Can I Change From Medicare Supplement To Medicare Advantage

When Can I Switch From Medicare Advantage To Medigap

To switch from Medicare Advantage is a multi-step process. First, you need to drop your Medicare Advantage plan and return to Original Medicare, Part A and Part B. Then, you can apply for a Medicare Supplement insurance plan.

In most cases, you can only leave a Medicare Advantage plan during certain times of the year, such as:

• The Medicare Advantage Open Enrollment Period between January 1 and March 31.
• The Annual Election Period , between October 15 and December 7. This is also called the Open Enrollment Period for Medicare Advantage and Medicare Prescription drug coverage.

Outside these periods, you can only switch between Medicare Advantage and Original Medicare if you meet certain requirements like moving outside your plans service area. You may also lose your Medicare Advantage plan if it leaves your area or ends its contract with Medicare. Youll get returned to Original Medicare.

If you move from home into a nursing facility or other institution, or move back home from an institutional setting, you may also be able to switch from Medicare Advantage to Original Medicare.

Without guaranteed-issue rights, your insurance company may require medical underwriting before it sells you a plan. During medical underwriting, the insurer looks at your past medical history and current health status. If the company determines the risk of covering you is too high, it can refuse to sell you the plan you want, or it may charge you much higher premiums for the coverage.

Changing Medicare Advantage Plans: Compare Plans Before You Switch

If you want to change Medicare Advantage plans, you may want to make sure youre choosing the right plan for your needs and not missing out on a plan that might be better for you. For an instant side-by-side look at Medicare Advantage plans in your area, start by entering your zip code in the box on this page.

From the list of plans displayed, you can enter your medications to see if theyre covered, look at specific plan costs, and more. Follow the links below to request an email with customized information, or to set up a phone call with me.

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Enrollment Periods For Medicare Supplements

Just like Medicare has special enrollment periods throughout the year, Medicare Supplements have a special window where you need to purchase a plan.There is really only one Enrollment period for Medicare Supplements. It is referred to as the Initial Enrollment Period. This window is from 3 months prior to your 65th birthday and 3 months after.

During this period you can enroll in a Medicare Supplement without being subject to medical underwriting and policies are guaranteed issues

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Whats The Difference Between Medicare Advantage And Medicare Supplement

Medicare Advantage combines Medicare Part A and B for comprehensive coverage, all in one plan. It often includes Part D Prescription Drug coverage, too. These are also called Part C plans.

Medicare Supplement insurance policies, also called Medigap, help pay the out-of-pocket expenses not covered by Original Medicare . It is not part of the governments Medicare program, but provides coverage in addition to it.

When Can I Change To Medicare Supplement With Guaranteed

In some cases you may be able to change from a Medicare Advantage plan to a Medicare Supplement plan with guaranteed-issue rights, meaning that the insurance company must accept you as a member and cannot charge you more due to your health condition. However, in some cases the company may be allowed to impose a waiting period on coverage relating to your health condition.

Here are some general circumstances under which you may generally change from a Medicare Advantage plan to a Medicare Supplement plan with guaranteed issue. This list might not include every situation that could give you guaranteed-issue rights. Please note that these situations generally have time limits in most cases, you apply for the Medicare Supplement insurance policy within 63 calendar days after your Medicare Advantage coverage ends.

• You enrolled in a Medicare Advantage plan when you were first eligible for Medicare and you arent happy with the plan, which youve had for a year or less. You generally have a special right to purchase a Medicare Supplement plan if you return to Medicare Part A and Part B within 12 months of enrolling in the Medicare Advantage plan.
• You move to an area your Medicare Advantage plan does not serve.
• Your Medicare Advantage plan no longer serves the area where you live.
• Your plan no longer has a contract with Medicare.

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Important Information About Your Plan

The Medicare deductibles, coinsurance and copays listed are based on the 2021 numbers approved by the Centers for Medicare and Medicaid Services. You can go to any hospital, doctor or other health care provider in the U.S. or its territories that accepts medicare. You don’t have to use our network. Blue Cross Blue Shield of Michigan administers Blue Cross medicare Supplement plans. Where you live, your age, gender and whether you use nicotine products may affect what you pay for your plan. Your health status may also affect what you pay. This is a solicitation of insurance. We may contact you about buying insurance. Blue Cross Medicare Supplement plans aren’t connected with or endorsed by the U.S. government or the federal Medicare program.

Medicare plans

The First Year Exception

There is a 12 month exception on underwriting if the Medicare Advantage plan you are in is the first one you have ever tried. If you leave that Medicare Advantage plan in the first 12 months, you can return to your Medigap plan without underwriting. In that first year ONLY, you will be guaranteed to reinstate your former Medigap plan.

Be aware of this window if you try Medicare Advantage and decide you dont like it.

Moral of the story: It has been my experience that people like their Medicare Advantage plan until they get sick. Once they develop a chronic or serious health condition, they often desperately want to go back to their Medigap plan for the fuller coverage.

However, because of that health condition, you may not be able to get back into a Medigap plan. Ask yourself if that is a risk you are willing to take in order to lower your health insurance costs now. The old motto that you get what you pay for definitely applies here.

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Do Medicare Supplement Plans Cover Pre

For the first six months after you enroll, a Medicare Supplement plan can cover the Part A coinsurance when the visit doesnt relate to the pre-existing condition. A visit relating to a pre-existing condition wont have coverage.

Although Medicare will pay some of the hospital bills, you pay the rest. This is because Medicare doesnt have a pre-existing condition waiting period like Medigap. Those with a pre-existing condition enrolling in or changing Medigap plans outside of the OEP need to budget to ensure theyre able to cover any medical costs for six months.

So What Should You Do

Because of the variety of options and potential costs you might incur, it is a good idea to regularly review your coverage. This is especially true if you have had your plan for several years.

After a thorough review, you may discover you are exactly where you need to be.

Our agents have years of experience with the wide varieties of plans in the marketplace throughout the United States. We can review your coverages and present multiple options that meet your health and financial needs.

We may find you should stay right where you are and we will tell you that as well.

Whatever you do, dont let the amount of information out there overwhelm you. You could be putting your retirement savings as well as your health at risk.

Prefer to chat by phone? Give us a call at

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The Medicare Supplement Free Look Period

When you switch Medicare Supplement Insurance plans, you generally are allowed 30 days to decide to keep it or not. This 30-day free look period starts when your new Medicare Supplement plan takes effect. To qualify, you need to pay the premiums for both your new plan and your old plan for one month.

You Cannot Have Both So Choose Wisely

When switching from a Medicare supplement to another plan, it is easier to switch within programs rather than switch programs altogether. You cannot have an Advantage plan and a Medicare Supplement plan simultaneously, so you need to make an informed decision based upon your needs.

For instance, Medicare Advantage provides both part A and B benefits, and some of part D, which sounds great, but there are some drawbacks. According to Investopedia:

Medicare Advantage Plans do not offer the same level of choice as a Medicare plus Medigap combination. Most plans require you to go to their network of doctors and health providers. Since Medicare Advantage Plans cant pick their customers , they discourage people who are sick by the way they structure their copays and deductibles.

If you are someone who has chronic illness, or just tends to be ill more often, then Medicare Advantage may not be for you because of their copay structure. That does not mean it is a bad plan, it just is not for everyone.

Medigap coverage tends to cost more than most Advantage plans, but Medigap has a wider network of physicians covered.

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Changes During Annual Open Enrollment

There are many plan changes that Medicare beneficiaries might want to make from one year to the next.

For most of them, the applicable open enrollment period is October 15 to December 7, with changes effective on January 1. During that timeframe, you can:

• Switch from Original Medicare to Medicare Advantage, or vice versa.
• Switch from one Medicare Advantage plan to another.
• Enroll in a Part D Prescription Drug Plan for the first time
• Switch from one Part D plan to another.
• Drop your Part D coverage altogether .

Read more about the four ways you can upgrade your Medicare coverage during open enrollment. And take a minute to read about Medicare enrollment mistakes that could cost you money.

Can I Change Medigap Plans After My Open Enrollment Period

Under federal law, you have a guaranteed issue right to buy a Medicare Supplement insurance plan during the Medigap Open Enrollment Period, which begins the first month you have Medicare Part B and are age 65 or older. This means that during this six-month enrollment period, insurers cannot turn you down or charge you more because of a pre-existing health condition*.

After the Medigap Open Enrollment Period, insurers can refuse to sell you a Medigap policy, delay coverage, or charge you a higher premium because of an existing health condition. The insurance company may also ask you to submit to a medical underwriting process and deny you coverage or charge you a higher rate based on its findings.

There are some exceptions to the rule, however. In some situations, you have the guaranteed-issue right to buy a Medicare Supplement policy outside of your Medicare Supplement Open Enrollment Period:

You may qualify for guaranteed issue into a Medicare Supplement insurance plan, regardless of your medical history, if you meet certain criteria such as applying during your Medicare Supplement Open Enrollment Period. Additional guaranteed issues rights may be available and are dependent on your state of residence.

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Can I Leave Medigap To Join A Medicare Advantage Plan

When choosing to supplement your Original Medicare coverage, you must decide between Medigap and Medicare Advantage you cannot have both. If you decide to join an MA plan, you must first cancel your Medigap policy. You may do this during any of the enrollment periods listed above or if you qualify for one of the Special Enrollment Periods.

If you decide to return to Original Medicare AND this is the first time you’ve had a Medicare Advantage plan, you qualify for “trial rights.” This allows you to return to your original Medigap policy without undergoing medical underwriting. If you do not change back within the first 12 months or if this wasn’t your first time enrolling in an MA plan, you may be denied Medigap coverage based on underwriting.

If You Enroll In Drug Coverage Thats Equivalent To Medicare Part D

If you enroll in TRICARE, VA coverage, or another plan that offers comprehensive prescription drug benefits and you have a Medicare Advantage plan that includes prescription drug coverage then you can leave your Medicare Advantage plan and return to Original Medicare.

• Youll want to check with your prescription drug plan to make sure that it provides you with credible drug coverage.
• You can do this at any time, but your ability to enroll in the alternative creditable drug coverage may be limited by that plans rules.

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Medigap & Medicare Advantage Plans

Medigap policies can’t work with Medicare Advantage Plans. If you have a Medigap policy and join a

, you may want to drop your Medigap policy. Your Medigap policy can’t be used to pay your Medicare Advantage Plan copayments, deductibles, and premiums.

If you want to cancel your Medigap policy, contact your insurance company. If you leave the Medicare Advantage Plan, you might not be able to get the same, or in some cases, any Medigap policy back unless you have a “trial right.“

If you have a Medicare Advantage Plan, it’s illegal for anyone to sell you a Medigap policy unless you’re switching back to

. Contact your State Insurance Department if this happens to you.

If you want to switch to Original Medicare and buy a Medigap policy, contact your Medicare Advantage Plan to see if you’re able to disenroll.

If you join a Medicare Advantage Plan for the first time, and you arent happy with the plan, youll have special rights under federal law to buy a Medigap policy. You have these rights if you return to Original Medicare within 12 months of joining.

When Can You Change Your Medicare Supplement Plan

Already enrolled in a Medicare Supplement plan but want to know how and when you can change it? Read our guide to learn more about this process with tips you should be aware of.

Each Medicare plan and insurance product we feature has been independently selected and reviewed by our editorial team in conjunction with our partners at Medicare Expert USA. If you make a purchase using the links included, Health.com may be compensated.

Key Takeaways:

• There are certain restrictions when it comes to changing Medicare Supplement plans.

• There are a number of reasons why you might want to change your Medicare Supplement plan.

• Medigap Open Enrollment is the best time to change plans.

• You dont have to wait to change policies if you are buying your very first Medicare Supplement plan.

• New rules took effect on January 1st, 2020 that you should be aware of.

There may be times when you want to change your Medicare Supplement plan. Perhaps you want a less expensive policy, or you need more benefits. But you should know that there are certain restrictions on changing Medicare Supplement plans. In this guide, we will highlight key information and the dates you need to know in order to choose the right option for you.

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How To Switch From Original Medicare To Medicare Advantage

Medicare Advantage plans offer a popular substitute for Original Medicare . These private plans often provide more comprehensive coverage than Original Medicareâsuch as dental, foot, and eye care benefits, coverage for a wider variety of medical supplies, or coverage for acupuncture and other forms of complementary medicine. If youâre interested in switching from Original Medicare to Medicare Advantage, you can do so during specific times of the year.

When Can You Switch From Original Medicare To Medicare Advantage

If youre enrolled in Original Medicare and interested in making changes to your Medicare plan, you can typically only do this once a year. During the Annual Election Period , which is every fall between Oct. 15 and Dec. 7, you can switch from Original Medicare to a Medicare Advantage plan, or vice versa. Coverage will be effective on Jan. 1.

There is also a built-in safety net for circumstances that are often beyond your control that allow you the flexibility to switch from Medicare Advantage to Original Medicare or enroll for the first time. The Special Election Period gives you the opportunity to change your Medicare Advantage and prescription drug plans or go back to Original Medicare outside of the normal time restraints.

Situations that qualify for SEP might include a move outside the area your current plan covers, becoming eligible for a low-income subsidy, losing creditable prescription drug coverage from your employer or if your plan is no longer available.

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