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Need advice. When I turned 65, I enrolled in a High Ded F Supp, with a Part D plan. Don't normally doctor much, so I though it would work for me. But basically, with the deductible, all I did was pay - pay premiums, and pay the lion's share of any doctor visits I did have.
It's been 3 years and premiums, drug costs and deductible kept going up. I am poor to say the least, and I often didn't doctor at all when I probably would have, if I was in an Advantage plan, because it was all coming out of my pocket. So, in December, I bit the bullet and switched to an Aetna Advantage Plan. I have had my 90+ year old Mom with them for a few years and I have to say they have been wonderful. She had an 11 day hospitalization this past year, with about 6 days in ICU, with a $50K total bill and her out of pocket cost only ended up being $1,600. I thought that was amazing, especially compared to what UHC had socked her for a hospitalization of lesser time and import a few years back. So I felt I'd be good on Aetna as well.
Medicare notified my Part D drug plan and they sent their notice of cancellation effective 1/1/2020 at lightning speed. And Aetna enrolled me almost as quickly.
However, the advice I had read was to NOT cancel my High Ded F supp plan immediately, in case I decided to switch back, as I have the right to do that. So, I did NOT contact BC/BS and just paid the January premium as always. So as far as BC/BS knows, I am still insured by them. I was told this would make it easier, should I decide to drop out of the Advantage plan and return to the supplemental plan.
So, of course, two days ago, 1/6/2020, I had an "incident", because, as always, my timing in life sucks. This being a public forum, I do not care to give details as to what that was - just think "lady troubles" and you'll have an idea of what I am up against. But let me just say, that one of the distinct possible causes behind this "incident" is cancer. Yes, it could also be several other things, and I won't begin to know for sure until I see the specialist in a week. But even if it isn't cancer, some of the other causes could also involve some heavy duty surgeries.
I know if it turns out to be cancer - or another situation involving some serious surgeries - that I will be much better off, both financially and with the health options and not needing pre-approval, if I am back on my High Ded F Supplement plan. I know I can contact Medicare and ask to disenroll from the Advantage plan and just keep paying my F Supp plan.
But what I don't know is: can and how do I get back on a Part D drug Plan? Am I even allowed to do this right now or will I have to get through 2020 with no drug plan? And if I can re-enroll in a Part D drug plan now, will I have to go back to Express Scripts, which is the plan I had been in? Or am I allowed to choose another Part D Drug Plan, which I was going to do, had I not enrolled in the Advantage Plan, because Express Script's prices for the drugs I do take, had gone up substantially for 2020?
All advice and information will be much appreciated, thanks!
Once you switch to a advantage plan they don’t have to let you back in and it will require medical underwriting which it doesn’t sound like you can pass.
You said you are still with the High Ded F plan and that they have Part D coverage? So, I am not understanding your question. Are you saying you want to keep Aetna and the High Ded F plan, keep both plans?
No, she needed a separate Part D with the hd Medigap. Hopefully, her Advantage plan also covers drugs.
Actually, under Medigap Trial Rights, if this is her first enrollment in an Advantage, she could have dropped the hd-F and still had the right to repurchase the same plan within a year if she didn't like Advantage. I am not sure if this also applies to Part D, however.
That said, yes, one can own a Medigap and then enroll in Advantage and keep the Medigap 'just-in-case.' It is, however, illegal for an insurance company to sell a Medigap to a person already enrolled in Advantage.
Thanks. I had a Medigap and a separate part D plan. For 2020, I enrolled in an Aetna Advantage Plan that comes with drugs. I know I have the right to go back to the Medigap Plan (yes, for the whole year) without going through any underwriting or health questionnaire/checkup. On advice, I had paid the January Medigap plan payment, reason being it would make it easier to just continue with the Medigap plan once I dropped the Advantage plan (if I do go that route.)
What I don't know is do I also have the right to go back to a Part D drug plan for 2020, should I choose to exercise my right to go back to my Medigap plan. Obviously, if I can't get a drug plan at all for 2020, I'd be screwed. Not just for 2020, but I would also probably be stuck paying that penalty for not having a drug plan for the period of time you are allowed to skate on that (a couple of months, IIRC), for the rest of my life. If I can't also re-enroll in a Part D drug plan, obviously, I'll have to stay with the Aetna Advantage plan.
So that was the question I had - if I go back to Medigap, can I also go back to a Part D plan right away. And if I can get a Part D plan, do I have to go back to the one I was on - Express Scripts - or am I allowed to pick a new Part D?
There are a few ways you can get Part D outside of the enrollment period, none are simple or easy and may not apply to your situation. There are advisors in every state in a program called SHIP and they could help you figure out what to do.
Good luck.
I got good advice from SHIP people when I signed up for Medicare, Dec 2019 signup.
My husband got good advice several years ago.
The best thing is they are neutral, not affiliated with any business, not sales people.
I second the SHIP recommendation. As I type this, the guy I'm dating is working for the one in KS. They get extensive training and he deals with a LOT of people who switched to Advantage and want to switch back. My Dad did that at this time last year and had no problems.
You cannot have both medigap and Advantage coverage. Even if you paid the medigap premium, BC/BS will still try to collect the medicare premium and find that’s going to Aetna Advantage. Your medigap premium is only the additional you pay on top of the medicare premium they collect and both insurance companies expect to get paid by medicare in addition to your payments.
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