tMZ INSURANCE SOLUTIONS
Why plan members sometimes switch from one type of plan to another . . .
It's interesting to ask friends and family about their choice for a Medicare plan. What type of plan did they choose? Why did they choose Medicare Advantage vs a Medicare Supplement plan? And, if they recently switched plans, why did they switch? Knowing why people switch from one type of plan to another can help you pick the right plan from the beginning. Here are a few examples:
Why some switch from a Medicare Advantage to a Medicare Supplement? Advantage plans are tremendously popular, and often work beautifully for many retirees for decades of their retirement. Some people, however do switch out of an Advantage Plan and go back to original Medicare and purchase a Medicare Supplement. Why? It may be that a favorite doctor has left their Medicare Advantage network, or perhaps because the copays and co-insurance in their Advantage plan were adding up to more than what the premiums would have been with a Medicare Supplement. Most who switch do some because they like the idea of not worrying about doctor/hospital networks—they want to see go to any facility or see any doctor who accepts Medicare and is accepting new patients.
Why some switch from a Medicare Supplement to a Medicare Advantage? Some Medicare recipients start out with a Medicare Supplement because of the “guaranteed issue” right as a first-time enrollee. They may keep the supplement for a few years, but because of the higher premiums with Medicare Supplement, they switch into a Medicare Advantage plan. Additionally some switch to Medicare Advantage for the added benefits. Just be aware before you leave that Medicare Supplement plan that was so easy to get into at age 65, it may not be as easy to get back into later on. If you are no longer in the guaranteed issue period you can be turned down or charged a higher premium for a Supplement due to the medical questions that are asked as part of the application.
The bottom line of choosing Medicare Advantage vs Medicare Supplement…. Pay attention to all the details when choosing your plan, and not just the premiums.
Medicare Advantage plans are terrific, and the savings in premiums go a long way toward saving money for future healthcare. If you decide to go with an Advantage plan, be sure to set aside some of that money you saved in premiums to meet the maximum out of pocket cost—it could happen one year. Review the "Summary of Benefits" of a Medicare Advantage plan with a fine tooth comb and pay particular attention to services that require the member to pay a "co-insurance" (percentage) rather than a set co-pay. Know which doctor and hospital networks are in the plan network.
Regarding Medicare Supplement, be aware of guarantee issues rights for new Medicare enrollees, and how medical underwriting can play a role if you are thinking about switching back to original Medicare and buying a Medicare Supplement. Remember that you will need to purchase a separate prescription drug plan with Medicare Supplement.
These decisions about which plan to go with are similar to the decision employees make every year at annual enrollment. To pick the perfect plan, we all need that crystal ball! Sitting down with a broker we can help you learn the important facts about Medicare, the differences between plans, how your medication factors in to the different options, and the cost/benefit analysis of the different types of plans.
I hope that gaining some understanding as to why people switch from one type of plan to another is helpful as you consider what type of plan is right for you. If you are already on Medicare, and interested in making a change to your coverage, I can help you make sense of the allowable timeframes for making such a change, and help you select a plan that may be a good fit for your situation.