The Medicare & You 2017 handbook has very important pieces of information that can get lost in the 132 pages of text. Changing or dropping Medicare coverage, for example, can have far reaching implications that commission-based insurance representatives might not warn you about in their zeal to sell you one of their products. The annual Medicare Enrollment (October 15-December 7) is a time when many hard-sell tactics can gloss over important coverage details in the beneficiary’s quest for the “best” deal in private Medicare health, drug, and even supplemental (Medigap) plan options.
I have taken select excerpts from the Medicare & You 2017 handbook that warn about dropping Medicare coverage and put them together. The government tells you that dropping Medicare coverage is not to be taken lightly by repeating the warning six times in the handbook. I have attached a Danger sign to each excerpt for emphasis.
“If you have coverage through a former or current employer or union or other source, talk to your benefits administrator, insurer, or plan before making any changes to your coverage. If you drop your coverage, you may not be able to get it back.” (pg 18)
“In some cases, joining a Medicare Advantage Plan might cause you to lose your employer or union coverage. If you lose coverage for yourself, you may also lose coverage for your spouse and dependents… Remember, if you drop your employer or union coverage, you may not be able to get it back.” (pg 71)
“You can’t use (and can’t be sold) a Medicare Supplement Insurance (Medigap) policy while you’re in a Medicare Advantage Plan. You can’t use it to pay for any expenses (copayments, deductibles, and premiums) you have under a Medicare Advantage Plan. If you already have a Medigap policy and join a Medicare Advantage Plan, you’ll probably want to drop your Medigap policy. If you drop your Medigap policy, you may not be able to get it back.” (pg 71)
“If you have a Medigap policy and join a Medicare Advantage Plan, you may want to drop your Medigap policy. Your Medigap policy can’t be used to pay your Medicare Advantage Plan copayments, deductibles, and premiums. If you want to cancel your Medigap policy, contact your insurance company. In most cases, if you drop your Medigap policy to join a Medicare Advantage Plan, you won’t be able to get it back.” (pg 84)
“If you drop your employer or union coverage, you may not be able to get it back. You also may not be able to drop your employer or union drug coverage without also dropping your employer or union health (doctor and hospital) coverage. If you drop coverage for yourself, you may also have to drop coverage for your spouse and dependents”. (pg 86 and identified as Important!)
“If you have employer or union coverage and you join a Medicare drug plan, you may lose your employer or union coverage even if you qualify for Extra Help. Call your employer’s benefits administrator before you join a Medicare drug plan. (pg 98)
Changing or Dropping Medicare Coverage
A commission-based insurance broker is in the business of selling you a private Medicare insurance plan first and foremost. He may even push the product that gives him or her the largest commission.
I didn’t use an insurance broker when I recently helped my mom sign up for a new Part D prescription drug plan online, but the warnings I describe above did not appear in the online application (see the screenshot below) until we were practically at the end of the enrollment process. If I didn’t write this blog, I would probably have simply glossed over this “fine” print warning.
My mom doesn’t have any other retiree or government benefits, so for her the warning didn’t matter, but for many Medicare beneficiaries, changing or dropping Medicare coverage can have irreversible consequences. For example, Medigap guaranteed issue rights are lost when you drop your Medigap policy after you have been in a Medicare Advantage plan for 12 months or more. If you get sick and want to return to original Medicare, a new Medigap policymight be prohibitively expensive or even unavailable to you.
READ the Medicare & You 2017 carefully. Seek unbiased Medicare plan advice before talking to a commission-paid private insurance representative. Make the appropriate calls to those in charge of your present coverage and ask about the consequences if you change or drop your present health coverage. Get all information in writing.
Every present and future Medicare beneficiary needs to heed the warnings in the handbook before signing up for either a stand-alone Medicare Part D prescription drug plan (PDP) or a Medicare Advantage plan (MA or MA-PD) plan. Always remember that signing up may have long-term ramifications to the coverage you presently enjoy and might want back some time in the future.