UNITED STATES—Hi Toni, I am turning 65 this February and have no idea what I should do because I have lung cancer. Currently I am on a COBRA policy from my old employer with all my medical bills now being paid because I have met my deductible.
I receive my care from a major cancer center in my area and my chemotherapy with my radiation treatments to start in December. Do I enroll in Original Medicare with a Medicare supplement and get Part D, go with a Medicare Advantage plan, or stay with my current COBRA plan until it ends in about 15 months?
If you could help me sort this out, I would greatly appreciate your help. Thanks, John from San Diego, CA.
Hello John: Recently, I had a phone call from a frantic daughter, who was trying to help her father who had been diagnosed with pancreatic cancer and he had chosen a Medicare Advantage HMO when he turned 65. Now her father must wait until Medicare’s Annual Enrollment Period from October 15 to December 7 to make a change back to Original/Traditional Medicare because MD Anderson is not in that Medicare Advantage plan’s HMO network. She must hope that she can find a Medicare Supplement that will accept her father due to his medical condition. She is not sure if he will pass the medical underwriting.
I have great news for you, John, because you are turning 65 in January and there is a special enrollment time called Medicare Supplement/Medigap open enrollment.
As I have said before, this is the best time for someone to purchase a Medicare Supplement/ Medigap because the open enrollment lasts for a 6-month period beginning the first day of the month in which you are 65 or older and have just enrolled in Part B for the first time. During the Medicare Supplement/Medigap open enrollment period, you may enroll in a Medicare Supplement/Medigap Plan and not have to answer any health questions to be accepted by any Medicare Supplement Plan.
If you decide not to keep your COBRA plan, you do not have to worry about your medical care being taking care of with the Medicare Supplement/Medigap, but after the 6-month window, you will have to submit to a complete underwritten application for a Medicare Supplement. You may not qualify for a certain policy or it may cost more, if there are other health issues including the cancer after this 6-month window.
I have been advised by many healthcare professionals that some of the newest healthcare and cancer procedures are not readily approved by Medicare Advantage plans, but these procedures are generally approved with “Original or Traditional Medicare.” These healthcare professionals must fight every day to get the care many desperately need when they have a Medicare Advantage plan. Talk to your medical professional who knows your health situation when making your Medicare plan choice, even if you are someone with a serious health condition, such as heart problems, Alzheimer, MS, end stage renal disease and the list could go on and on…always talk to those that know your health situation.
There are specific Medicare rules when changing from a Medicare Advantage plan to a Medicare Supplement. Call the Toni Says Medicare Hotline at 1-832-519-8664 to have your Medicare questions or concerns answered or visit the Medicare Annual Enrollment webinars which explain what Medicare is and how to properly find your Medicare Part D plan at www.tonisays.com.
Toni King, author of the Medicare Survival Guide® is giving a $5 discount on the Medicare Survival Guide® Advanced book to Toni Says® Medicare column readers.