Having second thoughts about Medicare choices as deadline approaches?

Ask Lance


Published:

Dear Lance,

My wife and I had Original Medicare for several years. During the recent Medicare Annual Enrollment Period, we signed up for a Medicare Advantage Plan that has prescription drug coverage. We are both anxious about our decision because we have never had this type of plan before.

If we are not happy with our Medicare Advantage Plan, must we wait until next year’s Annual Enrollment Period to switch back to original Medicare?

Having Second Thoughts

Dear Having Second Thoughts,

It is not uncommon for people to have second thoughts about their choices. Medicare recognizes that this can happen and that beneficiaries might wish to change the options they chose during the Annual Open Enrollment Period or at other times.

Here are a few of the most common situations in which people may want to make changes to the choices made during Medicare’s Annual Open Enrollment Period. I have also included options available.

Situation 1: (This is your situation.) You enrolled in a Medicare Advantage Plan for the first time and would like to enroll in Original Medicare instead. You can dis-enroll from the Medicare Advantage Plan and switch to original Medicare any time during the first 12 months you are in the Medicare Advantage Plan. This is called the Medicare Advantage Trial Period, and it is a once-in-a-lifetime opportunity. If you had a Medicare Supplement Plan, you can get it back. If the plan is no longer available, you can enroll in any Medigap Plan A, B, C, F, K, or L. If you had a Part D Prescription Drug Plan, you can re-enroll in it.

Situation 2: You had original Medicare and just enrolled in a Medicare Advantage Plan. You previously also had a Medicare Advantage Plan and now would like to return to original Medicare instead. If it is before Dec. 7, you can cancel your enrollment in the Medicare Advantage Plan and you will keep Original Medicare. Otherwise, there is a Medicare Advantage Disenrollment Period from Jan. 1 to Feb. 14 at which time you can call Medicare to dis-enroll and return to Original Medicare. You can also sign up for a Part D Prescription Drug Plan during this period. You cannot switch to another Medicare Advantage Plan during this period unless Situation 3 applies to you.

Situation 3: You enrolled in a Medicare Advantage Plan but would like to switch to a different Medicare Advantage Plan. If it is prior to Dec. 7, you can dis-enroll in the plan you chose and select a different one. After this date, you can make a change only if the Medicare Advantage plan that you wish to switch to is rated by Medicare as a 5-Star Plan (if available in your area). If so, you can do this at any time.

Situation 4: You have Original Medicare or Original Medicare plus a Part D Prescription Drug Plan and would like to enroll in a Medicare Advantage Plan instead. After Dec. 7, you cannot make any changes for the coming year.

Well-trained volunteer SHINE counselors can further explain the options available to you. 

SHINE (Serving Health Insurance Needs of Elders) is an award-winning statewide volunteer program that provides free, unbiased and confidential counseling and information for people on Medicare, their families and caregivers. SHINE is a program of the Florida Department of Elder Affairs and is administered in partnership with the state’s 11 Aging and Disability Resource Centers (ADRCs). In Brevard County, our ADRC is the Senior Resource Alliance, located in Orlando.

To contact a SHINE volunteer counselor for confidential and unbiased assistance, call the Elder Helpline toll-free at 1-800-963-5337, or call 321-752-8080 locally. SHINE has 12 counseling locations throughout Brevard County. Counselors can assist you by telephone or in person. To find a SHINE counseling site near you, go to floridaSHINE.org or call the telephone numbers listed above.