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Changing Medicare Plans After The Enrollment Period

Your limited options for dropping or changing your Medicare Advantage plan after Open EnrollmentRed Act Now Button

Enrolling in a Medicare Advantage plan only to find out later that you made a mistake is frustrating. Enrolling in the wrong plan can cost you; cost you money and cost you lost opportunity to be taking advantage of a better choice.

If you are unhappy with your current choice, you may have an opportunity to make a change after the annual enrollment period has ended. You don’t necessarily need to be locked into a bad Medicare Advantage plan.

This article will address the ways that you can cancel a Medicare Advantage plan or change to a new Medicare Advantage plan that you believe will be a better choice.

Get me out of here! Canceling your Medicare Advantage plan

Gone are the days when you had the first 3 months of the year to test drive your Medicare Advantage plan and make a like-to-like plan change. You now have an opportunity to drop your plan and return to original Medicare.

Between January 1st and February 14th you can dis-enroll from your current plan. This does not mean you are able to switch into another Advantage plan. You will instead return to original Medicare. You are then free to compare Part D, choose a plan and submit an application to purchase a Medigap policy if you wish.

You will be covered by your current plan through the end of the month in which you drop your plan. Your stand-alone Part D plan will become effective the first of the following month. There could be a lag in coverage with a Medigap policy due to varying underwriting times. Check with a local insurance agent to review underwriting guidelines.

Change Medicare Advantage plans anytime – well maybe

You do have a Special Enrollment Period that applies to both Medicare Advantage and Part D. The big question is whether or not you will be able to take advantage of it.

Medicare Advantage and Part D plans are rated from 1 to 5 stars. These ratings can be reviewed by visiting medicare.gov and searching for Health and Drug Plans in your area. The new enrollment period allows you to switch into a 5 star rated plan as long as you are currently enrolled in a plan with 4.5 stars or less. You can enroll at anytime during the year but are only allowed to change one time.

Here’s the problem… there are very few 5 star plans available. You may not have any 5 star plans available in your area. To many people that seems about as fair as some areas having several Medicare Advantage plans to choose from, while others may not have any plans at all.

Now that some politicians are beating the drum for the privatization of Medicare things will need to get a little more equitable. You can’t force everyone into a private plan¬† and then allow insurance companies to pick and choose where they play.


If your circumstances change you may be entitled to a Special Enrollment Period

Special Enrollment Periods are available to certain classes of people and to people who are undergoing a change in circumstance that renders their old insurance plan null and void.

If you receive extra help due to a limited income you are able to change plans as often as you would like. It’s strange that people who earn $1 more than the extra help qualification threshold AND struggle to make ends meet can’t change even if it will put them in a better position.

Most Special Enrollment Periods for people who do not receive extra help are a result of losing employer coverage or moving out of a plan’s service area. Review your Medicare and You Handbook to see all qualifying events.

If you have a Special Enrollment Period you should certainly take advantage of it to maintain coverage. And if you are unhappy with your current choice and would like to change Medicare plans, either take advantage of the dis-enrollment period or search medicare.gov to determine if you have any 5 star plan options.

 

 

15 comments

  1. Nathan Pendleton

    Anything would be better than Obamacare! Let the market operate to everyone’s benefit with privatization

  2. The reason we are having the privatization conversation is because our wonderfully wise and helpful “representatives” have never properly funded Medicare, have not monitored it for fraud, and are millionaires with great insurance, so why should they care anyway? They care much more about their wars and corporate interests. Obamacare was passed because the current system is badly broken and will self-destruct. Obamacare puts a band-aid on a brain hemorrhage. Single-payer would be similar to VA, and would be the best solution that we will have to continue to await until Washington just implodes.

  3. I am not well-informed on the subject of privatization and its affect. Where can I learn more on this subject. I do believe that the monies allocated for Medicare have been poorly managed. Happy New Year to you as well!

  4. What DEMOCRATS are moving towards privatization of Medicare?

  5. After what has happened this past session in Congress it seems that ANYTHING the representatives are in favor of will be a disaster to the American people especially those of us on Medicare. They do not listen to those who elected them and they do not care why should they their medical insurance is paid for by us who cannot get the same insurance coverage. I am sure that if Medicare is privatized it will be given to some of their cronies who will make more millions on the backs of ordinary people who will suffer. That seems to be the mission of the Congress steal from the people, make millions for themselves and their friends

  6. private industry is always more efficient than any government agency so it would have to be better. They would have better programs to catch fraud also which would automatically mean increased savings.

  7. Privatization could be more efficient since private companies have more incentive than federal bureaucrats to keep costs & fraud down.

    Legislation would need to make sure that the service structure is adequate and standard across all carriers.

    Privatization should reduce the bureaucrat portion to regulating industry vs. administering the entire program for all individuals.

  8. Gabriel, Senator Ron Wyden (D) of Oregon is working on legislation with Paul Ryan (R) of Wisconsin on legislation. Here’s an article about the working relationship.

  9. Larry, Have you called an insurance companies customer service number lately? I’m just saying… always more efficient?

  10. Doug, I agree and I think the key is your second point about service structure and standardization.

  11. The question on privitization is “will it be affordable?”
    I had much better health care when I was working- but much of it was paid by my employer. Privately- insurance costs at least $800/month to get any kind of decent coverage.- Not something seniors can afford.
    The flip aide is getting rid of some of the ridiculous government rules and regulations now in effect over medicare.
    The entire system is broken- but Obamacare is definitely NOT the answer.
    Right now our doctors have to work with a miriad of insurance carries and know who pays what for which patient and which lab or out patient testing facility a patient can use! I firmly believe all my doctor should have to worry about is being able to treat patients without memorizing all the other red tape!

  12. Idahoejoe, So conversely, people under 65 should have only one choice of insurance so their doctors will not have to deal with many insurance companies and patient testing facilities? sounds like eliminating a patient’s freedom of choice. I think it’s safe to say that your doctor is not staying up at night memorizing all the other red tape. Typically office staff handles billing.

  13. how can I get in touch with you thanks

  14. I am enrolled in a Healthspring Advantage plan in Tennessee. I applied for membership in December, 2011 and became a member on 1/1/12. Part of the sales pitch was that Healthspring would provide a monthly $75 buy-down against my Part B premium. I recommend you not do business with this company because I have not received any buy-down. Not only that, but I have had to pay Medicare a quarterly premium of $399.60. I have been through my agent and 8 customer service people to no avail. Again, don’t take the risk of dealing with Healthspring. Fair warning!

  15. David, if you feel you have been wronged, file a complaint with Medicare. If HealthSpring does not offer the buy-down, the issue may be a misinformed or dishonest insurance agent. In which case corrective action is necessary.

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