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Switching From Medicare Advantage To Medicare Supplemental Coverage

Enrolled in Medicare Advantage? You may be able to switch to a Medicare supplementChange from Medicare Advatage to Medicare supplemental Coverage

Of course you can switch to a Medicare supplement if you are in your Annual Election Period and can pass underwriting requirements. But what about when you are enrolled in a plan mid-year and would like to switch?

This article will detail when you can switch into a supplemental coverage without being subject to medical underwriting.

The key determinate in switching from Medicare Advantage to supplemental coverage is whether or not you are still in your Medigap Open Enrollment Period or are entitled to Guaranteed Issue Rights.

5 times when you can drop Medicare Advantage and buy a Medicare supplement outside of the Annual Election Period

1. When you are in your Medigap Open Enrollment Period – This is especially useful for people who became eligible for Medicare when they were under 65 due to a disability. If this is you, and you enrolled in an Advantage Plan because supplemental coverage was not available or the premium was to high, this is your time to switch.

The Open Enrollment Period for Medicare supplemental begins on the first day of the month you are enrolled in Medicare and lasts for 6 months. You are able to buy any plan offered by any company.

2. If your Medicare Advantage Plan is leaving Medicare or isn’t renewing – Medicare Advantage Plans are good for one calendar year. Your plan may not renew for the following year or the plan provider may leave Medicare.

If this happens, you are entitled to Guaranteed Issue Rights and can buy a supplement even if you have preexisting health conditions. You will be limited to Supplemental Plans: A, B, C, F, K or L.

3. You joined Medicare Advantage when first eligible and it’s been less than one year – This scenario is referred to as a Trial Right and allows to switch to original Medicare and buy a Medicare supplement policy if you wish. You can buy any supplement that is sold in your State by any company.



4. You dropped Medigap to join an Advantage Plan for the first time and it’s been less than a year – This is another time when you have a Trial Right. You can buy the same plan you had before you switched to Medicare Advantage. If the plan included drug coverage, it will not be included this time. You can also buy Plans: A, B, C, F, K, or L.

5. You leave your Medicare Advantage Plan because it broke the rules – If your plan broke the rules or misled you and you leave the plan, you can buy Plans: A,B, C, F, K, or L.

Each of these scenarios include a time limit on when you must opt to buy a qualifying plan. Choosing a Medigap Policy: A Guide to Health Insurance for People with Medicare is a good resource for additional information.

This is another important example of when understanding all your Medicare plan options can expand your opportunities and really pay off.

 

2 comments

  1. what are good/best reasons to switch a Medicare Advantage plan to a medicare supplement plan other than the Ins. co. is no longer offering the Advantage plan ?

    Also, doesn’t an Advantage plan have to apply the same coverage, benefits that medicare medigap, supplemental plans offer that are costly ?
    Many thanks for your great help/advice.

  2. Ang, People switch to a Medicare supplement from an Advantage Plan because a supplement works different than an Advantage Plan. Choose a supplement with comprehensive coverage (Plan F) and you can eliminate all deductibles, copayments and coinsurance for all covered expenses. An Advantage Plan usually has a lower premium but you are paying every time you use it. When you own a supplement, you are not subject to network restrictions. You can use any provider that accepts Medicare. A choice between the two is a matter of personal preference.

    A Medicare Advantage Plan must include all Part A and Part B benefits, but there are differences in what you will pay out-of-pocket when you use your respective plan. For example, many Advantage plans require a higher copay than original Medicare for some services. It’s not uncommon for out-of-network outpatient surgery to require 30% coinsurance. Original Medicare would require 20% and most supplemental plans would pay the 20%. In this example an outpatient surgical procedure costing $6000 would require you pay $1800 (30%) with an Advantage Plan and nothing with most supplements. Here’s a video on 5 things you should know about Medicare supplement insurance.I hope that helps.

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