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I Need to Return to Medicare Because My Doctor’s are Not Accepting My Medicare Advantage Plan!!

by | Sep 30, 2015 | Enrolling in Medicare, Medicare Advantage Plans, Original Medicare, Supplemental Plans

My Doctor’s are Not Accepting My Medicare

My Doctors are Not Accepting My Medicare

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 my doctors are not accepting my Medicare Advantage HMO 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 (without having to answer questions) is simple 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 Annual Enrollment period starts on Thursday, October 15, and it will end at midnight on Monday, 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 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 95 of the 2015 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.”

  • If you had a Medigap policy before you joined you can get the same policy back if the companystill 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.

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.
  • 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 King is the author of the Medicare Survival Guide® which is on sale in our Store. Personal consultations or to have Medicare/Social Security questions answered, please contact Toni at Ask Toni or Call 832-519-8664.

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