Dear Toni: During last year’s Medicare open enrollment time, my husband, John, and I qualified for a Medicare supplement Plan G over the phone from a telemarketing call. The supplement has never paid a dime! We still must use the same doctor and get referrals from the Medicare Advantage HMO that we were enrolled in. We can’t get the supplement to pay because no one advised us how to stop the Advantage plan and return back to Medicare.
The supplement is costing us over $400 a month since the plan began in January. How can we get out of this Medicare Advantage HMO plan and return to original Medicare to use the supplement? — Ginger, Sugar Land, Texas
Dear Ginger: This is a common mistake: An insurance company or agent marketing a Medicare supplement without explaining how to disenroll from a Medicare Advantage plan and return to original Medicare.
The change would have been a simple one, since you and John both qualified medically for the new Medicare supplement. All the agent needed to do was enroll you into a stand-alone Medicare Part D prescription drug plan by the end of the open enrollment period (Dec. 7). This would have canceled your Medicare Advantage plan effective Jan. 1. You and John would have returned to original Medicare with a supplement and a new Part D prescription drug plan.
Currently, nothing can be done about your situation with the Medicare Advantage plan, because you’re outside of the open enrollment period for such plans (Jan. 1 to March 31).
But there is one option you could try: Call Medicare at 800-633-4227 and explain your situation. Perhaps the Medicare representative could override the problem and enroll you in a Part D prescription drug plan, which would disenroll you from the Advantage plan and return you to original Medicare with your current supplement.
People enrolling in a Medicare supplement need to be sure they have passed the medical underwriting process and are approved before enrolling in a stand-alone Part D plan, which will automatically cancel their Advantage plan. Many Medicare beneficiaries do not realize you cannot have original Medicare and a Medicare Advantage plan at the same time.
Toni King is an author and columnist on Medicare and health insurance issues. If you have a Medicare question, email info@tonisays.com or call 832-519-8664.
