Last Updated on 21/02/2019 by NM Staff
Change is the only permanent thing in life. Things change over time. What you need today may not be the same tomorrow, same with Medicare options and your healthcare needs. That is why you, as a Medicare beneficiary, have the opportunity to update and tweak your current plan every year. During Medicare Open Enrollment period, you may opt to upgrade, change or switch your current policy. But there are cases that changing policy can be done only in certain times, such as switching from Medicare advantage to a Medicare supplement plan.
Before you switch to a Medicare supplement insurance plan, be certain that you have fully understood the coverage, possible outcome, and the right time when you can do the switch.
What Is A Medicare Supplement Insurance Plan?
Medicare supplement plans, also known as Medigap, are a type of health insurance that is sold by private insurance companies. It works by paying the Medicare-approved health care costs that the Original Medicare did not cover. It helps you by minimizing the out-of-pocket expenses of both Medicare Part A and Part B which may include all or part of deductibles, copayments or coinsurance.
When can I switch?
Switching to Medicare supplement plan works differently from other Medicare options. If you are considering this type of Medicare option, make sure that you are aware of the different periods when you can apply for a plan.
Here’s what you need to know when switching to Medicare supplement:
- To switch to a Medigap plan, you must leave your Medicare Advantage plan and return to Original Medicare.
Leaving Medicare Advantage plan can only take place during a certain period of the year – that is during the Medicare Advantage disenrollment period (January 1 – February 14) or during the Medicare open enrollment period or annual election (October 15 to December 07).
Exceptions would apply if you moved from home to an institutional setting or vice versa.
- Once you are back on Original Medicare, you can apply for a Medigap plan anytime. But…
Medigap application during this time does not guarantee approval. Insurance may reject your application or ask you to undergo medical underwriting if you have any pre-existing conditions. If your application is accepted, insurance providers may charge you with a higher premium because of your health condition.
There are also certain events that you can take advantage of the guaranteed issue rights outside the Medigap open enrollment period. These circumstances often have a limited time of 63 calendar days after your Medicare Advantage coverage ends. These situations are but not limited to the following:
- You moved to a new location that is not served by your Medicare Advantage plan.
- Your current plan has no contract with Medicare anymore.
- Your current Medicare Advantage plan no longer serves the location where you live.
- You enrolled and have your Medicare Advantage plan for less than a year and are not happy with it. You may have a special right to switch to Medicare supplement plan if you return to Original Medicare in less than 12 months after you enroll in Medicare Advantage plan.
Note that you may have a limited choice of Medicare supplement plans in these circumstances.
Reasons Why You Should Switch to Medigap
There are circumstances when we need our coverage to adapt to the changes in our health. Now that you know when you can change plans, it is time to know why you should switch to Medicare supplemental insurance.
Here are some reasons:
- You want or need to access a bigger network of doctors.
There may be a point that you need the services of a medical provider which unfortunately is not covered by Medicare Advantage plan. You may want to switch to a Medicare supplement because this plan has the same network of doctors as what Original Medicare have, which is by far the largest network of doctors in the US.
- Deductibles, copays or coinsurances are getting heavy to deal with.
Deductibles and copays can add up over time. When that happens, it may be hard for you to cope up with bills that you may even have to exhaust your financial resources.
There are types of Medicare supplements that cover all or part out-of-pocket expenses which include deductibles, copays or coinsurances.
- You want more benefits
If you are a frequent traveler, you may want to have a coverage that travels with you. Medicare supplement can do that for you. There are types of Medigap that provide medical coverage even outside the US.
In addition, Medigap can also provide you with an additional 365 days of hospital coverage that a Medicare Advantage plan can’t provide.
- You want to protect your family, wealth and assets
If you are someone who requires a lot of medical attention and health care services, expenses could easily build up. At some point, Medicare or Medicare Advantage alone is not enough to help you cope with the staggering healthcare costs.
Medicare supplement, on the other hand, is considered by many as a way to protect yourself from the debilitating cost of health care. It will cover all or part of the Medicare-approve expenses that Original Medicare did not cover in both inpatient and outpatient healthcare settings. With this policy, you may not have to deplete your wealth or assets and burden your family because of medical expenditure.
Currently, there are about 13 Million Americans who trusted Medigap to cover their health care needs. Showing that you could put your trust in Medicare supplement insurance coverage.
- Pre-existing conditions
If you have pre-existing conditions, your medical expenses landscape may seem to be not on the good side. If you can still grab the opportunity to obtain a Medigap policy with a guaranteed issue right then go ahead and grab it! Pre-existing conditions are often the reason for staggering healthcare expenses, if you have a Medigap, you can be at peace that your out-of-pocket costs will be minimized, if not completely eliminated.
As you decide to switch plans or not, it is important that you consider your needs first and all other Medicare options. If you find yourself in the middle of confusion, don’t hesitate to reach out to someone who can assist and walk you through your options. You can contact your State’s health insurance assistance program to provide you with an in-depth understanding of the different Medicare options available in your area.