Medical professional attends to senior woman. Home healthcare.

The 2022 holiday season is over. It’s the New Year, 2023, and you’re next in line at the pharmacy. You whip out your new Medicare Part D drug plan and the sticker shock has you at a loss for words. 

Or perhaps you realize the same drug plan you had last year that rolled over went from $22 to $40 a month. What now?

Let’s delve into what to do when you, the Medicare beneficiary, neglected to study the annual notice of change your insurance company sent you regarding your Part D drug plan – or worse, your insurance agent, after spending an inordinate amount of time trying to find the best plan for you based upon your drugs, forgot to hit the submit button.

This happened to me, because … I don’t have a reason or an excuse, but for a couple of my clients, I firmly believe the mistake was on my end, not theirs. 

I filled out the application and applied for a new drug plan with my client right in front of me at our office, but because of a technical snafu or user error, the application was not received by CMS. 

Is there any recourse? Well, yes, there is. I plan on doing a three-way call with Medicare and the three clients whose plans should have been changed on Jan. 1. 

Do I have a case? The Office of Aging says this about changing plans after Dec. 7: “However, there are some exceptions: You accidentally enrolled in the same plan or stayed in a plan you didn’t want, or you enrolled in a Medicare plan by mistake. If you are enrolled in the wrong Medicare plan by mistake or after receiving misleading information, you may be able to disenroll from the plan and enroll in a new plan that is a better fit for your needs.”

I dropped the ball for three of my new clients. In my three-way call with my clients and Medicare, I can explain to CMS that the new technology I used to enroll these folks did not work properly or perhaps I messed up. Either way, I am confident we will resolve the issue. 

If you’re uncertain as to what drug plan you are on, or perhaps the plan you kept made huge changes to the drug formulary, premium and deductible, and you never received the Annual Notice of Change, you should call Medicare and explain your situation. Or, better yet, have your agent make that call with you. 

Chris Dewey is the founder of May River Medicare Insurance in Bluffton.