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When it comes to Medicare Advantage plans, they don’t have to be as permanent a choice as you might think.
Your 2021 plan, which you have chosen or re-enrolled, can be changed or abandoned between January 1 and March 31. That is, you can change your benefit plan for another or give it up and go back to basic Medicare (Part A hospital coverage and Part B outpatient coverage).
The most common reasons beneficiaries make changes include their doctors who are not in the plan’s network or a drug that is not included in their coverage, said Danielle Roberts, co-founder of Boomer Benefits.
Also, from January 1 to March 31: If you missed the initial Medicare enrollment period and don’t qualify for an exception, you can enroll at that time. If this is your situation, coverage will not begin until July 1, said Elizabeth Gavino, founder of Lewin & Gavino and an independent broker and general agent for Medicare plans.
Of the approximately 63 million Medicare beneficiaries, approximately 25 million are enrolled in an Advantage Plan, which provides Parts A and B and usually Part D, coverage for prescription drugs, along with facilities such as dentistry. and sight.
The current opportunity to change or drop your Advantage plan comes just weeks after Medicare’s annual fall enrollment ended, when a variety of options were available for those who wanted to change their coverage.
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Instead, the next Advantage Plan window comes with restrictions.
For starters, you can only make one switch. This means that once you switch to another Advantage plan or drop out of basic Medicare, the change is generally blocked for 2021 (unless you meet an exclusion that qualifies you for a special enrollment period).
In addition, this three-month window does not allow you to switch from one prescription drug plan, Part D, to another.
If you chose a Part D plan during the fall open enrollment period based on faulty or misleading information, you can call 1-800-Medicare at any time of the year to see if your situation allows you to make a change.
In the meantime, giving up a benefit plan in favor of basic Medicare often means losing your drug coverage – which means you’ll have to sign up for a Part D stand-alone plan. This matters, because if you go 63 days without coverage, you may face a penalty for late enrollment for life, which will be applied to the monthly premiums.
Also, if you go back to the original Medicare and want to get an additional policy (known as “Medigap”), keep in mind that you may not qualify for guaranteed coverage. These policies cover, in whole or in part, the allocation of costs for some aspects of Parts A and B, including deductibles, co-payments and co-insurance. However, they come with their own registration rules.
“If someone is planning to go back to the original Medicare and get a Medigap plan, they should be aware that they will probably have to answer health questions and go through the subscription,” Roberts said.
She advises starting the process by applying for the Medigap plan and obtaining approval before leaving the Advantage plan or joining an independent Part D plan.
Enrolling in Part D plans will take them out of the Medicare Advantage plan, so it’s important to wait for that part as well, Roberts said. “We encourage people who need to make a change to do so at the beginning of the election period.”