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Reminder: Special Enrollment Period for Members of Florida Physicians United Plan, Inc. (PUP) Medicare Advantage Plans

Category: Special Enrollment Periods SEP
Published on 2014-06-29 13:56:37


Important: If you are enrolled in a Physicians United Plan, Inc. (PUP) Medicare Advantage plan, and want Medicare Advantage plan coverage starting July 1st, you will need to enroll into another Medicare Advantage plan by the end of Monday, June 30th. You can telephone Medicare at 1-800-633-4227 and a Medicare representative can help you find the most economical health and prescription drug coverage that is available in your area. 

This Special Enrollment Period will continue through August 31, 2014 and if you choose another Medicare plan, coverage will begin the first day of the month after your enrollment. (For instance, if you enroll into another Medicare plan on July 2nd, your Medicare plan coverage will not begin until August 1st, 2014.) 

As many members of the PUP Medicare Advantage plans know, PUP will be liquidated on July 1, 2014. As a result, Medicare has terminated the PUP Medicare Advantage plan contract and retroactively enrolled all PUP Medicare Advantage plan members back into original Medicare (Part A and Part B) and enrolled all members into a Medicare Part D prescription drug plan. 

You can read more about the financial status of Physicians United Plan, Inc. on the Florida Department of Financial Services site:

  

Question: How many Medicare beneficiaries will be affected by the liquidation of the PUP Medicare Advantage plan?

According to recent calculations, 50,314 people were enrolled in the Physicians United Plan, Inc. Medicare Advantage plans. 

Here is a list of the 2014 PUP Medicare Advantage plans found in the following 17 Florida counties:

·    PUP Plus (HMO)

·    PUP Simple (HMO)

·    PUP Easy (HMO)

·    PUP Rewards (HMO)

·    PUP Extra (HMO SNP)

 

Florida counties with PUP Medicare Advantage Plans

Brevard
Broward
Hillsborough
Lake
Marion
Martin
Miami-Dade
Orange
Osceola

Palm Beach
Pasco
Pinellas
Polk
Saint Lucie
Seminole
Sumter
Volusia

 

Question: If I was enrolled in a PUP Medicare Advantage plan, how do I know what Medicare Part D prescription drug plan I now have?

As a result of the upcoming PUP liquidation, Medicare has terminated the PUP Medicare Advantage plan contract and retroactively enrolled all PUP Medicare Advantage plan members back into original Medicare (Part A and Part B) and enrolled all members into a Medicare Part D prescription drug plan.

You now have several ways to learn more about your current coverage: 

(1) Telephone Medicare at 1-800-633-4227 and ask a Medicare representative to look up the name of your newly assigned Medicare Part D plan. You can also ask the Medicare representative to ensure that the plan provides the most economical health and prescription coverage or the Medicare representative can help you enroll into a new Medicare plan.

(2) Ask your pharmacy to look-up the name of your new Medicare Part D plan and check the coverage of your medications. 

(3) Watch your mail for the arrival of a letter from your new Medicare Part D prescription drug plan notifying you of your new plan coverage. Be sure to keep all correspondence and seek help from a friend, neighbor, or senior volunteer if you are having trouble with any of the information. For assistance you may wish to contact, Florida's Serving Health Insurance Needs of Elders (SHINE) at: 1-800-963-5337.

 

Question: Will my medical and prescription cost be the same as they were with my PUP Medicare Advantage plan? 

Probably not. As of June 1, 2014, you no longer have coverage under your Medicare Advantage plan and instead you have original Medicare Part A and Medicare Part B coverage (and a new Medicare Part D plan) that may cost more than you paid when you were covered by your PUP Medicare Advantage plan. You also will no longer have a maximum out of pocket limit with original Medicare (meaning, your medical expenses are not limited like they were under your PUP plan).

Bottom Line: Be sure to speak with your doctors and other healthcare providers about what you pay for coverage, before receiving treatment. If you wish to join another Medicare Advantage plan starting in July, telephone Medicare at 1-800-633-4227 before the end of June.

  

Question: My Medicare Advantage plan is no longer available and we now have a Special Enrollment Period until the end of August. So can we change Medicare plans more than once while the Special Enrollment is still available?

Not usually. Typically, a person only has one chance to make a Medicare plan selection during their Special Enrollment Period. The choice of a Medicare Part D or a Medicare Advantage plan usually will "close" the Special Enrollment Period with coverage beginning the first day of the month after the Special Enrollment Period. 

However, some people are able to take advantage of more than one Special Enrollment Period during the year and they may be able to change Medicare plans again based on another Special Enrollment Period. For instance, if you qualify for the Medicare Part D financial Extra Help program, you are granted a continuous Special Enrollment Period that allows you the opportunity of changing your Medicare plan at any time during the plan year.

Also, it is possible that an exceptional situation may arise from the Special Enrollment Period and, in effect, create another Special Enrollment Period allowing a person another chance to change their Medicare plan. 

For instance, if a person chose a Medicare Part D plan during their Special Enrollment Period based on false or misleading information, the person may be granted another Special Enrollment Period providing them the opportunity to join another plan.

Usually such an exceptional Special Enrollment Period is only granted by CMS on a case-by-case basis. To obtain such an SEP, a person would need to telephone Medicare at 1-800-633-4227 and speak with a Medicare representative.

 

Question: My Medicare Advantage plan no longer exists and so I joined an MA that does not have any premium and even pays me back my monthly Part B premium, but when should I get my money back?

Some Medicare Advantage plans, such as the 2014 WellCare Dividend (HMO) available to residents of Brevard county, Florida, have a $0 premium and also rebate your $104.90 Medicare Part B premium back to you as part of your monthly Social Security check.

However, due to processing time when you first enroll into such a plan, it may take up to 3-months before you see find these rebates or refunds in your Social Security check. If there is a delay in your monthly rebate payment, you will actually see that three-months (or whatever time has passed since a refund has arrived) of Medicare Part B premiums will be included at one time in your Social Security check for a total of around $314.70 (or 3 * $104.90). After the initial Medicare Part B premium rebate payment, then your monthly Social Security checks should then reflect a regular increase of $104.90.








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