INSURANCE

Laura Mutsko Agent, CSA and Certified Healthcare Reform Specialist

Q:What if I choose a Medicare plan and then my health or other circumstances change. Am I locked in ‘for life’ to my original choice?

A:The one thing we can count on in life is change. Many of the biggest changes such as your financial situation, your health or where you live can make a big difference in the kind of health care coverage you require. The good news is that you are not locked in for life to the kind of Medicare coverage you originally select.

Annual Open Enrollment

You have the option every year to make changes during Medicare’s fall annual enrollment period. It usually takes place from mid-October through early December. During the annual enrollment period, you can switch from Original Medicare to a Medicare Advantage plan, or vice versa. You can also switch from one Medicare Advantage plan to another or one Prescription Part D plan to another. If you did not enroll in a Medicare Part D plan when you were first eligible, you can sign up during open enrollment, although a late enrollment penalty may apply.

Special Circumstances

Outside of the Annual Open Enrollment, you are permitted to make changes to your Medicare Advantage and Medicare prescription drug coverage when certain life events occur. Medicare classifies these as ‘Special Circumstances.” Rules about when you can make changes and the type of situations that are considered Special Circumstance are outlined in detail on the Medicare.gov website and include changing where you live, losing your current coverage, having the opportunity to get other coverage and any time a plan changes its contract with Medicare.

Medicare Supplements

When you first turn 65 or enroll in Part B, whichever comes later, you will have a window during which you can buy any Medicare Supplement. During this window, the insurance company cannot turn you down for health reasons. After that six-month open enrollment window passes, you can still apply to change your Medicare Supplement at any time during the year. However, you now have to answer the health questions on the application. You must be able to pass the insurance company’s underwriting to be accepted. There are some exceptions but these are the general rules. The rules that govern changes to your Medicare coverage, Medicare Advantage Plan, Prescription Part D Plan and Medicare Supplements are strict. However, if you think your situation warrants a change in your coverage, give me a call at 440-255-5700 or email me at Lmutsko@mutskoinsurance.com to discuss your options. I look forward to assisting you.