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Buyer's remorse? Medicare gives seniors a second chance

Maryalene LaPonsie | January 6, 2011

From Nov. 15 - Dec. 31, Medicare beneficiaries saw a flurry of activity in their mailboxes. Letters, postcards and glossy brochures arrived, each promising fabulous things for those who choose their Medicare Advantage plans. Now that open enrollment is over, the government has opened the Medicare Advantage Disenrollment Period to allow those regretting their choice of health plans a second chance.

Are you eligible to change your Medicare health plan?

When it comes to receiving their medical insurance, Medicare beneficiaries have two choices: original Medicare and Medicare Advantage. While original Medicare is administered by the federal government, Medicare Advantage plans are offered by private health insurance companies.

These plans are often run as PPOs or HMOs and may include services not generally included in original Medicare, such as dental and vision. While Medicare Advantage insurance may offer increased benefits and convenience, they can also come with increased costs. Co-payments, deductibles and premiums may differ from those charged by original Medicare.

During the open enrollment period, all Medicare beneficiaries can switch between original Medicare and Medicare Advantage plans. During the Medicare Advantage Disenrollment Period, only those enrolled in a Medicare Advantage plan can change their medical coverage. In addition, they can only switch to original Medicare. Selecting another Medicare Advantage health plan is not an option at this time.

Should you change your Medicare medical coverage?

If you are eligible to switch from Medicare Advantage to original Medicare, you have until Feb. 14 to make up your mind. Just as the decision to enroll in a Medicare Advantage plan requires careful review, returning to original Medicare is not a decision to make lightly either.

While Medicare Advantage health plans can be more costly than original Medicare, they can also offer greater benefits. To cover the gaps in original Medicare coverage, many beneficiaries choose Medigap supplemental health insurance. However, enrollment periods for Medigap can be limited so you may not be able to obtain supplemental coverage after leaving your Medicare Advantage plan.

Although supplemental health insurance may not be available, you will be able to enroll in a Medicare Part D prescription drug plan. Since original Medicare does not include prescription drug coverage, beneficiaries leaving their plan during the Medicare Advantage Disenrollment Period have the opportunity to select a separate policy to pay for their medications.

Be aware that you only get the option to select a new prescription drug plan if you were previously receiving prescription drug coverage through your Medicare Advantage plan. Some Medicare Advantage Private Fee-For-Service (PFFS) plans do not include prescription drug coverage, and in those cases, you must keep whatever separate prescription drug plan you already maintain.

After comparing out-of-pocket costs - premiums, deductibles, co-insurance and co-payments - you will have a clearer picture as to the right health insurance choice for you. Don't forget to include premiums for Medigap supplemental health insurance and prescription drug costs when adding up your costs.

Then, if it ends up that your Medicare Advantage plan isn't such a great deal after all, you have until Valentine's Day to break up with your health plan and return to the original Medicare program.

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