UNITED STATES—Toni: Last year, I made a mistake and changed to a Medicare Advantage Plan because I understood from talking with my friends that this PPO plan has an in-network and out of network provider and facility list. I was led to believe that a Medicare Advantage PPO plan was like a Medicare Supplement.
Boy, was I wrong! Many specialists and even the facility that does MRIs are out of network and this is costing me a fortune. I’ve been advised by my doctor’s office to return to Traditional Medicare. Is Traditional Medicare different than Original Medicare and how do I go back to plain old Medicare? Signed, Jerry from Kingwood area.
Jerry: You will be happy to know that “Original Medicare” and “Traditional Medicare” are the same as “plain old Medicare.” The medical profession knows Medicare as “Traditional” Medicare not “Original Medicare.”
Each year, the Medicare’s Annual/Open Enrollment period starts on October 15, and it will end at midnight on December 7 (Pearl Harbor Day).
For you to disenroll from a Medicare Advantage plan, all you need to do is enroll in a Medicare Prescription Drug plan that fits your needs.
You will automatically be out of your old Medicare Advantage plan and back to “Original Medicare with a Medicare Prescription Drug plan; then you can apply for a Medicare Supplement to pick up what Medicare does not pay for. What happens if you have health issues which can keep you from qualifying with the health questions in a Medicare Supplement’s application? Don’t worry; there are protections in place for this type of situation. The Medicare rule from the Medicare & You Handbook says: “If you join a Medicare Advantage Plan for the first time, and you aren’t happy with the plan, you’ll have special rights to buy a Medigap policy if you return to Original Medicare within 12 months of joining.”
Below are 8 ways that a Medicare beneficiary (You) can make a change to their Medicare plans during Medicare Annual/Open Enrollment:
1) Enroll in a new Part D Medicare Prescription Drug Plan, which automatically disenrolls one from a Medicare Advantage plan.
2) Enroll in a new Part D Medicare Prescription Drug Plan when you have never been in Part D from the time you have been with Medicare.
3) Change from one Part D Medicare Prescription Drug Plan to a new Part D Medicare Prescription Drug Plan.
4) Enroll in a Part C Medicare Advantage Plan with Prescription Drugs
5) Change from one Part C Medicare Advantage Plan to a new Part C Medicare Advantage Plan.
6) Return to Original Medicare and purchase a Medicare Supplement and enroll in a Part D Medicare Prescription Drug Plan.
7) Return to Original Medicare only and enroll in a Part D Medicare Prescription Drug Plan.
8) Or Return to Original Medicare with no Part D plan. * Don’t forget there is a penalty for not enrolling in a Part D Medicare Prescription Drug plan when first eligible. *
Concerned that your medical providers or facilities are not accepting the Medicare Advantage plan which you are considering or is applying for a Medicare Supplement your right option? Call the new Toni Says Medicare Hotline at 1-832-519-8664 to have your Medicare questions or concerns answered.
Toni King, author of the Medicare Survival Guide® is giving a $5 discount on the Medicare Survival Guide® Advanced book to the Toni Says Medicare column readers at www.tonisays.com.