New York Estate Planning & Elder Law Blog
Approximately, 26.9 million Americans are enrolled in Medicare Advantage Plans as of January 2022. While many people are content with their plans, not everyone is. Individuals have between January 1, 2022, to the end of March 2022 to make revisions to their Advantage Plan. During this period, a person can also drop a Medicare Advantage Plan and opt for a basic Medicare plan, which includes Part A and B.
Individuals should be aware of some important details before switching Medicare plans, though. For one, people can change plans early in the year. For example, a person might discover that their Medicare plan no longer covers important medication.
The Narrow Window to Change Plans
Of the 63.6 million individuals who have Medicare plans, approximately 26.9 million individuals have Advantage Plans. Many people prefer Advantage Plans because they come with the benefit of offering Parts A and B as well as Part D prescription drug coverage in addition to other extra benefits including dental and vision. Each plan, however, comes with its own cost-sharing structure including deductibles and copays and the list of drugs covered differs substantially between plans.
Despite the window that exists to revise or drop an Advantage Plan, people should also understand that they only have one opportunity to switch plans. As a result, after a person moves to a new Advantage Plans or chooses basic Medicare, that individual is often locked into what plan he or she must use.
Be Careful About Switching Plans
After an election is made, you remain in the plan for the rest of the year. Furthermore, a three-month window does not permit a person to switch from one standalone Part D plan to an alternative. If you’re in a situation where you selected a Part D plan during fall open enrollment as the result of faulty or misleading information, you can later call 1-800-Medicare to determine if your situation would permit you to make a change. At the same time, dropping a Medicare Advantage plan for a Medicare basic plan often leads to losing drug coverage, which might mean that you have to sign up for only a Part D plan.
Concurrently, dropping an Advantage Plan and selecting a basic Medicare plan results in losing drug coverage. This means you will have to enroll in a standalone Part D plan. This can be critical because if you proceed for 63 days without Medicare, you might be in jeopardy of enduring a permanent late-enrollment penalty that is added to each monthly premium. This charge constitutes 1% of the national base premium for each month that you proceed without drug coverage.
Navigating Medigap Policies
Additionally, if you switch back to Medicare but want to receive a supplemental Medigap policy, you should be aware that might not qualify for guaranteed coverage. Medigap policies either partially or fully cover cost-sharing of some parts of Medicare Part A and Part B, which includes coinsurance, copays, and deductibles. Medigap insurance, however, has its own regulations concerning enrollment.
In New York as well as most other states, a person will need to proceed through underwriting and receive approval for a Medigap plan. It’s a good idea to apply for a Medigap plan first to make sure that you receive approval before canceling an Advantage Plan in which you might be enrolled.