What Happens If I Chose the Wrong Medicare Advantage Plan?

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Hello Toni:

I recently attended a Medicare Advantage meeting because my Medicare Supplement Plan F is costing me $220 a month and was going to join. A friend introduced me to your articles explaining the various Parts and Plans of Medicare. Now I am having second thoughts.

My question is if I change to an Advantage plan and find out it is not working for me after January 1st… #1) Can I return to regular Medicare and apply for a new Medicare supplement? # 2) Will I be able to enroll in a Medicare Part D plan for prescriptions. Thanks, Stephanie from Kingwood, TX

Hi there, Stephanie:

#1 Question: Yes, Stephanie you can return to Original Medicare, but your window of time is small. The time to change you MAPD plan (for those that have second thoughts) is from January 1 to March 31and is known as Medicare Advantage Open Enrollment Period. Whether you are approved by a new Medicare Supplement is another issue because you now may have to answer medical underwriting questions to qualify. 

#2 Question: Enrolling in a Medicare Part D plan disenrolls you from your Medicare Advantage plan. During Medicare Advantage Open Enrollment Period, you can only disenroll from your current Medicare Advantage Plan and enroll in another Medicare Advantage plan or return to Original Medicare only by enrolling in a standalone Part D Medicare Prescription Drug plan. That answers your question about enrolling in a new Part D plan when you leave your Medicare Advantage plan after January 1st. Remember, you may have to answer medical underwriting questions when applying for a new Medicare Supplement.

You would think that Medicare would give you time to tryout a new Medicare Advantage plan…but is 3 months enough time to discover whether you made a good choice enrolling in your new Medicare Advantage plan, but Medicare does not give you more time!

Stephanie since you currently have a Medicare Supplement, you may consider not cancelling your Medicare Supplement until after March 31st to be sure you are satisfied with your new Medicare Advantage plan, especially if you have a health issue.

To get out or disenroll from a Medicare Advantage plan after March 31st you cannot because you are “locked in” and will have to wait until the next Medicare enrollment period, which should be October 15 of that year. You can then disenroll and make a change with January 1st of the next year as your effective date.

At the Toni Says® office, we always advise a Toni Says® Medicare clients to call all their doctors to see which Medicare Advantage plans the healthcare professional or medical facility accepts.

One thing to be aware of 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.

Since you are spending about $220 on a Medicare Supplement and want something less expensive with the same access to doctors that accept “Original Medicare”, there may be a less expensive option. You might consider shopping for a different, less expensive Medicare supplements such as Plan G or even Plan N.

Call the Toni Says Medicare Hotline at 832/519-8664 to have your Medicare questions or concerns answered or email info@tonisays.com.

Register for November’s Toni Says® Medicare Annual Enrollment Zoom webinar on Wednesday, November 17 at 4:00 PM which explains the ABC and D of Medicare at www.tonisays.com.

Medicare Open Enrollment Special: $10 discount to the Toni Says® readers on the 2021Medicare Survival Guide® Advanced book at www.tonisays.com.

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