November 21, 2023 - 11:32 am
Dear Toni: Last year during Medicare’s annual enrollment period, my husband and I qualified for a Medicare supplement Plan G from a telemarketing call. The supplement has never paid a dime! We still must use the same doctor and get referrals from our Medicare Advantage HMO. We can’t get the Medicare supplement to pay because no one advised us how to stop the Advantage plan.
We have spent over $250 a month since January, and the Medicare Plan G has never been used. How can we get out of this Medicare Advantage plan and return to original Medicare to use the supplement purchased last November? — Laura, Tampa, Florida
Dear Laura: The biggest no-no in the Medicare insurance world is when an agent sells a Medicare beneficiary a new Medicare supplement without advising them how to disenroll properly from their Advantage plan.
The change would have been a simple one because you both qualified medically for the new Medicare supplement. All the agent needed to do was enroll you and your husband in a stand-alone Medicare Part D prescription drug plan. This step would have canceled your Advantage HMO effective Jan. 1 and returned you both to original Medicare with a supplement and a new Part D prescription drug plan.
You need to enroll in the stand-alone Medicare Part D plan that covers you and your husband’s current prescription drugs as soon as possible (no later than midnight Dec. 7) or you will remain in the same situation that you are in right now.
This is what Medicare’s annual enrollment period, from Oct. 15 to Dec. 7, is all about. It’s the time to enroll in a new Part D prescription drug plan or Advantage plan.
If you are changing to a Medicare supplement, you need to have passed the medical underwriting process and be approved for the supplement before enrolling in a stand-alone Part D plan, which will automatically cancel your Advantage plan. If you are not approved for a Medicare supplement before you sign up for Part D and you miss the Dec. 7 deadline, all costs that original Medicare does not pay will become your financial responsibility without a supplement.
Insurance agents who are properly trained regarding Medicare Advantage rules know that those enrolled in Advantage plans should enroll in a stand-alone Part D plan by midnight Dec. 7 to be disenrolled properly from an Advantage plan once the supplement is approved.
Many people do not realize that they cannot have original Medicare and a Medicare Advantage plan at the same time.
Toni King is an author and columnist on Medicare and health insurance issues. If you have a Medicare question, email firstname.lastname@example.org or call 832-519-8664.