My Income Has Dropped Sharply
If you are in original Medicare, your Part B monthly premium is locked in, but your Part D drug plan isn’t. And there’s a chance you can find a lower-cost policy that covers the medicines you are on. If youre in an Advantage plan, consider a switch to a plan in which there is no extra payment on top of the mandatory Part B premium. And you might qualify for help. Ask your state Medicaid office about Medicare Savings Programs. Find the state offices here or call 800-MEDICARE .
When To Switch Plans
You can switch to a new Medicare prescription drug plan simply by joining another drug plan during Medicare’s yearly Open Enrollment Period, Oct. 15 – Dec 7.
To find out which plans cover your drugs, go to the Medicare.gov Plan Finder . Enter your ZIP code and your prescription drugs.
There are other times of the year Medicare may allow you to switch plans. For example, if you move to a new area, or you lose or gain other health insurance. Contact us to find out if you might qualify for a Special Enrollment Period to change plans without having to wait for the Open Enrollment Period.
Basics Of Medicare Supplement Policies
Before jumping into how to change your Medicare Supplement policies, lets go through the basics.
Medicare Supplements cover the costs not covered by Original Medicare Part A & Part B. For a refresher, remember Part A covers hospitalization and Part B is essentially health coverage for doctors and specialist visits. Each part has standard deductibles and copays you can get stuck paying if you dont have a way to cover those costs.
Medicare Supplements are not Medicare. They pick up the out-of-pocket expenses that Medicare does not cover. Supplements otherwise known as Medigap policies are sold by private insurance but regulated by the federal government.
Regardless of the company you choose, the coverages will be the same. Rates and availability will vary by company. Many companies will also add extra benefits to the products to distinguish themselves from competitors.
There are 10 Medicare Supplement plans on the market in every state but 4. Following are the basic plans most customers choose:
Plan A is the most basic plan you can purchase. All other plans build off of the coverage offered by Plan A.
Plan A covers Part A Medicare co-insurance, including an extra 365 days of hospital costs.Part B 20% co-insurance is covered, along with three pints of blood and Part A hospice care
Plan B is identical to A except it covers the Part A deductible, which is $1,484 in 2021.
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Notes On Part D Changes
- If youre enrolled in a Medicare Advantage plan that includes prescription drug coverage, you can simply enroll in a stand-alone Part D Prescription Drug Plan, which will automatically disenroll you from your Medicare Advantage plan .
- If your Medicare Advantage plan does not include prescription drug coverage and youre planning to switch to Original Medicare plus a Part D plan, youll need to actively disenroll from the Medicare Advantage plan and then enroll in a Part D Prescription Drug Plan. Its recommended that you complete both actions within the same month if you disenroll from a Medicare Advantage plan in January but dont enroll in a Part D prescription plan until February, your Original Medicare coverage would take effect in February, but your drug coverage wouldnt kick in until March.
- Youll also have the option to apply for a Medigap plan when you switch to Original Medicare, albeit with medical underwriting in most cases .
How To Cancel A Medicare Supplement Plan
There is not a required disenrollment period for canceling your Medicare Supplement plan. You may drop your Medigap policy at any time by requesting a cancellation through your insurance company however, if you decide to leave, you may not be able to buy a Medicare Supplement Insurance plan at another time, unless you have a trial right or guaranteed issue right .
Need help choosing a Medicare Supplement Plan? No matter where you are in your Medicare journey, Medicare.orgs information and resources can help make it easy to find the quality and affordable Medicare plan thats right for you. We offer free comparisons for Medicare Advantage Plans , Medicare Supplement Plans , and Medicare Prescription Drug Plans .
Get an online quote for Medicare plans that fit your health care needs today! Or call TTY 711 to get answers and guidance over the phone from an experienced licensed sales agent.
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Original Medicare Vs Medicare Advantage Plans
Allows you to use any doctor, hospital, or health care provider that is enrolled in Medicare and accepting new Medicare patients.
Includes both Medicare Part A and Part B coverage.
No need to choose a new primary care doctor, and referrals are generally not required to see a specialist.
Generally means paying a deductible and copays or coinsurance, along with premiums for Medicare Part B.
Medicare Part D coverage is not included.
Typically requires you to use doctors, hospitals, or health care providers that are in-network. Visiting out-of-network providers may trigger a fee.
Plans must cover the same things that are covered by Medicare Parts A and B.
You may need a referral to see a specialist.
Out-of-pocket costs vary by plan, though plans may cap what you’ll need to pay annually.
Most plans include Medicare Part D coverage for drugs.
When comparing Original Medicare and Medicare Advantage plans, it’s important to consider what’s covered and what you’ll pay. Most people do not pay a premium for Medicare Part A coverage. The standard premium for Medicare Part B in 2021 is $148.50, though your premium may be higher based on your income.
Both Parts A and B have deductibles and coinsurance. For Part A they are as follows:
For Medicare Part B deductibles, you pay $203. After your deductible is met, you typically pay 20% of the Medicare-approved amount for most services including inpatient care, outpatient therapy, and durable medical equipment.
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What Is Medicare Open Enrollment
Medicare open enrollment is a designated window of time each year when individuals can make changes to their Medicare coverage.
Open enrollment is primarily for people who already have Medicare. New applicants should sign up during their initial enrollment period, which starts three months before they turn 65 and ends three months after the month they turn 65. If they miss their initial enrollment period, they can sign up during open enrollment.
The fall open enrollment period for Medicare begins Oct. 15 and runs through Dec. 7 in 2021. This enrollment period is open to people who are covered by:
- Medicare Part A
- Medicare Part B
- Original Medicare
A separate Medicare open enrollment period applies to people who are covered by a Medicare Advantage plan . The open enrollment period for Medicare Advantage plans runs from Jan. 1 to March 31 each year.
Can I Change Medicare Supplement Plans
Policies have a six-month Medigap Open Enrollment Period. This period begins the month after a beneficiary turns 65 and signed up for Part B. During this time, you can enroll in any one of the 10 standardized plans without going through medical underwriting.
This means an insurance company cant turn you down or charge you more if you have a pre-existing health condition.
As a Medicare beneficiary, you can change supplements at any time. As a result, theres no guarantee an application will be accepted if switched outside the designated Open Enrollment Period.
An application may be medically underwritten. This means the insurance company will use the applicants age and health history to decide if they will cover them, and what the premiums will cost. Therefore, a new policy may cost more than your old one.
Always remember, a quote is only a quote, its not a final offer. Dont cancel coverage until you are approved for new coverage, this will prevent any possible lapses in coverage.
Any good insurance agent will tell you to keep your old coverage until your new coverage goes into effect.
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Initial Coverage Election Period
If you are newly eligible for Medicare, you have an Initial Coverage Election Period to join an MA plan that begins 3 months before you first become eligible for both Medicare Part A and Part B and ends on the later of:
- The last day of your Part B Initial Enrollment Period
- The last day of the month preceding your eligibility for both Part A and Part B
Example 1: A persons month of eligibility is April. His IEP for Parts A and B is January 1 to July 31. If the effective date of his Part A and Part B benefits is April 1, his ICEP to enroll in an MA plan is January 1 to July 31.
Example 2: A persons month of eligibility is April and her IEP for Parts A and B is January 1 to July 31. She does not enroll in Part B because she continues to work and is covered by her employers group health plan. She retires and then enrolls in Part B, which becomes effective December 1 of that same year. Her ICEP to enroll in an MA plan is September 1 to November 30.
Submit your application directly to the MA plan or its sales representative. Enrollment is usually effective on the first day of the month following the month you enroll. You cannot receive coverage for medical care from MA plan providers until enrollment takes effect.
Note: You should not drop your existing coverage until coverage with your new MA plan is in effect.
Medicare Advantage Trial Period
All Medicare Advantage enrollees have a one-time trial period that runs for the first year they have coverage under a Medicare Advantage plan. This applies to people who enrolled in Medicare Advantage as soon as they turned 65, and also to people who switched from Original Medicare to Medicare Advantage but only if its their first time being on a Medicare Advantage plan.
At any point during that year, the enrollee can switch back to Original Medicare, and can also enroll with no medical underwriting in a Medigap plan , and in a Part D Prescription Drug Plan if the Medicare Advantage plan covered prescriptions.
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Consider Your Health Care Needs
Some things you cant predict, but you can plan for the things you know. A recent diagnosis or a planned surgery, for example, may mean you need to see a specialist. Or your doctor may have prescribed a new medication. Changes like these may mean your Medicare plan needs to change, too.
Make a list of all the health care needs you know you may need coverage for including preventative screenings and procedures, routine exams and medications and how often you plan to see a physician or other specialist.
You Have A Chance To Get Other Coverage
- I have a chance to enroll in other coverage offered by my employer or union.
What can I do?
Drop your current Medicare Advantage Plan or Medicare Prescription Drug Plan to enroll in the private plan offered by your employer or union.
Whenever your employer or union allows you to make changes in your plan.
- I have or am enrolling in other drug coverage as good as Medicare prescription drug coverage .
What can I do?
Drop your current Medicare Advantage Plan with drug coverage or your Medicare Prescription Drug Plan.
- I enrolled in a Program of All-inclusive Care for the Elderly plan.
What can I do?
Drop your current Medicare Advantage Plan or Medicare Prescription Drug Plan.
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Medicare Advantage Open Enrollment Period
The Medicare Advantage Open Enrollment Period runs from January 1 March 31 each year. It allows you, if youre already enrolled in a Medicare Advantage plan, to:
- Switch to another Medicare Advantage plan , or
- Disenroll and return to Original Medicare. If you do so, you can also join a Part D prescription drug plan.
If you switch plans, enrolling into your new plan will trigger your automatic disenrollment from your old plan. If you return to Original Medicare, you can either 1) submit a disenrollment request to your MA plan and then enroll into a stand-alone Part D plan, or 2) enroll in a stand-alone Part D plan, which will trigger your automatic disenrollment from your MA plan.
Your enrollment into your new plan, or your return to Original Medicare with or without a Part D plan will be effective the first of the following month during this 3-month window.
When Can I Change My Medicare Coverage
You can make changes to your Medicare coverage during a few key times.
- The Medicare Annual Enrollment Period , October 15 December 7
- The Medicare Advantage Open Enrollment Period, January 1 March 31
- The Medicare Special Enrollment Period for qualifying life events dates vary based on qualifying event
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Fall Medicare Open Enrollment For Medicare Advantage Plans
Interested in signing up for a Medicare Advantage plan? There are certain times when you can enroll, and one of them is during Fall Medicare Open Enrollment .
You must be already enrolled in Part A and Part B, and live within the service area of the plan youre enrolling in to participate in the Fall Medicare Open Enrollment.
Besides enrolling in a Medicare Advantage plan, you can make other changes throughout the Fall Medicare Open Enrollment period, such as:
- Switch from a Medicare Advantage plan back to Original Medicare .
- Switch from one Medicare Advantage plan to another.
- Switch from a Medicare Advantage plan that doesnt offer prescription drug coverage to a Medicare Advantage Prescription Drug plan.
- Switch from a Medicare Advantage Prescription Drug plan to a Medicare Advantage plan that doesnt include prescription drug coverage.
General Medicare Enrollment For Those Who Didnt Sign Up When First Eligible
From January 1 to March 31 each year, people who are eligible for Medicare Parts A and B but not yet enrolled can sign up for coverage. Coverage will take effect on July 1 of that year. If you didnt sign up for Part B when you were first eligible and you havent had creditable coverage from an employer plan in the meantime, youll have to pay an additional premium for your Part B plan, as a late enrollment penalty.
If you sign up for Medicare during the general enrollment period, you have three additional months during which you can select a Part D plan or a Medicare Advantage plan. And once youre enrolled in Medicare Part B , youll have a one-time enrollment window during which Medigap plans in your area are guaranteed-issue. In most states, Medigap plans will then be medically underwritten if you apply after that six-month window ends.
Although the fall enrollment window for 2022 coverage is approaching, people who arent enrolled in Part B cannot sign up for it during the fall window. Instead, theyll need to wait until January 1, and enroll in Part B during the general enrollment period.
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How To Change Medicare Plans
Be aware that if you want to disenroll from a Medicare Advantage plan and dont want to enroll in another Medicare Advantage plan, you have to notify your plan in writing. However, if you want to change from one Medicare Advantage plan to another or from one Medicare prescription drug plan to another, all you have to do is join the new plan, and you will automatically be disenrolled from the old one.
Also understand that you can generally only change Medicare plans during the Medicare Advantage Open Enrollment Period, Annual Election Period, or a Special Election Period .
Medicare information is everywhere. What is hard is knowing which information to trust. Because eHealths Medicare related content is compliant with CMS regulations, you can rest assured youre getting accurate information so you can make the right decisions for your coverage. Read more to learn about our Compliance Program.
Can You Enroll In Medigap
If youre switching from Medicare Advantage to Original Medicare, you can also purchase a plan Medicare Supplement plan. This kind of plan, also known as a Medigap policy, pays for gaps in Medicares coverage.
For instance, Medicare Part B pays 80% of covered costs after you pay your annual deductible. A Medigap policy would pay the remaining 20% due. But if youve missed your Medigap Open Enrollment Period, an insurer could deny you coverage due to your health history.
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Im Super Healthy And Rarely Need A Doctor
If youre in original Medicare, all should be well: As a pay-for-service arrangement, not seeing the doctor isnt costing you anything extra beyond your mandatory parts B and D monthly insurance premiums. If youre in an MA plan in which youre paying a monthly premium on top of your standard Part B premium, that may be for a plan that offers lots of extras, such as gym memberships. Consider switching to a lower-cost MA plan that doesnt offer services you dont plan to use in the coming year.
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