By Elizabeth O’Brien February 12, 2018
Not loving your Medicare Advantage plan? You have until Feb. 14 to ditch it under the annual Medicare Advantage Disenrollment Period, which ends on Valentine’s Day.
Note that this isn’t a continuation of open enrollment, the annual period from Oct. 15 through Dec. 7 when you can make any number of changes to your Medicare coverage. Only one move is permitted during the winter disenrollment period: switching from Medicare Advantage to original Medicare, which is Parts A and B. You can also buy a Part D drug plan and a Medigap supplement plan. Unless you have special circumstances, you’ll have to wait until October to make any other changes to your coverage for a Jan. 1, 2019 start date.
Medicare Advantage, also known as Part C, is insurance offered by private carriers that are contracted with the government to provide Part A hospital coverage and Part B outpatient coverage. Since 2004, the number of beneficiaries enrolled in these private plans has more than tripled from 5.3 million, or 13% of all beneficiaries, to 19 million, or one-third of beneficiaries, according to the Kaiser Family Foundation. The average monthly premium for enrollees of Medicare Advantage plans with drug coverage is $36 per month in 2017, although some plans have $0 premium.
One reason Medicare Advantage plans are popular is because many pay for services and treatments that original Medicare doesn’t, such as eyeglasses, hearing aids and dental work. What’s more, many Medicare Advantage plans offer prescription drug coverage with no deductible, compared with a deductible of up to $405 under the Part D drug plans that are sold to beneficiaries on original Medicare.
The trade-off is that the majority of Medicare Advantage plans are HMOs with relatively narrow networks, so your doctor and hospital choices are more limited. In 2015, more than one-third of Medicare Advantage enrollees were in plans with narrow doctor networks, according to the Kaiser Family Foundation.
By contrast, under original Medicare, beneficiaries can see any doctors around the country who accept Medicare. That’s a big reason why you might want to go back to original Medicare.
There’s a big caveat, though: if your plan is to have original Medicare and a Medigap supplement plan, keep in mind that these supplemental plans are medically underwritten. That means, you may be charged more for coverage or rejected altogether based on your health status. While it’s too late to complete the underwriting process before the deadline, a consultation with a broker should give you a good idea whether you’re a candidate for the supplemental plans available in your region, says Joe DeLuca, director of sales at eHealthMedicare.com, a broker that helps consumers select private Medicare plans.
“The key is to call before the 14th,” he says. Each carrier has different selection criteria, and an experienced broker should be able to steer you to one that will accept you.
Don’t drop your Medicare Advantage plan until you’ve gotten assurances that you can buy a Medigap supplement plan at a price you can afford, DeLuca cautions.