Not happy with your Medicare Advantage plan? You have until March 31 to make a change, thanks to a discreet registration period.
During this open Medicare Advantage enrollment period, which occurs annually, you can switch to another Medicare Advantage plan or leave the program altogether and enroll in Original Medicare. (People currently on Original Medicare cannot make changes during this time. If you don’t like your coverage, you usually have to wait until the annual fall open enrollment period to choose a new plan for 2023.)
Also known as Part C, Medicare Advantage is a private alternative plan to Original Medicare, which is run by the federal government. In 2021, about 42% of the total Medicare population, or more than 26 million people, were enrolled in a Medicare Advantage plan, according to the Kaiser Family Foundation. These plans have become popular in part because many offer coverage that Original Medicare does not, including limited dental coverage and gym memberships.
Yet some Medicare Advantage enrollees might still end up with buyer’s remorse. For starters, many of these plans are HMOs, and you may want a wider choice of doctors and hospitals than your plan offers. On Original Medicare, you can see any doctor in the country who takes Medicare, but on Medicare Advantage, your choice of healthcare provider is often limited to those who participate in the plan’s network. And to see a specialist, you may need to get a referral from a primary care physician. “Make sure you understand the referral process,” says Gregg Ratkovic, president of Medicare for eHealth, an online brokerage.
You might also encounter unexpected costs. Medicare Advantage plans are aggressively advertised during open enrollment season in the fall, and many are advertised as free. Although they may have a monthly premium of $0, the plans are not free. Hospital co-pay fees are one type of expense that might surprise recipients, Ratkovic says. Another unpleasant surprise could be if your prescriptions aren’t covered to the extent you’d like. Although you are unlikely to find a completely free plan, you can look for one that better suits your needs.
One option is to search for Medicare plans on Plan Finder, the official Medicare.gov site, or go through a broker. If you switch to a new Medicare Advantage plan, you will automatically be removed from your previous plan when your new coverage begins. To switch to the original health insurance, contact your current plan or call 1-800-MEDICARE (1-800-633-4227).
Keep in mind that additional “Medigap” policies don’t work with Medicare Advantage, so you can’t use the former to pay for costs incurred under the latter. If you want to switch to Original Medicare and buy a Medigap policy to top it off, make sure you understand the rules: Unless you’re eligible for “trial entitlement” to coverage, health insurers can consult your medical records to determine whether or not to issue you a policy. They might charge you more or even reject your request, depending on your terms. Criteria vary by insurer, but poorly controlled diabetes and an ongoing cancer diagnosis are examples of conditions that may prevent you from purchasing a policy. Make sure you understand your eligibility before dropping your Medicare Advantage policy.
Medicare can be complicated. For free, unbiased help in understanding your options, contact your local health insurance assistance program.
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