Don’t like your Medicare Advantage plan? Now it’s time to swap or drop it

Female doctor working with senior patient in a modern office clinic / hospital

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When it comes to Medicare Advantage plans, they should not be as sustainable as you might think.

Your 2021 plan, which you have either selected or re-nominated, can be switched or discharged between January 1 and March 31. That is, you can swap your Advantage plan for another or leave it and return to Basic Medicare (Part A Hospital). Coverage and Part B outpatient coverage).

Co-founder of insurance companies Danielle Roberts, co-founder of insurance firm Boomer Benefits, said the most common reasons that changes are caused by their doctor not being in the plan’s network or a drug not being included in their coverage Are included.

Also from March 31 to January 1: If you missed your initial Medicare enrollment period and are not eligible for an exception, you can sign up during that time. If this is your situation, coverage won’t begin until July 1, said Elizabeth Gavino, founder of Levine & Gavino and an independent broker and general agent for Medicare plans.

Of the approximately 63 million beneficiaries of Medicare, about 25 million are enrolled in an Advantage Plan, which provides parts A and B with extras such as dental and vision, and usually Part D prescription drug coverage.

The current opportunity to change or drop its Advantage plan comes weeks after Medicare’s annual fall enrollment draws near, when a number of options were available to those who wanted to revise their coverage.

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Conversely, the upcoming Advantage Plan-related window comes with restrictions.

For starters, you can make only one switch. This means that once you move to a different Advantage plan or leave it for Basic Medicare, the change is usually discontinued for 2021 (unless you meet an exclusion Which makes you eligible for a particular enrollment period).

Additionally, this three-month window does not allow you to switch from one stand-alone Part D prescription drug plan to another.

If you have chosen a Part D plan in the fall open enrollment period based on faulty or misleading information, you can call 1-800-Medicare at any point during the year to see if your Status will allow you to make changes.

Meanwhile, dropping an Advantage plan in favor of Basic Medicare often means losing drug coverage – which means you have to enroll in a stand-alone Part D plan. This matters, because if you go 63 days without coverage, you may face a lifetime late-enrollment penalty that falls on your monthly premium.

Also, if you go back to the original Medicare and want to get a supplemental policy (aka “Medigap”), keep in mind that you cannot qualify for guaranteed coverage. These policies fully or partially cover the cost-sharing of certain aspects of parts A and B, including deductibles, coops, and coinsurance. However, they come with their own rules for nomination.

“If someone plans to go back to the original Medicare and get a Medigap plan, they should be aware that they will have to answer health questions and undergo underwriting,” Roberts said.

She advises starting the process by applying for a Medigap plan and getting approval before dropping the Advantage plan or enrolling in a standalone part plan.

“Enrolling in a Part D plan will exclude them from the Medicare Advantage Plan, so it is important to wait on that part as well,” Roberts said. “We encourage those who need to make changes in the election period to make it quicker.”


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