Female doctor working with senior patient in a modern clinic / hospital
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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 discarded between January 1 and March 31. That is, you can exchange your Advantage Plan for another one or abandon it and return to basic Medicare (Hospital Part A coverage and outpatient coverage of Part B).
The most common reasons why beneficiaries make changes include the fact that their doctors are not on the plan’s network or a drug is not included in their coverage, said Danielle Roberts, co-founder of insurance company Boomer Benefits.
Also from January 1st to March 31st: If you missed your initial Medicare enrollment period and don’t qualify for an exception, you can enroll during that period. If this is the case, coverage will not begin until July 1, said Elizabeth Gavino, founder of Lewin & Gavino and independent broker and general agent for Medicare plans.
Of the approximately 63 million Medicare beneficiaries, about 25 million are enrolled in a Benefit Plan, which provides coverage for prescription drugs for Parts A and B and usually Part D, along with extras such as dentistry and vision.
The current opportunity to change or cancel your Advantage Plan comes just a few weeks after the closing of Medicare’s annual fall enrollment, when a variety of options were available to those who wanted to modify their coverage.
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In contrast, the next window related to the Advantage Plan comes with restrictions.
To start, you can only make one exchange. This means that once you switch to a different Advantage Plan or cancel it for basic Medicare, the move is usually 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 an independent Part D prescription drug plan to another.
If you chose a Part D plan in the fall open enrollment period based on incorrect or misleading information, you can call 1-800-Medicare at any time during the year to see if your situation allows you to make a change.
In the meantime, abandoning an Advantage Plan in favor of basic Medicare usually means losing drug coverage – meaning that you would have to enroll in an independent Part D plan. This is important, because if you go 63 days without coverage, you may face a lifetime late registration penalty that will be added to your monthly premiums.
In addition, if you return to original Medicare and want to obtain a supplementary policy (also known as “Medigap”), be aware that you may not be eligible for guaranteed coverage. These policies fully or partially cover the cost sharing of some aspects of parts A and B, including deductibles, co-payments and coinsurance. However, they come with their own registration rules.
“If someone plans to go back to the original Medicare and get a Medigap plan, they should be aware that they are likely to have to answer health questions and subscribe,” said Roberts.
She advises starting the process by applying for the Medigap plan and obtaining approval before leaving the Advantage Plan or signing up for an independent Part D plan.
“Enrolling in the Part D plan will take them out of the Medicare Advantage plan, so it’s important to wait for that part too,” said Roberts. “We encourage people who need to make changes to do so early in the election period.”