I currently have a Regence MedAdvantage policy that I began when I turned 65. My Medicare card shows a start date of 1-1-2013; thus I am outside of the one year period for new enrollees that would allow me to just switch to any plan I chose.
I am currently considering changing my insurance to Medicare Supplement plan F and adding Part D coverage because my Advantage plan raised it premiums $30/month this year. I am concerned that in 5 or 10 years the premiums could be painfully high and I don’t believe the Supplement plans will escalate nearly as quickly.
My problem is as follows. I have 2 insurance agents telling me two totally different things. One says, during Open Enrollment, I can go to any Supplement plan without answering any health related issues as long as my current Advantage plan’s coverage is equal to or better than the Supplement plan I want to go to. The other agent says that even during Open Enrollment, I will have to answer health related issues depending on the specific Supplement plan, regardless of my present coverage. It can’t be both ways and I can’t find any information on the Medicare site that discusses this specific issue. I also do not know how Washington state’s insurance regulations might affect this.
I am currently in very good health and feel I could sail through any health questionnaire, but this could affect whether I go to a Supplement plan now or wait several years. If I must pass a health test, then I would sign up now. If I don’t have to pass a health test, there are several other Advantage Plans I would highly consider changing to until they price themselves out of the consumer market and then go to a Supplement plan.
Would appreciate an answer about which story is correct so I can decide how I should proceed. Thank you.
As you said, if you change your mind after purchasing a Medicare Advantage plan for the first time and you decide you are unhappy with that plan, you have “special rights” to switch back to Original Medicare within 12 months of joining. That 12 month period is over for you. However, in the state of Washington, beginning this year, if you have no gap in coverage there is a guarantee issue on both sides.
I recommend that you sit down and talk to a good agent for about 15 minutes because your decision about what plan you go with should include looking at three things—premiums, coverage and network. Many people get hung up on staying with the plan they are familiar with. The problem with that is that, no one ever asks if that is this my only option. Some plans offer a great deal more value and network than others and every year I talk with people who have spent two or three times the amount they needed to on a plan because that’s the plan they were offered when they retired. Perhaps more importantly, many of those more expensive plans have holes in their coverage because they don’t offer networks that you may need at a later date such as a cancer treatment center or other specialized treatment options.
I should say here that insurance brokers get paid by the insurance company rather than the client so it’s a good opportunity to ask questions and look at information without feeling any pressure to buy anything. If you look for someone that has several years in the business, they’ll take the time to make sure you get into an appropriate plan. You are probably better off financially with an advantage plan than you would be with a supplement plan. For one thing a prescription plan could add significant costs to your health insurance costs if you had to purchase that separately.
If you’d rather not talk to a broker, consider contacting SHIBA. SHIBA stands for Statewide Health Insurance Benefits Advisors and they are part of the insurance commissioner’s consumer protection service. This well-trained group of volunteers provide free, unbiased assistance to consumers about Medicare and health care choices.
A final option I would like to suggest is to attend a Medicare Open Enrollment Seminar. You can find a list of them on our website at https://agingoptions.com/resources/.