Toni:
Last year, I made a big mistake and changed to a Medicare Advantage HMO from my Medicare Supplement and I want out!! I cannot even get a MRI with this company. I am in Galveston County and most of the doctors are not accepting these plans. What can I do? Signed…George in La Marque, TX
Dear George:
You will be happy to know that going back to “Original Medicare’ and enrolling in a new Medicare Supplement is simple because this year’s Medicare’s Open Enrollment started on Tuesday, October 15, and it will end at midnight on Saturday, December 7th (Pearl Harbor Day).
For you to disenroll from a Medicare Advantage company, all you need to do is enroll with a Medicare Prescription Drug plan. You will automatically be out of your old Medicare Advantage plan and back to “Original Medicare with a Medicare Prescription Drug plan; then apply you can apply for a Medicare Supplement to pick up what Medicare does not pay for.
What happens if you have health issues such as cancer, diabetes, COPD, heart problems, etc that can keep you from qualifying with the health questions in a Medicare Supplement’s application? Don’t worry there are protections in place for this type of situation. The Medicare rule from page 71 of the 2014 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.
1) If you had a Medigap policy before you joined, you may be able to
get the same policy back if the company still sells it. If it isn’t available,
you can buy another Medigap policy.
2) If you joined a Medicare Advantage Plan when you were first eligible for Medicare, you can choose from any Medigap (Medicare Supplement) policy.
For those who this situation does not apply and want to change their Medicare option or want to enroll new plan, Medicare Open Enrollment Period is for you.
Medicare Open Enrollment is the time that you can make changes to your Medicare Part D prescription drug plan or Medicare Advantage plan or you can enroll in a Medicare Part D prescription drug plan if you missed your enrollment period when you were first eligible.
Below are the changes that a Medicare beneficiary can make to their Medicare plans during Medicare Open 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
- Or 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’s last 2 Confused about Medicare workshops for 2013 are:
- Wednesday October 30th- St Vincent De Paul Catholic Church from 6:30-8:30PM at 6800 Buffalo Speedway, Houston, TX 77025 Public is invited; RSVP is limited on a first come first serve basis.
- Tuesday November 5th–West University Senior Center from 6:00 PM -8:00PM at the West University Senior Center, 6401 Auden, Houston, TX 77005
These workshops are free and the public is invited. RSVP as seating is limited. Call 832/800-4674 to RSVP or visit www.tonisays.com to sign up online
Toni King, author of the Medicare Survival Guide, a simple guide that puts Medicare in “people” terms, is on sale at www.tonisays.com.
