Here’s why enrolling in a Medicare Advantage plan will not cancel your Medicare
There are several misconceptions about Medicare Advantage plans. The biggest error is believing that when you join a Medicare Advantage plan you are some how dis-enrolled from Medicare.
Here’s the truth: Joining a Medicare Advantage plan will not cancel your Medicare.
I receive countless emails and comments that indicate confusion about how joining a Medicare Advantage plan effects Medicare enrollment.
It’s this sort of misinformation and confusion that keeps some people from exploring all of their potential Medicare options.
This article will highlight some facts about Medicare Advantage plans in relation to original Medicare.
Some facts about Medicare Advantage plans
1. You must have Medicare Parts A and B, live in the plan’s service area and not have end-stage-renal disease to join a Medicare Advantage plan. You do not lose Parts A and B by joining a plan. You are reminded of such by continuing to have your Part B premium deducted from your Social Security check!
2. When you enroll in a Medicare Advantage plan you have merely chosen another way to receive your Medicare benefits. You will present your membership card when receiving services and your plan will handle the payment of claims.
3. The Medicare Advantage program is highly regulated and claims must be paid in a timely manner as determined by CMS. Covered services cannot be denied, in fact many medical services beyond what Medicare normally covers are provided by Medicare Advantage plans (which is not the case with Medigap Insurance).
4. Advantage plans cannot charge more than original Medicare for certain services such as; dialysis, chemotherapy and skilled nursing facility care.
5. Medicare Advantage plans limit your maximum annual out-of-pocket expense by imposing a yearly cap. The amount can vary from plan to plan. This feature goes beyond the the way original Medicare treats your annual expenses. Original Medicare does not include a cap on expenses.
6. An Advantage plan is not a Medicare supplement. You cannot be enrolled in both a Medicare Advantage plan and a Medicare supplement at the same time.
Enrolling, switching and dropping a Medicare Advantage plan
As further proof that your Medicare is not canceled when you join an Advantage plan you can choose to return to original Medicare at certain times.
Each year during the Open Enrollment Period you could choose to drop your current Advantage plan and return to original Medicare. You also have the opportunity to cancel your Medicare Advantage plan between January 1 and February 14.
Leaving a plan during this time will return you to original Medicare. Your option will then be to choose a stand-alone Part D plan if you wish (highly recommended) and also make the choice whether or not to purchase a Medicare supplement.
If you choose to drop your Advantage plan you will not be allowed to enroll in another until the next Open Enrollment Period unless you are entitled to a Special Enrollment Period.
By understanding how a Medicare Advantage plan works and the protections provided it’s easy to see that your original Medicare is not canceled when you choose an Advantage plan.
Does enrolling in a Medicare Advantage Plan cancel your Medicare ??? In a sense, it DOES, but YOU do not lose the right of being a Medicare Beneficiary. You will have the right to return back to original medicare at each Annual Enrollment Period (AEP) or during the Medicare Advantage Disenrollment Period (MADP) or any any other time you qualify for a Special Enrollment Period (SEP). But keep in mind that only certain SEP’s guarantees that you can get into a Medicare Supplement without underwriting.
One has to consider, is the Medicare Advantage (MA) Plan going to serve your needs? Normally a medicare supplement is going to cost more premium, so you need to weigh everything out to see which route is more economically feasible for each individual circumstances. If premium is not an issue, then I say go for the gusto and be on original Medicare and have a Medicare Supplement plan F with a stand alone RX plan. You will not have co-pays or out_of_pocket expenses on any Medicare covered part A & B expenses. If you are covered in this manner and later develope a serious illness e.g. End Stage Renal Disease (ESRD), you will be fully covered. If you are on a Medicare Advantage plan and develope ESRD, you will incur your out-of-pocket maximum each and every year, which can range anywhere from normally $3000.00 to $10,000.00 per year depending on the plan, which can throw many people into financial ruin. So I say if you can handle the premiums, go for the gusto, if not find the best MA plan you can find at the lowest possible premium and hold you breath that you don’t get ESRD or any other kind of serious lingering illness. I have been an insurance agent for over 30 years and I approve of this statement.
John, thanks for sharing your insight.