Updates for CCA Health Rhode Island Members

If you don’t take action before December 31, 2024, you will lose your prescription drug coverage and only be covered by Original Medicare starting January 1, 2025.

Even if Medicare places you in Original Medicare, you still have other opportunities to join a Medicare health or drug plan. Because your plan will no longer be available to you, and to provide you additional time to evaluate your options, you have a special opportunity to join a new plan any time until February 28, 2025. If you join a new Medicare plan AFTER December 31, your coverage in the new plan won’t start until the month after you join.

If you don’t join a plan with prescription drug coverage or a stand-alone Prescription Drug Plan with Original Medicare by February 28, 2025, you won’t have prescription drug coverage in 2025 and you may have to pay a lifetime Part D late-enrollment penalty if you join a Medicare prescription drug plan later.

You need to choose how you want to get your health and prescription drug coverage. Review your options for Medicare coverage and decide which is best for you:

• Option 1: You can join another Medicare health plan. Call 1-800-MEDICARE (1-800-633-4227) 24 hours a day, 7 days a week or visit Medicare.gov¹ to choose a new plan. A Medicare health plan is offered by a private company that contracts with Medicare to provide benefits. Medicare health plans cover all services that Original Medicare covers and may offer extra coverage such as vision, hearing, or dental. Most Medicare health plans include prescription drug coverage. If you join a Medicare plan without drug coverage you may want to join a separate Medicare prescription drug plan to get prescription drug coverage. If you don’t join a separate Medicare prescription drug plan you may have to pay a lifetime Part D late enrollment penalty if you choose to join one later.
• Option 2: You can change to Original Medicare. Original Medicare is fee-for-service coverage managed by the Federal Government. If you choose Original Medicare, you need to join a separate Medicare prescription drug plan to get prescription drug coverage. You may also want to buy a Medicare Supplement Insurance (Medigap) policy to fill in the gaps in Original Medicare coverage. See below for more information on Medigap policies

If you currently pay a reduced Part B premium, based on your current plan’s benefit, you will lose access to this benefit effective January 1, and you will have the full Part B premium deducted from your monthly Social Security check unless you join another plan that offers this benefit.

If you have an employer or union group health plan, VA benefits, or TRICARE for Life, contact your insurer or benefits administrator. Ask how joining another plan or returning to Original Medicare affects your coverage.

You have a special right to buy a Medigap policy because your plan is ending. You will receive a letter in the mail, which can serve as your proof that you have a special right to buy a Medigap policy.

You’ll have this special right for 63 days after your coverage with CCA Health Rhode Island ends. You’ll likely need to join a separate Medicare prescription drug plan if you want Medicare drug coverage.

For information on Medigap plans, please call the Office of the Health Insurance Commissioner at 855-747-3224. TTY users should call 711.

You need to choose how you want to get your health and prescription drug coverage. Whichever choice you make, you will still have Medicare and Rhode Island Medicaid benefits, including prescription drug coverage. If you don’t choose another prescription drug plan by December 31, 2024, Medicare will choose a new drug plan for you, and you’ll have health coverage through Original Medicare starting January 1, 2025.

Even if Medicare places you in Original Medicare and/or chooses a drug plan for you, you still have other opportunities to join a Medicare health or drug plan. Because your plan will no longer be available to you, and to provide you additional time to evaluate your options, you have a special opportunity to join a new plan any time until February 28, 2025.

Because you have Rhode Island Medicaid, you may have other opportunities to join a Medicare health or drug plan. If you join a new Medicare plan AFTER December 31, your coverage in the new plan won’t start until the month after you join.

You need to choose how you want to get your health and prescription drug coverage. Review your options for Medicare coverage and choose which is best for you:

• Option 1: You can join a Medicare-Medicaid Plan. If you choose to enroll in one of these plans, it will cover your Medicare and Medicaid benefits, including prescription drugs. A Medicare-Medicaid Plan also covers additional services such as behavioral health and community-based services, vision, dental services, and care coordination. To find out which Medicare-Medicaid Plans are in your area or to enroll in another Medicare-Medicaid Plan, call the Medicare-Medicaid Plan Enrollment Line at 1-844-602-3469 or TTY: 711, Monday to Friday 8:30 am to 6:00 pm. The calls are free.
• Option 2: You can join another Medicare health plan. Call 1-800-MEDICARE (1-800-633-4227) 24 hours a day, 7 days a week or visit Medicare.gov¹ to choose a new plan. A Medicare health plan is offered by a private company that contracts with Medicare to provide benefits. Medicare health plans cover all services that Original Medicare covers and may offer extra coverage such as vision, hearing, or dental. Some health plans are designed specifically for people who have both Medicare and Medicaid. These are called Dual Eligible Special Needs Plans.
• Option 3: You can change to Original Medicare. Original Medicare is fee-for-service coverage managed by the Federal Government. If you choose Original Medicare, and don’t choose a prescription drug plan by December 31, Medicare will enroll you in a separate prescription drug plan. You’ll get a blue letter in November telling you the name of your new drug plan. You will only be enrolled into a separate prescription drug plan by Medicare if you do not make another selection by December 31.

For questions about Rhode Island Medicaid, contact the Rhode Island Medicaid Customer Service Help Desk at 401-462-5274 (TTY 711), Monday – Friday 8 am to 5 pm. Ask how joining another plan or returning to Original Medicare affects your Rhode Island Medicaid coverage.

If you have an employer or union group health plan, VA benefits, or TRICARE for Life, contact your insurer or benefits administrator. Ask how joining another plan or returning to Original Medicare affects your coverage.

In general, there are times of the year that you can change your health plan. They are:

• From October 15 through December 7, anyone with Medicare can switch plans or return to Original Medicare. This includes adding or dropping Medicare prescription drug coverage for the following year. You can make as many changes as you need during this period. Your last coverage choice will take effect on January 1, 2025.
• From January 1 through March 31, anyone enrolled in a Medicare Advantage Plan (except a Medicare Medical Savings Account (MSA) plan) can switch plans or return to Original Medicare (and join a stand-alone Medicare Prescription Drug Plan).
• In addition, because you have Medicaid, you can make certain changes to your Medicare coverage any month including:
  • Disenrolling from a Medicare health plan and changing to Original Medicare by enrolling in a Medicare prescription drug plan.
  • If you have coverage through Original Medicare, enrolling in a Medicare prescription drug plan or changing to a different Medicare drug plan if you already have one, or
  • If eligible, enrolling in an integrated D-SNP that provides your Medicare and most or all of your Medicaid benefits and services in one plan.

There may be other situations when you are eligible to make a change to your enrollment. If you want to make a change, call 1-800-MEDICARE (1-800-633-4227). This toll-free help line is available 24 hours a day, 7 days a week. TTY users should call 1-877-486-2048.