How Do I Get Out of Medicare Advantage?

Medicare, Retirement Planning, Uncategorized , , , , , 0 Comments

It is December 2nd and by now you are all very aware of the Medicare Annual Enrollment Period (AEP). This is the time of year from October 15th to December 7th when you can make changes to Medicare Advantage plans and Medicare Prescription Drug plans.

You may recall from my past articles that there are two sides to Medicare, Original Medicare and Medicare Advantage (Part C). On the Part C side, you tell Medicare that you want one of their contracted plans to combine and administer your health care and Prescription coverage. So, for that year you are locked into that Part C plan. Except under certain special circumstances, you will not be able to make changes to your coverage until the next AEP. During the AEP, you are only allowed to move from a Part C plan to another Part C plan.

If you wish to leave Part C and return to the Original Medicare side, unless you qualify for one of a few Special Enrollment Periods (SEP), you must wait for the annual Medicare Advantage DISENROLLMENT Period. That period begins January 1st and ends February 14th. The Part C Disenrollment Period allows you to get out of Medicare Advantage and go back to Original Medicare. The catch here is that you may not qualify for a Medicare Supplement (Medigap) Plan.

Under Original Medicare, once you turn 65 and six months, if you want to purchase a Medigap plan, you must answer several health questions. Based on your answers to those questions, you can be declined by the Medigap company. In that case, you would be left with Medicare alone and no supplemental coverage. This is a recipe for disaster and you would be better off staying with Part C.

There several special circumstances that may qualify you for Guaranteed Issue of a Medigap plan with no health questions asked. One of those situations is that during your first year of being in a Part C plan you can change your mind and go back to Original Medicare. Another common guaranteed issue situation is when your Medicare Advantage plan cancels your coverage or moves out of your area.

Whatever your circumstance, you should consult a reputable, local, independent broker who is experienced in not only health care, but holistic retirement planning. He or she will be able to guide you to making a well-informed, wise decision. Making the wrong choice may be irreversible, and can cost you thousands of dollars in out of pocket costs.

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