Ask Toni

Toni:

I made a terrible mistake during the current Medicare Advantage Enrollment Period and changed to a Medicare Advantage HMO plan because I understood from talking with my friends that this plan was great way to save my Medicare dollars. Now I have discovered that my orthopedic surgeon is not in this plan and I have not asked for a referral so my hip surgery that is scheduled for the middle of January is now postponed. The surgeon’s office is requesting that I return to Original Medicare so he can do the type of surgery that is needed Can you explain how I can return to Medicare? I am glad I had not cancelled my Medicare Supplement Plan F even though the premium has increased.   Signed…Jason from Clear Lake area

Hello Jason:

Beginning January 1st is the time for those that have discovered they have made a wrong choice of selecting a Medicare Advantage plan and wish to change to a different Medicare Advantage Plan or return to Original Medicare. 

On page 72 of my new Medicare Survival Guide® Advanced edition, I explain how you can disenroll from the Medicare Advantage Plan. This time is called the Medicare Advantage Open Enrollment Period and begins January 1-March 31(each year).

During the Medicare Advantage Open Enrollment Period (MA OEP), you can switch from your Medicare Advantage Plan to another MA Plan, or to Original Medicare with or without a Part D plan. You can only use this period if you have a Medicare Advantage Plan not to change a stand-alone Medicare Part D plan.

To disenroll from a Medicare Advantage plan after March 31st, you cannot because you are in “lock in” from April 1st to December 31st.  You will now have to wait until the next Medicare enrollment period, which begins October 15 thru December 7th to change to a different plan or return to Original Medicare.

If your health prevents you from being accepted by a Medicare Supplement to help pay your Medicare out of pocket, then all you can do is have Original Medicare with a Medicare Part D prescription drug plan.  You will pay Medicare costs out of your own pocket. 

Make sure that you do not cancel your Medicare Supplement plan for the first months that you are trying a Medicare Advantage plan just in case you need to return to Original Medicare. In case you may want to return to Original Medicare during Medicare Advantage Open Enrollment Period from January 1-March 31.

At the Toni Says® office, we always advise a Toni Says® Medicare client to call all their doctors to see which Medicare Advantage plans the healthcare professional/facility accepts. I do not believe you did this when you enrolled in your Medicare Advantage HMO and that has caused a huge problem for you.

One thing to remember is that the doctor can also stop taking a Medicare Advantage plan in the middle of the year. If you find a Medicare Advantage plan that you like, and your doctor is not in the plan, then you might have to change doctors to use that plan.

The most important thing to remember is to always talk to your doctor or the doctor’s office manager before you make any changes to your Medicare insurance needs and see what Medicare Advantage plan they accept. 

For assistance in disenrolling from the Medicare Advantage plan that does not fit your needs and find a Medicare Supplement that fits your needs, call the Toni Says® Medicare office 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

 

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