Female doctor working with senior patient in a modern office clinic / hospital
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When it comes to Medicare Advantage plans, they don’t have to be as permanent a choice as you may think.
Your 2021 plan, which you have chosen or re-enrolled, can be switched or dumped between January 1 and March 31. That is, you can exchange your benefit plan for another or drop it and return to standard Medicare (Part A hospital). coverage and outpatient coverage Part B).
The most common reasons beneficiaries make changes include their doctors not in the plan’s network or a drug not included in their coverage, said Danielle Roberts, co-founder of insurance company Boomer Benefits.
Also, January 1 through March 31: If you missed your first Medicare enrollment period and don’t qualify for an exception, you can enroll during that time. If this is your situation, coverage won’t start until July 1, said Elizabeth Gavino, founder of Lewin & Gavino and an independent broker and general agent for Medicare plans.
Of Medicare’s approximately 63 million beneficiaries, about 25 million are enrolled in an Advantage Plan, which offers Part A and B and usually Part D prescription drugs, along with extras such as dentistry and vision.
The current ability to change or drop your Advantage Plan comes just weeks after the close of Medicare’s annual fall enrollment, when a variety of options were available for those who wanted to change their coverage.
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The upcoming Advantage Plan related window, on the other hand, has limitations.
For starters, you can only make one transfer. This means that once you move to a different benefit plan or drop it for basic Medicare, the change is generally stuck for 2021 (unless you meet an exclusion that qualifies you for a special enrollment period).
Additionally, this three-month period does not allow you to switch from one standalone Part D drug plan to another.
During the fall enrollment period, if you chose a Part D plan based on false or misleading information, you can call 1-800-Medicare at any time during the year to see if you can make a change in your situation.
Meanwhile, scrapping a benefit plan in favor of basic Medicare often means the loss of drug coverage – meaning you would have to enroll in a standalone Part D plan. This is important because if you go 63 days without the coverage, you can get a lifetime penalty for late registration that will be deducted from your monthly premiums.
If you switch back to the original Medicare and want an additional policy (also called “Medigap”), you should be aware that you may not be eligible for guaranteed coverage. These policies cover all or part of the cost of some aspects of Parts A and B, including deductibles, copays and coinsurance. However, they have their own registration rules.
“If someone plans to go back to the original Medicare and get a Medigap plan, they should be aware that they will likely have to answer health questions and go through an acceptance,” Roberts said.
She recommends starting the process by applying for the Medigap plan and getting approval before exiting the Advantage Plan or enrolling in a standalone Part D plan.
“Enrolling in the Part D plan removes them from the Medicare Advantage plan, so it’s important to wait for that part too,” said Roberts. “We encourage people who need to make a change to do this early in the election period.”