While you may feel overwhelmed as you go through the process of switching to a Medicare Advantage plan, try to stay calm. You aren’t losing many benefits at all. The switch does not mean that you’ll lose out on Medigap forever.
Read on to learn how you can effectively switch back to the original Medicare from the Medicare Advantage Plan.
How Does Medicare Differ from Medicare Advantage?
Traditional Medicare coverage was created by the government. If you have traditional Medicare coverage, you have access to every physician who accepts the coverage. Scheduling an appointment should be easy because you don’t need a referral to see a specialist. You also have the option to add Medicare Supplement Insurance.
Medicare Advantage Coverage provides you with benefits through a private health insurance company. Your policy must adhere to the guidelines from the Centers for Medicare & Medicaid Services. When you use Medicare Advantage as your primary coverage, you work with doctors and providers in a specified healthcare network. A primary care doctor can write a recommendation for you to visit a specialist. You will also have access to unique benefits that are not included in traditional Medicare policies. However, remember that you only qualify for Medicare Part D if you do not have prescription coverage.
Explaining Medigap
Medigap helps you avoid paying for deductibles and copays. During the enrollment process, you enter into guaranteed issue rights. This allows you to enroll in a Medigap plan without any medical underwriting. The underwriting process can be stressful. Health insurers evaluate several factors to determine the amount of your premium. You could be denied coverage if you don’t meet their health standards. This is something to be aware of if you have pre-existing conditions. At the start of your policy, you have time to decide if you want to make the switch or stay with your existing Medicare policy.
Trial Rights and Enrollment Period
At the start of your Medicare Advantage plan, you have trial rights over 12 months. During this period, you can opt-out of your policy and go back to traditional coverage. You can also re-enroll at any time if you choose to opt-out. You must pay attention to the Open Enrollment Periods. Medicare Advantage Open Enrollment begins in winter and continues until early spring. Fall Open Enrollment begins in fall and continues until early winter. You can check to see if you can sign up for coverage during a special enrollment period. There are unique standards you must meet to qualify for coverage during the Special Enrollment Period. These exemptions include returning to the US after traveling around the world, losing your Medicaid coverage, and moving out of a nursing home or similar facility.
Things to Consider
Set up reminders on your calendar so that you will not miss the enrollment dates. Look at your policy every quarter to ensure that you are still satisfied with your coverage. Consider writing down the strengths and weaknesses of your policy. If you are relying on the trial period, be aware that plans change often, and you may not be able to re-enroll if you decide to opt-out.
Before you decide whether to stick with Medicare Advantage or switch to original Medicare, learn all the rules associated with each policy. You should also take into consideration the underwriting process. Do you need help with your health insurance coverage? If so, then contact the experts at Randy Jones Insurance Services in Pleasanton, California today.
