How To Unwind Problems
If you want to switch between Medicare Advantage plans,
Perhaps you have watched a commercial, called, and enrolled in a plan over the phone (I don’t think this is a very good idea on a single call, there are too many moving parts when considering your most-fitting Medicare setup). Anyways, the message throughout Maximize Your Medicare is that there are powerful consumer rights, if you know what you are doing.
You have a single time to change, beginning January 1, ending March 31. The sooner the better, and the reason is that any progress towards the out of pocket maximum will reset if you are moving to a new plan (there can be exceptions, but this is a conservative path).
You can switch OUTSIDE this window, if:
You are switching INTO a 5-star plan as determined by the CMS. Once, between Jan 1 – Sep 30, and again during the Annual Election Period.
You qualify for Extra Help, which is the federal program that assists with pharmaceutical costs. Once a quarter, you can change.
You qualify or are disqualified for Medicaid in your state.
Your plan is discontinued.
If you have switched from Medigap to Medicare Advantage, and want to switch back,
January 1 – March 31: you can cancel your Medicare Advantage and enroll in a Part D plan. BUT remember that you CANNOT switch back to Medicare Advantage for the rest of the year. That means that you need to make sure that you are accepted by the Medigap carrier FIRST. Doing this out of order could be a huge mistake, which is easily avoided by FIRST getting accepted by a Medigap carrier. Note that this is trickier than it may seem, because the Medigap carrier may require additional information or have questions that everyday people can find very difficult to answer correctly.
There are other ways to do this (12-Month Trial Right), but it requires expertise in the rules, and on top of that, it may require evidence to prove that you are following those rules.
Individual Health Insurance
DON’T FORGET TO SUBSCRIBE TO THE CHANNEL, THERE ARE LOTS OF VIDEOS ON TOPICS NOT INCLUDED ON THIS SUBSTACK.
If you have chosen wrongly or if you receive inaccurate information (as many do),
Now – January 15: you can enroll in any ACA-compliant plan, and the coverage will begin on February 1.
If you do not qualify for the Advance Premium Tax Credit (APTC), for whatever reason, then you do not need to use healthcare.gov or your state-specific portal in order to select a plan. Many carriers have off-marketplace plans that do not exist on-marketplace.
If you have a life qualifying event, then you can change plans.
Here’s your hint. Please please make sure that your doctors and hospitals accept your insurance. Sometimes you will need to check and double check. We will help you, but please understand that sometimes the online data is inaccurate or incomplete.
If you are unsure if you want or can afford health insurance, click the button, there is no obligation.