Question: My spouse just passed away, and I am so overwhelmed with all that needs to be done. Now I found out his retiree health insurance will no longer cover me. Now what do I do?

Answer: I am so sorry for your loss. This is an especially difficult and stressful period of time for you. Now with the loss of your insurance, you have one more task to take care of. So, let’s talk about solutions.

Usually when you lose coverage in this situation, you will lose coverage at the end of the month. It is February, so you have until March 1t to pick a replacement for that retiree coverage without a gap in coverage.

There are times when you can make changes to Medicare without penalties called Special Enrollment Periods (SEP). SEPs are made available for many different reasons, and your situation qualifies as one of those. Because your current plan is ending due to the death of your spouse, this is one of those SEP’s, so you are allowed to research and sign up for any Medicare products you wish. In your circumstance, your SEP lasts for 60 days after your coverage ends, so that would be all of March and April, but we really don’t want to wait as you would have a coverage gap if you wait, but the SEP gives you flexibility and avoids penalties.

In general, changes in Medicare coverage go into effect the 1st of the upcoming month. So, if you sign up for a for a product in February, it would begin March 1st, if you sign up in March it begins April 1, and so on. I would strongly encourage you to do something in February, so that when your coverage ends, you would go directly onto your new policy, with no gap in coverage at all.

In order to use that retiree plan, you needed Medicare Part A & B, and now you’ll need those same parts to pick additional coverage. To pick new coverage, you need to review all the alternatives. In Western New York, we have more than 60 different insurance options to add onto your Medicare A & B. Remember that in order to avoid penalties, you must also have Prescription Drug Coverage, which is not Part A & B, but you can pick this up during this month and the rest of your SEP.

Last week we talked about resources available to you. To check available plans, you could first check www.medicare.gov. The site is designed to help you learn about, research, and enroll into everything Medicare. If you have used this website in the past, you can log back in and update your information. If you have not used the website, I would encourage you to try it out. If you are uncomfortable using the website, you can also call 1-800-MEDICARE to work with the customer service staff to help you through the options and alternatives. I really like the website because it allows us to ‘see’ the alternatives, and I personally tend to learn easier if I can read it, so I often print out articles or pages I want to study.

The website collects the relevant data, your zip code, your pharmacy, your medications, and then sorts which plans work the best for your medications. But remember medications are only part of the answer. You need to be sure that the plan you choose works with your physicians, and your budget.

You can of course reach out to others for help with these alternatives as well. This could be a family member who is more tech savvy than you who could help you with this website. It could be an agency who helps with Medicare, like Office for the Aging, or Southwestern Independent Living Center. Or it could even be an Insurance Broker who works with Medicare products locally.

At this point, you really have two pathways: the first is add coverage to your Medicare Part A & B, like a Medicare Supplement Plan and a standalone Prescription Drug Plan. This pathway tends to be more expensive when it comes to monthly premiums, but it also works anywhere and is very comprehensive. Note this option is not “bundled,” so you would end up with 3 separate insurance cards, you Medicare ID card, one card for your Supplemental plan, one for your Prescription Drug Plan.

The second pathway is enrolling in a Medicare Advantage Plan. These include Preferred Provider Organizations (PPO), Health Maintenance Organization (HMO) and more. This alternative tends to be much lower with regard to premiums, but may be restrictive in where you are allowed to use it. Using this pathway, you would have one insurance card and you show it wherever you go.

Whatever you choose, it’s important that you do not put this off, and ideally should make your choice in February, so your new coverage can begin March 1st.

I hope this is helpful information and please reach out for help during this difficult time.

Janell Sluga is a Geriatric Care Manager helping seniors in our community access services and insurance. To reach her, please email editorial@post-journal.com.