How To Switch From Medicare Advantage to Medicare Supplement Plans

Changing from a Medicare Advantage plan to a Medicare Supplement plan. Hey guys, Alex Monnier here from Blue Wave Insurance. In this video, I'm going to cover some surprising things most people don't know when changing from a Medicare Advantage plan to a Medicare Supplement plan. A lot of folks are getting letters this year before annual enrollment period that their Medicare Advantage plan is not going to be available next year. A lot of insurance companies are cutting back on their Advantage plans and just getting rid of a lot of their unprofitable Medicare Advantage plans. So if you received a letter that your Advantage plan is not going to be available next year, you do have some options. You can switch to a different Advantage plan or you can change to original Medicare and pick up a Medicare Supplement plan without any health underwriting. This is called guarantee issue. So it gives you a free ride into a Medicare Supplement plan, no health questions asked. So losing your current Advantage plan would be one reason to change from Advantage to a Supplement. Another reason would be if your current doctors no longer accept your Advantage plan and you want to go back to original Medicare and have an option to see any doctor anywhere in the country that takes original Medicare, you could do so by having original Medicare and a Medicare Supplement plan as your secondary. Other reasons are coverage. Maybe you just want better coverage than what your current Medicare Advantage plan is offering you. A lot of folks deal with prior authorizations on their Advantage plans where maybe their Advantage plan is telling them they can no longer get certain tests or treatments done or they're restricting how many tests or treatments they can get done. If you no longer want to deal with that anymore, you can go back to original Medicare and pick up a Supplement plan. So that's another reason. So far we've talked about your current Advantage plan not being available, your current doctor is no longer taking your Advantage plan and getting better coverage than what you currently have with your current plan. So when can you change from an Advantage plan to a Supplement plan? Typically you can change each year between October 15th and December 7th. This is referred to as Medicare Annual Enrollment Period and takes place each year. So that is usually the best time to make that change from an Advantage to a Supplement with the Supplement plan would start January 1st of the following year. In addition, there's a secondary enrollment period called Open Enrollment Period, also known as OEP, which allows folks who have a Medicare Advantage plan to drop it and go back to original Medicare. Now if you dropped it and went back to original Medicare, you could also pick up a Supplement plan as well. Usually health underwriting would be required, which I will talk about next. If you happen to have a Special Enrollment Period, you are able to change from an Advantage plan to a Supplement plan outside of AEP and outside of OEP. Some examples of a Special Enrollment Period may include moving. If you're moving out of your plan's service area, you get a Special Enrollment Period to make a change. Also, if you've got a letter in the mail that says your Medicare Advantage plan will not be available next year, that does give you the extra Special Enrollment Period beyond Annual Enrollment Period. So Annual Enrollment Period would be October 15th to December 7th. You get an additional Enrollment Period December 8th to February 28th. So December to the end of February to make a change. If you are losing your Advantage plan, it's no longer offered next year. So let's talk about making the change. Underwriting is usually required when you're changing from Advantage to a Supplement. There are some circumstances where you can bypass the health questions or the health underwriting. This is called Guarantee Issue or GI. It's what we refer to it in the insurance industry. Let's talk about the health questions first. So normally, if you didn't get a letter that says your plan is going to be terminated, you just want to simply switch from Advantage to a Supplement during Annual Enrollment Period or during the Secondary Enrollment Period between January 1st and March 31st, which is Open Enrollment Period. You want to switch during those times. You would normally have to answer some basic health questions in order to get approved on the Supplement Plan. These health questions are going to include yes or no answers on heart attack, stroke, cancer, usually going back a couple of years. Each area is a little bit different on the questions that they ask, but normally those are the big questions, the yes or no's on the major health conditions. Now, if you're moving outside of your service area or you got a letter that said your plan is no longer being offered next year, you have what's called Guarantee Issue. That would mean no health questions at all. You get a free ride into a Supplement Plan. They cannot deny you. So it's either making the change from Supplement to Advantage. You're going to have to either do health questions, health underwriting, or if you're qualifying for a Special Enrollment Period and you can get a Guarantee Issue, you can bypass the health questions. Also, there are a couple of states that don't ask health questions ever, such as New York and Connecticut. So if you live in one of those two states, you can switch from an Advantage to a Supplement, no health questions at all, but you still have to do it during a valid election period, such as Annual Enrollment Period or Open Enrollment Period. Again, Open Enrollment is when you can drop your Advantage and go back to Original Medicare between January 1st and March 31st. Now, I would say some of the biggest surprises when going from Advantage to Supplement is probably that initial price shock. If you're used to paying zero on an Advantage Plan and then you sign up for a Supplement Plan, well, of course, you're probably going to know the price before you sign up. But when you initially start getting quotes on Supplement Plans, you're going to see that the pricing, depending on where you live and how old you are, can be anywhere from $100 to $200 plus per month for the Supplement Plan. So initially, that is a little bit of a shock to some people, but the coverage on the Supplement Plan really cannot be compared to the Advantage Plan. You have full coverage on most plans, minimal out-of-pocket, can go anywhere in the country that takes Medicare. So you really get ultimate flexibility and the best coverage possible on the Supplement Plan, but you do have to pay for it. The second gotcha is going to be getting a separate drug coverage. So if you're used to having an Advantage Plan, you're used to having the drug coverage included on that Advantage Plan. When you go back to Original Medicare and pick up a Supplement Plan, you'll need a separate Part D Drug Plan. Now, those plans are going to range in premium anywhere from zero up to $100 plus per month, depending on the plan. So that is an initial adjustment a lot of people have to make, getting used to have a separate standalone prescription drug plan that's separate from their Medicare Supplement Plan. And a lot of times that Supplement Plan and the drug plan are with two different insurance companies. So you might have a Supplement Plan Mutual of Omaha and a Part D Drug Plan with Cigna or UnitedHealthcare or a different carrier all together. So that can be an adjustment as well. And lastly, I'd say that having or not having dental, vision, gym benefits, or any other extra benefits that your Advantage Plan may include now, you normally will not have those on a Supplement. So you're not going to have the dental, the vision. You would need to get a separate policy to cover dental and vision if you're on Original Medicare because the Supplement Plan does not add in that coverage, that dental and vision. And then the gym benefits, most Supplement Plans don't cover gym benefits. There are a few carriers that do, but they're few and far between. So to conclude, price shock, having a separate drug plan and having to get a separate plan for dental, vision, and not having fitness benefits are some surprises many folks encounter when going from an Advantage to a Supplement Plan. Now, if you're wanting to look into making the transition from Advantage to Supplement Plan, give us a call at the number below. We'd be glad to help you out free of charge. We can give you price comparisons. We can tell you what's covered, what's not covered, and answer all your questions. The application process is pretty straightforward. If you're needing to do underwriting, you have to answer some basic yes or no health questions. If you have a guarantee issue, you would just need to submit proof of the guarantee issue with the application to the Medicare Supplement Carrier. After getting approved with the Supplement Plan, we normally, for our clients, will do a separate drug plan enrollment and that will automatically cancel out the old Advantage Plan. So again, once you're enrolled on the Supplement Plan, you do a separate drug plan enrollment to automatically cancel the old Advantage Plan. You do not need to call and cancel the old Advantage Plan if you do a drug plan enrollment because doing a drug plan enrollment automatically cancels the Advantage. So that's an easy way to make sure you're off the Advantage Plan just doing a drug plan. Thanks for watching the video. Click like and subscribe below to stay updated on all things Medicare. And if you're looking for quotes or need help with your Medicare, give us a call at the number below or use the link in the description to book a call with us. We'd be glad to help you out. Thank you.