Good Morning Ms. Toni:
The first week, my wife and I moved to Houston from Oklahoma, I had a wonderful surprise in my front yard and there was your Medicare column discussing different Medicare option for someone who has cancer.
I am 70 years old and need to go MD Anderson for colon cancer. I have been informed that MD Anderson does not accept the Medicare Advantage HMO plan I enrolled in when I was in Okla. that I was told could transfer to a Houston doctor when I moved in May. Now that I have moved I find out that MD Anderson does not accept this Medicare HMO plan.
I did not realize I could have chosen a Medicare Supplement instead of a Medicare Advantage plan when my Medicare Part B began this February after losing my job with company benefits. I understand from your article, I have a 6-month Medicare Supplement open enrollment guarantee issue period because I am now enrolled in Part B.
I need help disenrolling from this Medicare Advantage plan and go back to Traditional Medicare with a Medicare supplement. Time is ticking and I need to do this fast!! Thanks, James from Spring Branch area
Hi there, James:
Thank you for the great compliment!! I know how overwhelming it can be to understand the rules of Medicare, especially when you are stressed due to an illness.
Below is how I help clients who contact me and want to disenroll from their Medicare Advantage plan and back to Traditional also known as Original Medicare.
There is a “Special Enrollment Period or SEP” to help you qualify for a change of your Medicare Advantage plan. A special Enrollment Period or SEP is a certain situation when you are able to join, switch and drop a Medicare Advantage Plan. The special situations are:
- Moving Out of Area: Is when you have moved out of your area such as when James moved from Oklahoma to the Houston area.
Other SEPs are:
- Enrolled in Medicaid.
- Qualify for Extra Help for prescription drugs.
- Moving into a long-term care facility such as:
- Skilled nursing facility
- Assisted living facility,
- Personal care home
- Alzheimer’s assisted living facilities
- Loss of creditable prescription drug coverage.(insurance through your employer)
The trick to disenrolling from a Medicare Advantage Plan when a SEP is granted is to enroll in a Stand-alone Part D plan and automatically you are disenrolled from your Advantage plan and back to Original Medicare. This will be effective on the 1st of the next month.
Receiving Medicare Supplement Open Enrollment: James because you enrolled in Part B this February and are within your 6-month Medicare open enrollment period which ends on July 30, 2015, you can receive guaranteed issue. Medicare’s definition for guaranteed issue is that your acceptance in any Medicare Supplement plan is guaranteed during your Medicare supplement open enrollment period which lasts for 6 months beginning the first day of the month in which you are either age 65 or older and have just enrolled in Medicare Part B.
Wait past 6 months from enrolling in Part B and you must qualify with Medical underwriting. James you received a “little blessing” when you read my article and learned you have other Medicare options to choose from.
Toni King, author of the new Medicare Survival Guide®, which is a simple guide that puts Medicare in people terms, is on sales at www.tonisays.com. by email at www.tonisays.com/ask-toni. Please visit www.tonisays.com for workshops through out Houston.
