Medicare enrollment mistake: When can you drop Advantage plan?

Dear Toni: I made a terrible mistake during the recent Medicare annual enrollment period and changed to an Advantage HMO plan. Talking with my friends had convinced me that this plan was an effective way to save my Medicare dollars. But I have discovered that my orthopedic surgeon is not in this plan.

I was to have hip surgery in January, and now my surgery is 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 original Medicare? I am glad I had not canceled my Medicare supplement Plan G, even though the premium has increased. — Jason from St. Louis

Dear Jason: If you discover you made a wrong choice in selecting a Medicare Advantage Plan, Jan. 1 begins the three-month period allowing you to change to a different Advantage Plan or return to original Medicare. Your changes will take effect on the first day of the following month.

During the Medicare Advantage open enrollment period, from Jan. 1 through March 31 each year, a person can switch from one Advantage plan to another or to original Medicare with or without a Part D plan. The main difference between MA OEP and Medicare Annual Enrollment Period (AEP) is who can use each one: Only individuals on a Medicare Advantage Plan can utilize the Medicare Advantage Open Enrollment Period.

You may not disenroll from a Medicare Advantage plan or a Medicare Part D prescription drug plan after March 31. You have to wait until the next Medicare annual enrollment period, Oct. 15 through Dec. 7, to change to a different plan or return to original Medicare.

You made a smart choice, Jason, in not canceling your Medicare supplement because you may not be able to qualify for a new plan because of your health issues. Most Americans don’t realize there is no special period to enroll in a Medicare supplement the way there is for Medicare Advantage plans. One may change a Medicare supplement anytime.

Readers, do not cancel your Medicare supplement plan for the first few months that you are trying an Advantage plan, just in case you need to return to original Medicare.

We advise Medicare clients to call their doctors to see which Medicare Advantage plans they accept. I do not believe you did this when you enrolled in your Medicare Advantage HMO, Jason, and that has caused this surgery postponement.

Always talk to your doctor or the doctor’s office manager before you make any changes to your Medicare insurance and verify which Advantage plans they accept. And be aware that doctors and specialists can stop accepting a particular Advantage plan at any time.

Toni King is an author and columnist on Medicare and health insurance issues. If you have a Medicare question, email info@tonisays.com or call 832-519-8664.