Last year, during Medicare's annual enrollment, my husband and I qualified for a Medicare supplement Plan G from a telemarketing call. The supplement has never paid a dime! We still must use the same doctor and get referrals from our Medicare Advantage health maintenance organization. We can't get the Medicare supplement to pay because no one advised us how to stop the Advantage plan.
We have spent over $250 a month since January, and the Plan G has never been used. How can we get out of this Medicare Advantage plan and return to original Medicare to use the supplement purchased last November?
Looking forward to your answer, Toni.
— Laura from Tampa, Florida
The biggest no-no in the Medicare insurance world is when an insurance company or agent sells a Medicare beneficiary (which is what you and your husband are) who has a Medicare Advantage plan a new supplement without advising the client how to disenroll properly from their Medicare Advantage plan.
Laura, as you are now finding out, because the agent who sold you the supplement failed to inform you and your husband how to disenroll properly from your Medicare Advantage plan, you and your husband have not been in original Medicare for the past year and could not use the benefits.
The change would have been a simple one because you both qualified medically for the new Medicare supplement. All the agent needed to do was enroll you and your husband in a stand-alone Medicare Part D prescription drug plan. This simple step would have cancelled your Advantage Plan effective Jan. 1 and returned you and your husband to original Medicare with a supplement and a new Medicare Part D prescription drug plan.
You need to enroll in the stand-alone Medicare Part D plan that covers you and your husband's current prescription drugs as soon as possible or no later than midnight Dec. 7, or you will remain in the same situation that you are in right now, Laura.
Readers, this is what Medicare's annual enrollment period, from Oct. 15 to Dec. 7, is all about. It's the time to enroll in a new Medicare Part D prescription drug plan or Medicare Advantage plan. (Chapter 6 of Toni's "Medicare Survival Guide Advanced" edition explains the enrollment period rules in detail.)
If you are changing to a Medicare supplement, you need to have passed the medical underwriting process and be approved for the supplement before enrolling in a stand-alone Part D plan, which will automatically cancel your Advantage Plan. If you are not approved for a Medicare supplement before you sign up for Part D and you miss the Dec. 7 deadline, all costs that original Medicare does not pay will become your financial responsibility without a supplement.
Insurance agents who are properly trained regarding Medicare Advantage rules know those enrolled in Medicare Advantage plans should enroll in a standalone Medicare Part D plan by midnight Dec. 7 to be disenrolled properly from a Medicare Advantage plan once the supplement is approved.
Most Americans do not realize they can not have both original Medicare and a Medicare Advantage plan at the same time. Medicare will pay the Medicare Advantage plan for your care. Original Medicare and a Medicare Advantage plan can't pay at the same time. Confusing, I know! Remember, with Medicare, it's what you don't know that will hurt you.
Toni King is an author and columnist on Medicare and health insurance issues. She has spent nearly 30 years as a top sales leader in the field. If you have a Medicare question, email email@example.com or call 832-519-8664. Toni's books and her newsletter are available at tonisays.com.