Is your current Medicare Advantage plan giving you "buyer's remorse"? You're in luck, because January 1 to March 31 is Medicare’s Open Enrollment season. This is the time when you can make changes in certain situations.
Here are three actions you can take during this three-month period.
1. Switch from one Medicare Advantage plan to another
If you’re not happy with your current Medicare Advantage plan (also known as Medicare Part C), you can change to another plan during this timeframe.
Why might you switch from one Medicare Advantage plan to another?
- Your coverage network no longer includes the physicians and hospitals you prefer.
- Your plan doesn’t cover the prescriptions you need.
- There are other plans that offer the benefits you want with lower premiums.
- Your copays and coinsurance are higher than you expected.
2. Switch from Medicare Advantage to Traditional Medicare Part A and B
While the lower premium costs of Medicare Advantage may seem attractive at first, coverage limitations and other factors may compel you to switch over to Traditional Medicare Part A and B.
Medicare Part A (which is generally free) covers some (but not all) costs for inpatient hospital care; skilled nursing facility care; and short-term home health care. Medicare Part B covers some of the costs of services or supplies to diagnose or treat your medical condition; preventive services; ambulance services; medical equipment; outpatient treatment services; partial hospitalization; and limited outpatient prescription drugs.
Traditional Medicare plans plus optional Medicare Part D prescription drug coverage generally have higher monthly premiums than Medicare Advantage plans and only cover 80% of healthcare charges. But there are no coverage limitations. You can see any physician or go to any hospital that accepts Medicare payments.
Why might you switch from Medicare Advantage to Traditional Medicare?
- You want the freedom to meet with any physician or go to any hospital you want without paying out-of-network costs.
- You plan to live in another state during part of the year and don't want to pay more for physicians and hospitals that aren't in your network.
3. Enroll in Medicare Part D
If you decide to switch from Medicare Advantage to Traditional Medicare Part A and B, you can also sign up for a Medicare Part D prescription drug plan during this enrollment period.
Medicare Part D pays for some of the costs of prescription drugs not covered by Medicare Part B. Since Medicare Part D plans are offered by different private insurance providers, you should look for plans that cover your current prescriptions.
Note that if you’re currently a Traditional Medicare subscriber with Part D coverage you can’t change your Part D provider during this period. You’ll have to wait until the Fall Medicare Enrollment period from October 15 to December 7.
Making the right decision
Once you make changes, the new coverage will begin on the first day of the next month after you make your decision.
You can only make changes once during this enrollment period, so plan carefully. Fortunately, help is available. Every state has its own State Health Insurance Assistance Program, which offers personalized consulting to help you understand and evaluate your various Medicare options.
This material has been provided for general informational purposes only. Although we go to great lengths to make sure our information is accurate and useful, we recommend you consult a Medicare professional or contact your State Health Insurance Assistance Program if you need assistance.
This article was authored by Joelle Spear and Jeffrey Briskin. Joelle is a financial advisor and Partner located at Canby Financial Advisors, 161 Worcester Road, Framingham, MA 01701. She offers securities and advisory services as an Investment Adviser Representative of Commonwealth Financial Network®, Member FINRA/SIPC, a Registered Investment Adviser. She can be reached at 508.598.1082 or firstname.lastname@example.org. Jeffrey Briskin is Director of Marketing at Canby Financial Advisors.
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