UNITED STATES—Toni: Last year during Medicare’s Annual Enrollment, both me and my husband qualified for a Medicare Supplement Plan G over the phone from a telemarketing call. The supplement has never paid a dime! We are still having to use the same doctor and get referrals from our Medicare Advantage HMO. We can’t get the Medicare Supplement to pay because no one advised us how to stop the Medicare Advantage plan.
We have spent over $200 a month since January and the policy has never been used. How can we get out of this Medicare Advantage plan and return to Original Medicare to use the Medicare Supplement purchased last November? Looking forward to your answer, Laura from Longview, TX.
Laura: The biggest No-No in the Medicare insurance world is when an agent sells a Medicare beneficiary (which is what you and your husband are) that has a Medicare Advantage plan a new Medicare Supplement without advising the client how to dis-enroll properly from their Medicare Advantage plan.
As you are now finding out, the agent who sold you the Medicare Supplement failed to inform you and your husband how to dis-enroll properly from your Medicare Advantage plan. Thus, you and your husband have not been in Original Medicare for the last year to use the Medicare Supplement benefits.
The change would have been a simple one because you both qualified medically for the new Medicare Supplement and all that agent should have done is enrolled you in a standalone Medicare Part D prescription drug plan. That simple step would have cancelled your Medicare Advantage HMO Plan effective January 1 and returned you and your husband to Original Medicare with a Medicare Supplement and a new Medicare Part D prescription drug plan.
This is what Medicare Annual Enrollment period from October 15 to December 7 is all about; the time to enroll in a new Medicare Part D prescription drug plan or Medicare Advantage plan.
Those who wish to change from a Medicare Advantage plan to Original Medicare with a Medicare Supplement should enroll in a Medicare Part D prescription drug plan. Enrolling in a standalone Medicare Part D prescription drug plan is the easiest way to return to Original Medicare effective January 1.
Please be sure that you will qualify with medical underwriting before you cancel your Medicare Advantage plan or all the cost that Original Medicare does not pay will be your responsibility.
The average American does not realize that they cannot have both Original Medicare and a Medicare Advantage plan at the same time. Medicare will pay the Medicare Advantage plan for your care. Original Medicare and Medicare Advantage plan cannot pay at the same time.
The agent who helped you with your Medicare needs last year did not follow the Medicare rules. Insurance agents who are properly trained in Medicare Advantage rules are made aware that those enrolled in Medicare Advantage plans should enroll in a standalone Medicare Part D plan to be disenrolled from a Medicare Advantage plan.
Need help understanding your Medicare options. Attend a Confused about Medicare workshop or call the Toni Says® Medicare hotline at 832-519-8664.
Toni King, author of the Medicare Survival Guide® is giving a $5 discount on the Medicare Survival Guide® Advanced book at www.tonisays.com.