Is your Medicare Advantage Plan not all you thought it was cracked up to be? Are you stuck with it? There are several ways in which you can leave your Medicare Advantage Part C Plan.
What is Medicare Advantage and Why Would I Want to Leave?
Medicare Advantage is an alternative option to Original Medicare. It replaces your Original Medicare entirely, offering all of the same benefits in addition to other benefits such as dental, vision, hearing, etc… Very often it will encapsulate prescription drug coverage ordinarily offered by Medicare Part D. It will also limit your out of pocket costs with OOP Maximums and oftentimes, lower copays than Original Medicare.
However, Medicare Advantage networks are much more limited than Original Medicare. Additionally, should you find yourself in need of more specific treatment, for something such as cancer, your specific plan or Medicare Part C in general may no longer suit you. Even though the plans are often cheaper at face value, if you’re unable to take advantage of the services and physicians that you desire, your plan will not be of much use to you. That’s why many people choose to leave their Part C plan in favor of Original Medicare with a Medigap Plan (aka Medicare Supplement Plan).
Medicare Advantage Annual Enrollment
You probably already know about the Medicare Advantage Annual Enrollment Period or AEP. The AEP is every year from October 15-December 7th. During this time, you can add a plan, switch plans or drop a plan. It’s probably the easiest time to leave a Medicare Advantage Plan. Any plan changes you make will become effective January 1. But what do you do if you’ve missed the AEP or you’re nowhere near it and you need to switch now? Luckily there are other options.
Medicare Advantage Open Enrollment
Almost immediately after the Medicare Advantage Annual Enrollment Period is the Medicare Advantage Open Enrollment Period. This is every year from January 1-March 31. This is ever so slightly different than the Annual Enrollment Period.
During this time you can drop or switch plans BUT you cannot join a plan if you do not already have Medicare Advantage. Also, your change will become effective the 1st of the month after you’ve made the change. So, if you switch in anytime January, changes will be effective February 1st.
This is another easy way to leave a Medicare Advantage Plan (or just switch if you still want Part C, just not your plan). At this point, we’ve really covered almost half the year! If you need to switch outside these two time periods, there may still be other options, but it depends on your specific circumstances.
If you’ve been enrolled in a Medicare Advantage Plan for less than a year, you’re still in the trial period. So, you’re still able to wiggle out at any time. An added benefit is that you may be able to enroll in a Medicare Supplement Plan without medical underwriting. Basically, if you have enrolled in an Advantage Plan and it’s still within a year of your enrollment, you are in the trial period. When you enroll in Medicare Advantage, you’re giving up Original Medicare in favor or Medicare Advantage. If you decide that it’s not for you within the first year, you can switch back to Original Medicare. You’ll then have 63 days to enroll in a Medicare Supplement Plan.
Qualifying Life Events
Finally, you may be eligible for a special enrollment period if you undergo certain qualifying life events. For example, if you move or lose coverage. The list of qualifying life events is extensive and the rules for special enrollment periods can vary. So, if your Medicare Advantage Plan is not working for you and you want to switch now, hope is not lost! Call a licensed broker who can hopefully help you work out the easiest and quickest way to leave your plan.
Additionally, remember, that if you leave a Medicare Advantage Plan, you’ll probably want to enroll in a Medicare Supplement Plan. If you’re subject to medical underwriting, that may take a little time, so try to get the ball rolling before you drop your Advantage Plan so you’re not left without supplemental coverage. You’ll also need Medicare Part D because Original Medicare and Medigap Plans do not cover prescription drug coverage.
If you’d like our help, you can reach us at iHealthBrokers at 888-918-0518 or schedule a call today! Our services are 100% FREE!!!
Jesse Smedley is the Principal Broker for iHealthBrokers and the founder, president, and CEO of Smedley Insurance Group, Inc. and iHealthBrokers.com. Since the inception of SIG in 2007, Jesse has been dedicated to helping people save money on their health insurance by providing them with resources to educate themselves on all their health insurance options, both under age 65 and Medicare beneficiaries. He is featured in many publications as well as writes regularly for expert columns regarding health insurance and Medicare.