Yes, but there are some details you need to know before making that decision.
Here's one scenario we see quite often: You sign up with a Medicare Advantage insurance plan with any available insurance company in your resident county on your 65th birthday, but later determine that a Medicare Advantage plan is not for you. You have reached the conclusion that Medicare Supplement insurance would be a better fit for your needs and it's time to find a new insurer. So, what can you do, and when can you do it?
This is an issue that occurs more often than most realize when considering a change in health insurance. Medicare Advantage plans can be a perfect fit for many covered under Medicare. However, Medicare Advantage plans are not for everyone. Many individuals, for a myriad of reasons, simply prefer Medicare Supplement insurance. In New Jersey, about 30% of Medicare beneficiaries are utilizing Medicare Advantage plans. Around 22% are utilizing a Medicare Supplement plan. Regardless of which plan type you prefer, the good news is it is possible to switch from a Medicare Advantage plan to a Medicare Supplement plan (and visa-versa) if you follow certain federal guidelines.
Regardless of what plan you have, you are still under the Original Medicare Umbrella.
Whether you are covered by a Medicare Supplement plan, or a Medicare Advantage plan, Original Medicare is still behind everything. So, in a sense, you have the same horse with different saddles.
One thing to remember is Medicare Part A and Medicare Part B are required to enroll in either a Medicare Advantage plan (Part C) or Medicare Supplement insurance plan (also known as a Medigap policy).
Original Medicare is the eligibility key to supplemental coverage.
Medicare Advantage plans offer an alternate way to get your Original Medicare Part A and Part B benefits. The private insurance carriers that offer Advantage plans usually throw in some extra plan benefits above those of original Medicare to make the Advantage plans a more attractive option. Such benefits may include vision, dental, and hearing care. They may also include Medicare Part D prescription drug coverage.
Medicare Advantage helps manage your out-of-pocket costs using coinsurance and copays.
Medicare Supplement plans follow a more traditional format to offer coverage for "gaps" in the coverage with the original Medicare program. These gaps refer to out-of-pocket expenses that you would incur if you were medically covered only by original Medicare. Medicare supplement plans pick up certain copayment, coinsurance, and deductible costs that would otherwise be your responsibility. In most cases, Medicare supplement insurance plans do not add any additional benefits. They just provide financial protection where original Medicare coverage is less than complete.
Most common medigap plans:
It is against federal law to be covered by both a Medigap plan and a Medicare Advantage plan at the same time. If you try to enroll in a Medigap plan while currently on a Medicare Advantage plan, it will automatically disenroll you.
To switch from a Medicare Advantage plan, you need to first cancel the plan and return to original Medicare. The process to do this is simple. Then, you can apply for a Medicare Supplement insurance plan and add your Part D benefits.
In most cases, you can only switch from a Medicare Advantage plan to a new plan with the same company or a different Medicare Advantage plan during certain times of the year:
Outside these periods, you can only switch between Medicare Advantage and original Medicare if you meet certain qualifying events, such as changing your residency to a location that is outside your plan's service area. You need to have a good understanding of the federal guidelines for making this kind of plan switch. Switching plans within the right time of year, and properly following federal guidelines, will afford you guaranteed-issue rights. When you have guaranteed issue rights, your application for Medicare Supplement coverage cannot be declined (generally 63 days from the date you leave your Medicare Advantage plan).
There are many issues to understand and consider before switching from a Medicare Advantage plan to Medicare Supplement Insurance. Be certain to speak with a licensed insurance agent before making this change and consider your options so you can make the best choice the first time.
To ensure that Medicare beneficiaries receive the best possible care, the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) was signed into law a few years ago. Among other things, MACRA created the Quality Payment Program (QPP) to reward physicians based on the quality of care they provide to patients.
The program streamlined several other existing merit-based payment programs and refocused on providing value instead of paying clinicians based on the number of patients they treat. This fundamental shift rewards high-quality Medicare providers with payment increases while reducing payments to those clinicians who don’t meet performance standards. Reducing paperwork and focusing emphasis on delivering better health outcomes for Medicare patients has lowered program costs overall as well.
The QPP also has a built-in continuous improvement element, meaning it keeps evolving and remains flexible to best meet the needs of a rapidly changing healthcare environment. The result is that Medicare can better leverage the input and expertise of frontline staff to create a partnership that benefits patients, providers, and Medicare administration.
Information is for educational purposes only and should not be construed as an offer of insurance, advice, or recommendation. The information provided is not intended as tax, financial, investment or legal advice. Please consult legal or tax professionals for specific information regarding your individual situation.
Not connected or endorsed by the US Govt or the Federal Medicare Program. Medi-Solutions Insurance Agency, LLC is an independent Life, Accident and Health Insurance Agency, NJ Ref#1642311. Some plans and features may not be available in all states.
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