Are you planning on moving? Learn how to avoid some common Medicare Moving Mistakes!
Medicare Options
With Medicare, you have many options. You can opt for Original Medicare alone. Additionally, you can also enhance it with a Part D plan which covers prescription drugs, or a Medigap plan which covers copays and deductibles. You can also replace your Original Medicare coverage with a Medicare Advantage plan. These plans must offer at least the same benefits as Original Medicare and many also offer additional benefits and prescription drug coverage. Often these plans offer cost savings but with restrictive networks, referrals, and preauthorization. So, please proceed with caution.
Some Medicare plans are offered nationwide. Some are really determined by your geographic area. Although options and courses of action may vary, the main mistake you can make boils down to not taking advantage of your SEP.
Special Enrollment Periods
If you are moving out of your network area, you will be eligible for a special enrollment period for Part C. Because most pharmacies are nationwide (Part D plans) you should be able to find an in-network pharmacy without issue.
However, you may not be able to find providers or hospitals who accept your Medicare Advantage plan.
So, when you move, you will likely be eligible for a special enrollment period. This is a great time to reassess your needs and wants in a plan. Research the hospitals and providers in your area to determine which carriers and plans will work best for you. Compare premiums and copays. You can always rectify any mistakes made during the AEP but depending on what time of year you move, that may be a long way away!
Switching to Medigap
Another huge potential mistake is not switching to Medigap!
Medicare can be very confusing. People are often inundated with emails, flyers, and phone calls and it is very easy to become overwhelmed. Often times, people initially sign up for a Medicare Advantage plan because they are lured in by all of the appealing promises.
Medicare Advantage plans often advertise themselves as “free”. Are they free? Absolutely not. At the very least, you will still have to pay your Part B premium. They can offer additional benefits like dental, vision, hearing, and prescription drugs amongst others. They may have lower copays and deductibles. And they impose an out of pocket maximum.
At face value, they sound great!
However, in most areas of the country, Medicare Advantage plans are just not that great. Please understand that for some people, they are wonderful! There is no one-size-fits-all approach to health insurance.
They are often also not wonderful once have you larger medical needs (especially as you get older). Many people report that when they really need their Advantage plan for larger needs, it is just not adequate. Unfortunately, at that point that person would likely be unable to switch to a Medigap plan.
Medigap plans are a top notch insurance plan, especially if you are able to enroll in Plan F or Plan G. Original Medicare alone will cover almost all of your main and major medical needs. However, there are copays, coinsurance and deductibles. By enrolling in a Medigap plan, you will pay an extra monthly premium but if you are able to enroll in Plan F, G, or even N, almost all of your additional out of pocket bills will be taken care of by your supplement plan. Think of it as the all inclusive approach to healthcare. You pay more upfront, but almost everything is included.
Also, with Original Medicare and Medigap there are no networks, referrals or preauthorizations. When you have more extensive medical needs, this is paramount.
Medigap Enrollment
You are first eligible in the 6 month window after you turn 65 and enroll in Part B. During this time, you will not be subject to medical underwriting. After this time, you may be subject to medical underwriting so you could be charged more or denied outright. Unfortunately, many plans to make the switch when they need more comprehensive coverage, and at that point, it is often difficult if not impossible to find an affordable plan.
However, if you have a Medicare Advantage plan and you are moving, you will likely lose coverage. At that point, yes, you could switch to another Medicare Advantage plan OR you could switch to Original Medicare with a Medigap plan. Because you have moved outside of your network area, you should be able to enroll in a Medigap plan without medical underwriting.
It may take a little paperwork, but a qualified broker should be able to assist you with this. Please do not sleep on this opportunity. You may not get another one and in our estimation, this would be a huge mistake.
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.
