Female doctor working with senior patient in a modern office clinic / hospital
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When it comes to Medicare Advantage Plans, it does not have to be as permanent as you might think.
Your 2021 plan, which you have chosen or re-entered, can be switched or deleted between 1 January and 31 March. That is, you can drop your benefit plan with another exchange or drop it and return to basic Medicare (Part A hospital coverage and Part B outpatient coverage).
Danielle Roberts, co-founder of insurance company Boomer Benefits, says the most common reasons beneficiaries make changes are, among others, that doctors are not in the plan’s network or that medicines are not included in their coverage.
Also from January 1st to March 31st: If you missed your initial Medicare enrollment period and did not qualify for an exception, you can sign up during that time. If this is your situation, coverage will only start on July 1, says Elizabeth Gavino, founder of Lewin & Gavino and an independent broker and general agent for Medicare plans.
Of the approximately 63 million Medicare beneficiaries, approximately 25 million are enrolled for a benefit plan, which covers parts A and B and usually part D prescribed medication, along with extras such as dentistry and face.
The current opportunity to change or abandon your Advantage plan comes a few weeks after Medicare’s annual fall subscription, when a variety of options were available to those who wanted to change their coverage.
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By contrast, the upcoming window of the Advantage Plan holds restrictions.
To begin with, you can only make one switch. This means that once you go to another benefit plan or abandon it for basic Medicare, the change is usually locked for 2021 (unless you meet an exclusion that qualifies you for a special enrollment period).
In addition, three months does not allow you to switch from one stand-alone Part D prescription drug plan to another.
If you have opted for a Part D plan during the fall enrollment period based on incorrect or misleading information, you may call 1-800-Medicare at any time during the year to see if your situation enables you to make change.
If you abandon a benefit plan in favor of basic Medicare, it means you lose drug insurance – which means you have to participate in a stand-alone Part D plan. This is important because if you go 63 days without cover, you could face a life-long penalty for late enrollment that can handle your monthly premiums.
If you switch back to the original Medicare and want to receive a supplementary policy (or “Medigap”), please note that you may not qualify for guaranteed coverage. These policies cover cost sharing of some aspects of Parts A and B, including deductions, copays and currency insurance, in whole or in part. However, they have their own rules for enrollment.
“If anyone is planning to go back to the original Medicare and get a Medigap plan, they should be aware that they will probably have to answer health questions and go through underwriting,” Roberts said.
She recommends starting the process by applying for the Medigap plan and getting approval before leaving the Advantage plan or participating in an independent Part D plan.
“If they’re part of the Part D plan, they’ll upload the Medicare Advantage plan, so it’s important to wait for the part as well,” Roberts said. “We encourage people who need to make a change to do so early in the election period.”