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Joining a Medicare plan and switching between them

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Joining a Medicare plan and switching between them

Joining a Medicare plan and switching between them

Just like other insurance offered by private insurance companies, Medicare plans also have particular conditions governing enrollment and changes in plans applied for. The reason for the prevalence of such conditions is to restrain people from applying for a particular plan and then changing to another one when their condition changes. Visit this page for details.

There are very particular rules about when you can join a Medicare plan and when you can change it without having to go through a health screening test first. It is important that you understand this before joining the plan. This is because these guidelines are in place to prevent people from switching to a more comprehensive cover only when their health demands it. Think about it! Without these guidelines, people would opt for basic care under the original Medicare plan and then go for comprehensive covers only when they need expensive services. There are both geographical, time and other restrictions which prevent you from changing plans at any time.

For starters, you can only join a Medicare health plan or an advantage plan if you are a resident of that particular place. As most of these plans have particular doctors and providers you must visit, it is important to know whether their location is convenient for you. Also, in order to enroll for either of these plans, you need to have both Medicare Part A and Part B. If you have permanent kidney failure and may need transplants or dialysis, you may not qualify for the plans.

When you become eligible initially, you can join a plan. Your eligibility starts three months before you turn 65 and it ends three months after you have turned 65. You also become eligible for Medicare three months before and after the 24th month of your getting cash disability benefits. You can join the plan after November 15th if you fail to join when you become eligible. You can enroll for a plan for at least a year. If you want to join a plan beyond the timeframe of the plan, you may have to take a few health screening tests and even then enrolment is not guaranteed.

Of course there are exceptions to this rule. One of this is relocation. If you are enrolled in a Medicare Advantage plan and you move to an area where this plan is not provided, you may opt for a plan that is provided there. If the advantage plan is not being provided in that area, you may opt for Medicare Supplemental Insurance or other types of Medicare cover available in the area.

If you have the Original Medicare Plan, Medicare Cost Plan or Medicare Private fee for service Plan, you can enroll for a Medicare prescription drug plan. Usually you can only enroll for one particular plan at a given time. If you already have a plan and even then you apply for a second one, you will automatically loose covers for the first one. This applies to prescription drug covers also.

If your plan provides you with drug cover and you do not change to a different plan by June 30th, you can only change to another plan that includes prescription drug coverage. You may also have to pay a 1% per month penalty charge if you do not join during the right time. However, you can join at any time if you avail of full state help under Medicaid.

If you decide to change a plan, make sure you compare the benefits provided by all before you choose one.

If you are holding a Medigap policy right now, you can still get a Medicare Advantage plan or other health plans under Medicare. It may not make sense because you will have to continue payments of premiums for the former. As these plans will be covering most of your expenses, you may not receive any advantages from the Medicare plans. You may have to pay copayments and deductibles if you enroll for an Advantage plan and your Medicaid policy may not cover these expenses. If your plan provides drug coverage and you also enroll for a plan which offers drug coverage, you must remove that coverage first for the Medigap policy. On the one hand, if you drop your Medigap policy, you may not be able to get it back. If you join a Medicare health plan or a Medicare Advantage plan when you become eligible for covers at 65, you may get a few special protections from Medigap. It may help you get back your old policy or buy a new one if you left the earlier one within a year. You may enroll for a Medicare Prescription Drug Plan at the time.

If you enroll for a Medicare Advantage plan while you are receiving covers under a group plan or union coverage, you may be able to use it together with your plan.

You are allowed to change plans under particular circumstances. You can make these changes between 15th November and 31st December in a year. This time period is called the open enrollment period and during this period changes are settled for the next year. You may contact your insurance company and find out what changes you might take up. You may also opt for a different company altogether.

You must provide a prior notification to the company if you want to change from a Medicare Advantage plan to a Medigap policy. Remember, by simply enrolling for a Medigap policy, your Advantage Plan does not automatically end. Prescription drugs coverage is not available with Medigap from 1st January, 2006 onwards. If you choose to shift to another health plan from Medicare Advantage plan, your previous cover will be automatically cancelled. But it is always preferable that you inform your insurance company about any changes you might be making.

If the Medicare plan you were covered under leaves your area of residence, the plan will let you know your options through a letter. Generally, you will automatically become eligible to switch to another plan. You may also take up the original Medicare program if necessary. This rule is also applicable in case the company withdraws the Medicare program from your area. If you are a member of the Medicare Advantage plan and it leaves your area, you will revert back to the original Medicare plan if you donít join any other plan.

If it so happens that the plan is pulling out of your area and you donít have any other plans to fall back on, your benefits may continue. But you will have to avail of the services of providers that are available in the area where the plan is present and has a network of providers.

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