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Doctors Not Accepting Medicare Advantage PPO, Need to Return to Traditional Medicare!!

by | Oct 3, 2016 | Enrolling in Medicare, Medicare, Medicare Advantage Plans, Supplemental Plans, Toni Says

 

Toni:

            Last year, I made a mistake and changed to a Medicare Advantage PPO because I understood from talking with my friends that this PPO plan was like a Medicare Supplement. I want out!! Most specialists and even the facility that does MRIs are out of network and this is costing me a fortune. I’ve been advised to return to Traditional Medicare.  Is Traditional Medicare different than Original Medicare?

            Advise how I can return to Medicare? Signed…Jeremy from Hockley, TX

Dear Jeremy:

            You will be happy to know that “Original Medicare” and “Traditional Medicare” are the same thing, but the medical profession know Medicare as “Traditional” Medicare not “Original Medicare”.

             Medicare Annual/Open Enrollment will be your only time to make that change.  And it is simple for you to enroll in Original/Tradition Medicare and a new Medicare Supplement (without having to answer questions) only because this is your first year to be out of your Medicare Supplement or your first year to pick a Medicare Advantage Plan.

             This year’s Medicare’s Open/Annual Enrollment period starts on Saturday, October 15, and will end at midnight on Wednesday, December 7th (Pearl Harbor Day).

            For you to disenroll from a Medicare Advantage company, all you need to do is enroll in a Medicare Prescription Drug plan that fits your needs.  You will automatically be out of your old Medicare Advantage plan and back to “Original Medicare” with a Medicare Prescription Drug plan; then you can apply for a Medicare Supplement to pick up what Medicare does not pay for.

            Concerned you have health issues which can keep you from qualifying with a Medicare Supplement’s application? Don’t worry; there are protections in place for this type of situation. The Medicare rule from page 103 of the 2016 Medicare & You Handbook is: “If you join a Medicare Advantage Plan for the first time, and you aren’t happy with the plan, you’ll have special rights to buy a Medigap policy if you return to Original Medicare within 12 months of joining.”  Medicare rules concerning this issue are on page 103.

Below are the changes that a Medicare beneficiary can make to their Medicare plans during Medicare Annual Enrollment:

  • Enroll in a new Part D Medicare Prescription Drug Plan, which automatically disenrolls one from a Medicare Advantage plan.
  • Enroll in a new Part D Medicare Prescription Drug Plan when you have never been in Part D from the time you have been with Medicare.
  • Change from one Part D Medicare Prescription Drug Plan to a new Part D Medicare Prescription Drug Plan.
  • Enroll in a Part C Medicare Advantage Plan with Prescription Drugs
  • Change from one Part C Medicare Advantage Plan to a new Part C Medicare Advantage Plan.
  • Return to Original Medicare and purchase a Medicare Supplement and enroll in a Part D Medicare Prescription Drug Plan.
  • Return to Original Medicare only and enroll in a Part D Medicare Prescription Drug Plan.
  • Return to Original Medicare with no Part D plan. * Don’t forget there is a penalty for not enrolling in a Part D Medicare Prescription Drug plan when first eligible.*      

            Toni King, author of the new Medicare Survival Guide®, which is a simple guide that puts Medicare in “people” terms, is on sale at www.tonisays.com  Email questions to info@tonisays.com or call 832/519-TONI (8664).

 

 

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