Medicare: Time To Change

You can make certain changes during the Medicare Advantage Open Enrollment Period (MA OEP), which runs from Jan. 1 through March 31. Those enrolled in a Medicare Advantage Plan can switch to a different Medicare Advantage Plan or to Original Medicare with or without a standalone Part D plan. Changes made during this period are effective the first of the month after you make the change.

If you enrolled in a Medicare Advantage Plan or Part D plan by mistake or after receiving misleading information, you may be able to disenroll and change plans. Typically, you have the right to change plans if you:

* Joined unintentionally: You may have enrolled believing you were joining a Medigap plan to supplement Original Medicare. Or, you meant to sign up for a stand-alone Part D plan and accidentally joined a Medicare Advantage Plan.

* Joined based on incorrect or misleading information. For example, if a plan representative told you that your doctors are in the plan's network but they are not, or you were promised benefits that the plan does not really cover.

* Through no fault of your own, ended up or were kept in a plan you do not want: If you tried to switch plans during an enrollment period but were kept in your old plan. You can also make a change if you were enrolled in a plan because of an administrative or computer error.

Depending on the circumstances, this change may be retroactively effective.

You may be eligible for a Special Enrollment Period (SEP) in which to change your coverage. SEPs allow you to change your health and/or drug coverage outside normal enrollment periods. For example, if your Medicare Advantage Plan left your area or if you moved out of your plan's service area, you would have an SEP to switch to another MA Plan or to Original Medicare. Those enrolled in certain cost-assistance programs, such as Extra Help or the Medicare Savings Program, are eligible for other SEPs.

And of course, you can wait for the Fall Open Enrollment Period to make changes to your coverage for next year. The Fall Open Enrollment Period occurs each year from Oct. 15 through Dec. 7, with your new coverage starting Jan. 1.

If you have a Medicare Supplement plan and reside in California, or a handful of other states, you can change plans during your birth month. California allows changes for a month prior to your birthday to 60 days following your birthday. The most popular of these changes is people with a Medicare Supplement Plan F are paying $600 to $1,200 more annually than they need to. My office is aiding in changing about 30 policyholders a month. That's about $24,000 a year in the consumer's pocket instead of the insurance companies.

Currently, we have a few other tricks up our sleeves, and I am able to assist other changes where people have been told they were stuck. How about dropping a Medicare Advantage plan and getting a Medicare Supplement with no medical questions?

Harry P. Thal, the Medicare Guru in Kernville, is available for free phone consultations.