Changing to a Medicare Advantage plan is stressful

on Jul 11, 2024

Hello Toni:

My question is: If I change to a Medicare Advantage plan in the fall and find out it's not working for me, what are my chances of returning to Medicare and a supplement? I have a Medicare Supplement Plan F that is over $300 monthly and am looking for something more reasonable. I am a 78-year-old female, in fairly good health.

I have spent time searching on Medicare.gov for what different Medicare Advantage plans offer but cannot find out what doctors and hospitals are in the networks. I am just as confused right now as when I started and need your guidance. Looking forward to what you have to say. Thanks, Toni.

--Sally from Atlanta

Hi, Sally:

July is not the correct time to be searching for a Medicare Advantage Plan for Medicare’s Annual Enrollment Period (AEP) for 2025. The new MAPD plans are released for the public to begin viewing on Oct. 1 every year, with enrollment starting Oct. 15 and ending midnight on Dec. 7; your new MAPD plan begins Jan. 1, 2025. The MAPD plans will be different for 2025 from what you have looked at recently on the Medicare.gov website.

Sally, you will have a specific amount of time -- 12 months -- to be able to reenroll in your current Medicare Supplement plan and disenroll from the MAPD plan you’ve chosen if you are dissatisfied.

Since you are concerned about your $300 monthly Medicare Supplement Plan F, I would suggest that you consider changing your Medicare Supplement now before Medicare’s AEP to a less expensive Supplement plan. Supplement Plans G or N have lower premiums but higher out-of-pocket costs than your current Plan F, which has a zero out-of-pocket cost.

Sally, you will have to answer medical underwriting questions to qualify for the specific supplement plan that you pick. Then you will know if changing to a MAPD plan is the right option for you.

Here are the differences between Medicare Supplement Plan G and Plan N:

-- Plan G offers lower premiums and the same Medicare benefits as Plan F except the Medicare Part B deductible is not covered and will be paid for by the enrolled Medicare beneficiary. The Part B deductible for 2024 is $240, which is Plan G’s out-of-pocket.

-- Plan N generally has a lower premium than Plan G with higher out-of-pocket costs. There is a $20 co-pay for a doctor’s visit and a $50 co-pay for the emergency room. The Part B deductible is also not covered, and the Part B “excess charges” are not paid for by the insurance company (which Plan G covers).

Sally, you asked about your specific doctors or hospitals accepting Medicare Advantage plans. Most of the hospitals are included in many of the Medicare Advantage networks where you live. Primary care physicians or specialists are a different story because they accept MAPD plans differently. I always advise my Toni Says Medicare clients during a consultation and those who attend my “Confused about Medicare” webinars to call all of their doctors to see what plans the healthcare professional/facility currently accepts. The reason I say “currently accepts” is that doctors/hospitals can stop accepting a specific plan at any time of the year. Readers, please be aware of this situation.

For those confused about Medicare Advantage, Chapter 4 of my Medicare Survival Guide Advanced edition explains the different types of Medicare Advantage Plans and what to expect when enrolling for the first time or during the AEP.

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Toni King is an author and columnist on Medicare and health insurance issues. She has spent nearly 30 years as a top sales leader in the field. For a Medicare checkup, call the Toni Says call center at (832) 519-8664 or email info@tonisays.com regarding your Medicare plans and options. Toni Says Medicare Survival Guide Advanced edition is available at www.tonisays.com. Toni’s Medicare Moments articles have just been released: https://familytalktoday.com/medicare-moments.