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May 18, 2022

Medicare Benefits You May Not Be Aware Of

Medicare Supplement CoverageOne of the most frequent questions we get asked is:

“If I sign up for a Medicare Advantage plan, can I move to a Medicare Supplement at a later date?”

There are several ways to facilitate a move from Advantage to Supplement. These are the ones we see most often, and one may be surprising. First, I want to give you a term to use going forward: Guaranteed Issue. It means that if you apply for a Supplement, using one of the conditions that will follow, you cannot be denied coverage or charged more due to health.

 Here are the conditions for Guaranteed Issue.

1.       You are in a Medicare Advantage Plan. Your plan leaves Medicare or stops giving care where you live. Or you move out of the plan’s service area.

Occasionally carriers will stop offering an Advantage plan. It is pretty unusual but can happen. If so, you can enroll in a Supplement. What if you move from one state to another? In that case you have Guaranteed Issue rights for a Supplement, regardless of your health. What if you move in state from one county to another? If your current Medicare Advantage plan is not available in the new county, you have the right to enroll in a Supplement with Guaranteed Issue.

2.       If you join a Medicare Advantage plan when first eligible for Part A at age 65, you have a Trial Right to leave the Advantage plan and enroll in a Supplement as early as 60 days before the date your Advantage coverage will end, but not later than 63 days after the coverage ends.

This gives you the right to try out an Advantage plan and see if it’s the best fit for you. If you are older than 65 and enrolled in Medicare after leaving an employer plan, you won’t have a Trial Right. It’s only for those who enrolled in an Advantage plan upon turning 65.

3.       If you dropped a Supplement plan to join a Medicare Advantage Plan for the first time and you have been in the plan less than a year, you can move back to your original Supplement plan. You can only do this once.

4.       Here are a few more circumstances that allow you Guaranteed Issue.

• Your Supplement company shuts down or goes bankrupt

• If either a Medicare Advantage or Supplement carrier has not followed the rules or has mislead you.

It is good to know exactly what rights you have for Guaranteed Issue. You never know when a need may arise, and you need to make a change.

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