Can we reapply for Medicare C & D?

Tigers asked...

My mom, (85 yrs old) let her Medicare C & D lapse, accidentally. She is in a panic, what can she do? What will her options be to get back in? The deadline was 12/31/2009. What can we do?

Expert Answer

Tell her not to panic -- she still has a lot of coverage, and some options to get more. First of all, even without her Medicare Part C plan, she still has hospital and skilled nursing facility coverage through Medicare Part A. Her Medicare Part A hospital and nursing facility coverage remained in effect while she was enrolled in her Medicare Part C plan -- the Medicare Part C plan just administered it. So now, without her Medicare Part C plan, she's back to direct Medicare Part A coverage.

As for coverage of her doctors and other outpatient medical care, she remains covered by Medicare Part B. While she was in her Medicare Part C plan, she was required to stay enrolled in Part B -- the monthly Part B premium is probably deducted automatically from her Social Security benefits. So, even though she let her Part C plan lapse, it's almost certain that she's still enrolled in Part B. This means that she won't have the extra coverage provided by her Part C plan, which includes the 20 percent of outpatient medical bills that Medicare Part B doesn't pay. But she'll still be covered under Part B for 80 percent of those bills, and she will almost surely be able to see the same doctors and other providers she regularly uses (because almost any provider who's part of a Medicare Part C plan also accepts direct Medicare Part B patients).

It may also be possible for your mother to enroll in another Medicare Part C plan right away. Many Part C plans have open enrollment -- meaning they accept new enrollees regardless of their age and medical condition -- only during one month a year, usually November. But some plans have open enrollment for more than one month per year, and some plans have open enrollment all year long. So, depending on where she lives, there may be a Part C plan that she can enroll in and keep at least until her old Medicare Part C plan has its open enrollment period again, at which time she could switch back to her old plan if she prefers it. A new plan might not include her same doctors, however, so this is something to be careful about when deciding whether to enroll in a new plan. To find out what other Medicare Part C plans are available where your mother lives, and to compare their coverage, you can go directly to the official Medicare Web site's interactive tool for finding Part C plans.

Prescription drug coverage, which your mother had under her Medicare Part D plan, may be the toughest to replace. Except for nursing home residents, people with Medicaid, and people who first become eligible for Medicare, signing up for a Part D plan is only permitted during the yearly open enrollment period November 15 to December 31. Since your mother let her Part D plan lapse, she won't be able to sign up for a new plan until this coming November, and coverage won't begin until next January 1. Until then, she has several options. First, some Medicare Part C plans include prescription drug coverage -- if she looks for a new Medicare Part C plan, she might find one with drug coverage, too. If not, there are many drug discount programs available that she might be able to take advantage of until she can again join a Part D plan. These alternatives are discussed in this site's article Saving Money on Prescription Drugs Not Covered by a Medicare Part D Plan.