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If you have 401K funds, you might not be able to get "Extra Help" for Part D, or your Part B paid. Those things are for low income social security recipients, under a certain income amount. I receive a lot more than many people on SS but I still quality for those things.
At one time, Medicare.gov had a very good page listing Medicare trial rights. Can't find it on the revamped site.
In the alternative, Boomer Benefits says this:
Quote:
If you enroll in a Medicare Advantage plan when you first turn 65, Medigap Trial Right 1 allows you to leave that Advantage plan before those first 12 months are up and switch to a Medicare Supplement.
If you leave your Medicare Supplement plan and switch to an Advantage plan during the AEP, Medigap Trial Right 2 allows you to switch back to the same supplement within 12 months of being on the Advantage plan.
The Trial Rights are limited to certain Medigap plans.
Examples:
Trial Right 1: A beneficiary enrolls into a Medicare Advantage plan once they are 65. The effective coverage date is May 1st which matches their Medicare Part A and Part B effective dates. The trial period ends on April 30th of the following year.
In this example, since Part A, Part B, and the Advantage plan have the same effective dates, the client will qualify for this trial right. They can pick up a prescription drug plan and a Medicare Supplement in their area without underwriting. However, they must apply before their 12-month window is up.
Trial Right 2: During a beneficiary’s Annual Enrollment Period, say that he left his Medicare Supplement, Part D plan, and Original Medicare for a Medicare Advantage Prescription Drug plan. The Advantage Plan has an effective date of January 1st, and the trial right period will end on December 31st of that year.
In this example, the client can leave the Advantage plan and rejoin the Medicare Supplement plan they originally had within 12 months of being on their Advantage plan. They must go back to the same Supplement plan they had to qualify for this trial right.
I thought that anyone can switch to and from Medicare Advantage (C), or remain on whatever Plan they are enrolled, at EOY renewal time; Which is 1 year.
Not true. The ability to switch is state specific. See:
*The Trial Rights are limited to certain Medigap plans.
This should be paid close attention to.
Let's say for example that I decided right now to switch to Mutual of Omaha and pay far lower than what I do now because it's for Alabama instead of California (because Cigna for some reason isn't available here at a lower rate than what I pay now), even though I'm with Cigna already. I can only switch right now because I have COPD and Mutual of Omaha would ask that question. Of course I have to be truthful. I would be denied the switch unless it's during the annual switch period.
The fact is I'm just not willing to risk losing what I have now (Cigna Plan G - California) because I'm very happy with it and why fix what is not broken? I'm used to paying what I'm paying ($209/mo with no copays, no required referrals, and only a yearly $266 deductible). Again I'm very happy.
I consider it a blessing to have what I have because I would be very ill and even not alive if I didn't have it. Advantage doesn't work for someone like me (chronic critical care lung issues from birth and old age orthopedic issues). Even one hospitalization and people will realize what a crock Advantage is. That's why they are pushing it so hard.
You need to talk to a broker who understands these complicated issues. You can't just try Advantage for a few months and then switch. It's annually.
OK, so I could switch after a year. Again, FOR ME, that's not much of a gamble.
I do understand that you intensely dislike Advantage plans. That's fine. But please recognize that lots of people like theirs, as I have seen in other similar threads on C-D.
Quote:
Originally Posted by pathrunner
I don't know why people don't just surrender to paying for quality healthcare and instead gamble with their finances and their lives by choosing Advantage. As I said, Advantage is for those who don't mind gambling, or those who have the resources to pay for extreme medical care out of pocket.
The Advantage plans that I have reviewed have annual out-of-pocket maximums that aren't extreme (or don't seem so to me), e.g. all under $7,000 and most WAY under (some just a few hundred). I wouldn't LIKE to pay that much in a year, but it would not be a major hardship if I had to.
Right now I pay just under $130 a month for health insurance (through my former employer under the retirement-incentive plan). Starting 12/1/23, I will have to pay the $164 (at least) Medicare premium PLUS around $55 for Part D prescription coverage PLUS a Medigap premium of probably around $150. That's $369 or close to 3 times what I'm paying now. So yes, the $0 premium Advantage plans in my area are appealing, especially because I am used to HMOs and their coverage appears very similar.
YMMV, of course, and it sounds like it HAS! I still have more research to do before deciding, but I do want to have this settled by the end of this month.
I thought that anyone can switch to and from Medicare Advantage (C), or remain on whatever Plan they are enrolled, at EOY renewal time; Which is 1 year.
You can. I switched my mom from Advantage plan she had for 10 years to traditional with supplemental.
They’re getting really aggressive in trying to get people to switch. Those commercials make my blood boil, clearly trying to confuse people.
I work in skilled nursing home rehab over 25 years, Advantage is sooo much worse recently. They are cutting people from rehab with lightning speed. Our rehab director told us to assume any Advantage patient we get from now on only has two weeks for rehab, cause that’s how fast they’re getting cut. With Medicare and supplemental you can get up to 100 days. Makes a big difference if someone has a stroke or even a fracture. They used to at least wait until the patient was allowed full weight bearing but that’s not the case now. And they are denying more than 75% of appeals, which also didn’t used to be the case. If you lose an appeal your responsible to pay for however many days you spend in the rehab waiting for the decision, which discourages many from even trying (by design).
Posting this as an FYI. A rep from my prescription insurer called me yesterday and we had a really nice long chat. We got onto other subjects and she indicated that there is now a 12-month grace period for people with a Medicare Supplemental plan to switch and try Advantage to see if they like it or prefer it. I am very hesitant to try it, though it is tempting. Wondering if others have heard about this. She stated that many brokers don't inform about this, or haven't really heard of it yet in order to be able to inform their clients.
I'm probably not going to do it, but Advantage has recently beefed up their offerings in order to entice people. For example, I was on Advantage while disabled and still under age 65. There was no dental, vision, rides to the doctor or other benefits (which I don't recall right now).
So, are you able to switch back to your regular Medicare plan if you don't like the Advantage plan?
I’m about to retire and I have a Medicare coach I’m working with. They don’t rep any plans. They just find recommendations on Supplement and plan D options based on your health, income, risk tolerance.
Honestly between figuring out Medicare, SS and moving my 401k funds, working is looking easier.
I learned so much reading this board that I didn't need a Medicare coach. So much wisdom and experience here, thanks again to everyone for sharing your stories.
You can. I switched my mom from Advantage plan she had for 10 years to traditional with supplemental.
They’re getting really aggressive in trying to get people to switch. Those commercials make my blood boil, clearly trying to confuse people.
I work in skilled nursing home rehab over 25 years, Advantage is sooo much worse recently. They are cutting people from rehab with lightning speed. Our rehab director told us to assume any Advantage patient we get from now on only has two weeks for rehab, cause that’s how fast they’re getting cut. With Medicare and supplemental you can get up to 100 days. Makes a big difference if someone has a stroke or even a fracture. They used to at least wait until the patient was allowed full weight bearing but that’s not the case now. And they are denying more than 75% of appeals, which also didn’t used to be the case. If you lose an appeal your responsible to pay for however many days you spend in the rehab waiting for the decision, which discourages many from even trying (by design).
Advantage is awesome, just don’t get sick.
Exactly. Don't get sick, terminally ill or in a catastrophic accident. There are no guarantees.
Most states, unfortunately, allow insurers to impose health underwriting once past the six-month Medigap GI period, which means an applicant could pay a higher premium or be denied entirely.
Something special in your mom's situation - or a wrinkle in your state law - allowed her move to a Medigap without health underwriting. We've had this discussion before. You have reported similar for other patients you work with.
This is definitely is not true for most people in most states. Medicare gov specifically cautions on this, here:
Quote:
The best time to buy a Medigap policy is during your Medigap Open Enrollment Period. This is the 6-month period that starts the first day of the month you're 65 or older and signed up for Part B. After this period, your options to buy a Medigap policy may be limited and the policy may cost more.
So, are you able to switch back to your regular Medicare plan if you don't like the Advantage plan?
You may have a few months to switch back. But if you are ill may not be.
United Health Care/AARP seems to be busy bundling a "Wellness Care" plan to their G & F plans. So you may find some YMCA memberships & other items with the Plan.
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