, there are other enrollment periods that Medicare allows for throughout the year. These enrollment periods known as Special Election Periods (SEP), are available to Medicare beneficiaries in certain circumstances.

  • January 1 – March 31 Medicare Advantage open enrollment.
  • A SEP allows one to make changes to their prescription drug (Part D) plan or their Medicare Advantage (Part C) plan.
  • If you have a Medigap policy, you are able to shop that plan month-to-month for a better rate.
  • When you delay Part B of Medicare when first eligible, your SEP is created when the beneficiary holding the employer coverage drops that insurance.
  • If Medicare has awarded a Part C or Part D plan five-stars, Medicare beneficiaries have the option to change to that plan.
  • Financial assistance from Social Security or your state’s pharmaceutical program will likely qualify you for a SEP. Furthermore, if you have Medicaid along with Medicare you are eligible for a SEP.
  • Relocation could be a triggering event.
  • If you move into or out of an assisted living facility or nursing home.
  • A diagnosed chronic condition could qualify you for a SEP.
IF YOU HAVE QUESTIONS ABOUT SEPS OR GENERAL QUESTIONS ABOUT MEDICARE, THE ADVISORS AT LEGACY BENEFIT ADVISORS ARE ALWAYS AVAILABLE TO HELP.
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LBA consultants are members of OPEIU Local
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Robert Dumais, Principal

275 West Natick Road
Suite 450
Warwick, RI 02886

401-868-1400 (O)
774-991-3369 (M)
401-737-0330 (F)