Hip Surgery Postposed After Enrolling in Medicare Advantage Plan

Published 1:58 pm Sunday, December 19, 2021

 

Toni:

I made a terrible mistake during the recent Medicare Advantage Enrollment Period and changed to a Medicare Advantage HMO plan because I understood from talking with my friends that this plan was an effective way to save my Medicare dollars. Now I have discovered that my orthopedic surgeon is not in this plan, and I am to have hip surgery in January.                              Now my surgery is postponed. The surgeon’s office is requesting that I return to Original Medicare, so he can do the type of surgery that is needed. Can you explain how I can return to Medicare? I am glad I had not cancelled my Medicare Supplement Plan F even though the premium has increased. Signed…Jason from St. Louis, MO.

 

Hello Jason:

Beginning January 1st is the time for those that have discovered they have made a wrong choice of selecting a Medicare Advantage plan and wish to change to a different Medicare Advantage Plan or return to Original Medicare. Your Medicare Advantage change will take place the first day of the next month.

On page 72 of my new Medicare Survival Guide® Advanced edition, I explain how you can disenroll from the Medicare Advantage Plan. This time is called the Medicare Advantage Open Enrollment Period and begins January 1-March 31(each year).

During the Medicare Advantage Open Enrollment Period (MA OEP), you can switch from your Medicare Advantage Plan to another MA Plan, or to Original Medicare with or without a Part D plan. You can only use this period if you have a Medicare Advantage Plan not to change your Medicare Part D prescription drug plan.

To disenroll from a Medicare Advantage plan or a Medicare Part D prescription drug plan after March 31st, you cannot because you are in “lock in” from April 1st to December 31st. You will now have to wait until the next Medicare enrollment period, which begins October 15 thru December 7th to change to a different plan or return to Original Medicare.

You made a smart choice, Jason, by not cancelling your Medicare Supplement because due to your health issues you may not be able to apply for a new plan. Most Americans do not realize that you can change your Medicare Supplement any day of the week. There is not a special time to enroll in a Medicare Supplement like there is for a Medicare Advantage plan.

Be sure that you do not cancel your Medicare Supplement plan for the first months that you are trying a Medicare Advantage plan just in case you need to return to Original Medicare. You may want to return to Original Medicare during Medicare Advantage Open Enrollment Period from January 1-March 31.

At the Toni Says® office, we always advise a Toni Says® Medicare client to call all their doctors to see which Medicare Advantage plans the healthcare professional/facility accepts. Jason, I do not believe you did this when you enrolled in your Medicare Advantage HMO and that has caused a huge problem for you.

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 Remember to always talk to your doctor or the doctor’s office manager before you make any changes to your Medicare insurance needs and verify what Medicare Advantage plan they accept. Doctors and specialist can stop accepting a Medicare Advantage plan in the middle of the year.

            For assistance in disenrolling from the Medicare Advantage plan that does not fit your needs and find a Medicare Supplement that fits your needs, call the Toni Says® Medicare office at 832/519-8664 or email info@tonisays.com

Merry Christmas from Toni Says® with a $10 discount to the Toni Says® readers on the 2021Medicare Survival Guide® Advanced book at www.tonisays.com.