By Luisa Loi
La Conner Community News
Faced with “extreme” high demand, the Statewide Health Insurance Benefits Advisors and the Office of the Insurance Commissioner are providing information to help seniors choose a medical insurance plan. Here’s what you should know.
If your Part D drug plan is being canceled and you want to join a new one, visit medicare.gov, click on “Health & Drug Plans” and select “Find health and drug plans.” Once you do that, enter your zip code and prescriptions in the Plan Finder tool to find out what plans cover those prescriptions. Finally, contact the company to enroll.
Pick a Part D plan during open enrollment, which runs Oct. 15-Dec. 7, effective Jan. 1, 2027. If you do nothing through Dec. 31, you will not have Part D coverage starting Jan. 1. You have time to enroll until Feb. 28, but the effective date will be the first of the month after you enroll.
Celeste Virago, volunteer coordinator at the program serving Skagit and Snohomish counties and Camano Island, recommends people to set up automatic payments.
“If you miss even a month, the plan will drop you and then you will be without Part D coverage until the next year,” she said.
If your Advantage plan is being canceled and you want to join a new one, visit medicare.gov and follow the same steps. Pick a new Advantage plan between now and Dec. 7; it will go into effect Jan. 1, 2027. If you do nothing through Dec. 31, you will be automatically enrolled in Original Medicare Part A and Part B effective Jan. 1. If you choose an advantage plan between Dec. 8 and Feb. 28 during the special enrollment period for those who had their Advantage plan canceled, the effective date will be the first of the month following enrollment.
If your Advantage Plan is being canceled and you want original Medicare with a Part D drug plan, visit medicare.gov, use the Plan Finder tool and contact the company to enroll, as explained above. If you enroll by Dec. 7, your plan will start Jan. 1. If you do nothing through Dec. 31, you will be automatically enrolled in Medicare parts A and B effective Jan. 1. If you enroll between Dec. 8 and Feb. 28, the plan will go into effect the first of the month after you enroll.
If your Advantage plan is being canceled and you want original Medicare with a Medigap policy (which is a supplement that pays the 20% Medicare does not cover), you will have a guaranteed issue right to buy Medigap — no medical underwriting required. Medigap is private insurance, so call the carrier between Nov. 1, 2026, and Feb. 28, 2027 to enroll.
“They could have cancer, they could have a whole load of things that would normally completely disqualify them, but they have a guaranteed issue of a Medigap until Feb. 28,” Virago said.
If you miss that deadline, you will have to complete medical underwriting and your chances of getting accepted are slim.
The effective date will be the first of the month after you enroll, and you can change your Medigap coverage at any time.
If you would like to enroll in Plan N, you must first enroll in one of the other letters and then switch to a Plan N the month after your Medigap plan starts. If you have a guaranteed issue Medigap, there is no waiting period.
SHIBA recommends enrolling in both Part D and Medigap if your Advantage plan is canceled and you do not want to select another Advantage plan. You will not be automatically enrolled in a Part D or Medigap. If you feel on the fence about moving to another Advantage plan following cancellation, it’s best not to until you are sure. You have until Feb. 28 to decide.
If your Advantage plan is not being canceled and you want to enroll in a different Advantage plan, you have until Dec. 7, and it will go into effect Jan. 1. Visit medicare.gov, use the Plan Finder tool and contact the company to enroll. You can also switch to a different Advantage plan Jan. 1-March 31.
If your Advantage plan is not being canceled and you want to enroll in original Medicare with a Part D and Medigap, apply directly to Medigap companies and take their health screening questionnaire. This will not give you a guaranteed issue right to buy Medigap. SHIBA advises against canceling your Advantage plan before you are accepted for a Medigap policy. If you are accepted for medigap, you can switch to Original Medicare between Jan. 1 and March 31, and pick a Part D drug plan.
Other tips and resources
Contact your providers and check your hospital’s website to learn what coverage they will accept in 2027.
Call 1-800-Medicare and use the “call back” feature to avoid waiting on-hold for hours.
Drop in an online Medicare Q&A session hosted by the Office of the Insurance Commissioner. Wednesday sessions are scheduled from 5:30 to 7 p.m. Nov. 4, Nov. 18 and Dec. 2. Search tinyurl.com/2s9a5947 to join on Zoom or call 253-205-0468 and use the code 83657974296#
Monday sessions are scheduled from 10 to 11:30 a.m. Nov. 9 and 23. Visit tinyurl.com/4f5nnp7x or call the same phone number as above.
If you are enrolled in Medicare Advantage or Original Medicare, you may qualify to save $202 or more per month. The Medicare Savings Program may cover Part A premiums, Part B premiums, Medicare copayments and Medicare deductibles. To qualify, a single person must make up to $1,855 per month or $22,260 per year; for couples, the income is capped at $2,510 per month and $30,120 per year.
Extra Help, also known as “Low-Income Subsidy,” can cover premiums, some copay costs and deductibles for Part D prescription drugs. To qualify, individuals must earn up to $1,995 per month and $23,940 per year, and couples must earn no more than $2,705 per month and $32,460 per year. To apply or learn more, call 1-800-562-6900.
For more Medicare counseling sessions and events, click here.
Luisa Loi is a general assignment reporter for La Conner Community News.
