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Honored Social Butterfly

Question for Gail1 on changing Plan D

I'm on a very expensive cancer med. I have UHC (AARP) Plan D. It appears I can get a better price from another carrier, such as BC/BS. I would have to do more shopping around, online, to check.

  

  Question: When enrollment rolls around again, will another carrier take me on with a pre-existing condition, knowing that the cancer med is very expensive?  Or, am I 'locked in' at this point. Of course, I didn't know I would get this condition, so I wasn't looking at cancer drugs when deciding on a Plan D. 

 

Thank you.


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Reiterating, medical underwriting is not required when changing DRUG plans (Part D). Only when changing Medigap plans in most areas. Limited underwriting is required when seeking a new MA plan.

 

In addition to the SEP's listed above there are a few more that could apply.

  • You have or lose Extra Help.
  • You are admitted into or reside in a qualifying institution.
  • You enroll in an All-inclusive Care for the Elderly (PACE) program.
  • You become eligible for a Special Needs Plan (SNP).

Note: After the first 60 days of the year, a Part D plan can make changes to its formulary. If any of your drugs are removed from the formulary through such a mid-year change, your plan should continue to cover the drug for you until the end of the calendar year unless there are safety issues or there is a generic form of your drug. You do not get an SEP if your plan stops covering a drug you need.

https://www.medicareinteractive.org/get-answers/medicare-prescription-drug-coverage-part-d/medicare-...

 


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Thank you for the responses. I have the 'traditional' Part D (not Advantage) through United Healthcare. So, I'll wait and see if I am going to continue the expensive med beyond this year, and shop around. It's possible I can get a grant from one of the foundations to cover a great deal of the expense. It would be close --- I'm not poor and unsure if I'll qualify. But, I'll submit the forms and see.

 

Thanks again.


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