THINGS THAT HAPPEN DURING ANNUAL ENROLLMENT SEASON

There are 4 things that can happen during the Open Enrollment Season. They are as follows:

1) Change Drug Plan
You may change your drug plan during the OEP each year. There are no health questions. The information for the new 2021 season usually isn't out and available till late September, and some of the carriers wait even longer before putting that info out there.

2) MedAdvantage to MedAdvantage Plan 
You may change your MedAdvantage Plan during the OEP to a different one. Let's say you have Aetna and you'd like to switch to Humana, you may do it during this time frame. MedAdvantage Plans are only allowed to ask if you have end-stage renal failure, no other health questions.

3) Supplemental/Medigap to MedAdvantage 
Again the MedAdvantage Plan is not allowed to ask health questions, so if you are moving out of a supplemental plan and into an MAPD plan, the MedAdvantage plan is not allowed to ask you about health, other than end-stage renal.

4) MedAdvantage to Supplemental/Medigap 
Probably the most commonly misunderstood of the 4 options. People are commonly of the mindset that may switch or upgrade to a supplemental plan once their health starts going south. That is INCORRECT. If you are outside of the initial 6 month entry into your Medicare Part B, you will have to answer health questions in order to get into a supplemental/medigap plan. If you fail those health questions, you can either be denied or charged a higher premium by the supplemental plan. Those carriers who will accept you with the health issues, are well aware of the fact that most carriers won't take you, and they will make you pay for that, just ask anyone who's already been through this. It's a common rumor that you can simply switch your plans during Open Enrollment should you have health issues, nothing could be further from the truth. If you can't pass the health questions, you likely won't be able to switch, unless you're willing to pay a higher premium for it.

Switching supplemental to supplemental

This is something we cover all the time, and is probably the most misunderstood aspect of Medicare and Medicare coverages. In order to switch from one supplemental/medigap plan to another you MUST be able to pass the health questions. You can make this switch anytime of the year, it's not bound by Open Enrollment Period. However, you must be aware that if you are choosing to make a switch, the new carrier is allowed to ask you health questions, and if you fail to pass those health questions, they can either refuse you coverage, or they may charge you a much higher premium to take you. It is by no means a "slam dunk". The new carrier may also ask you about any drugs you take, and certain drugs are an automatic "Decline". They will tap into your health history and investigate your health and any issues you have. Things like cholesterol or high blood pressure are really not an issue. They are looking for more serious issues, such as cancers, strokes, diabetes (depending on the specific carrier, some are lax, some are not), weight, smoking, heart issues, circulatory issues, COPD, rheumatoid arthritis, and a series of others. If you ever feel you'd like more information on this, please reach out to me, and I can run down the list of questions with you.

As you age your premiums are going up. There is always the chance there may be a carrier out there that is cheaper than what you have, so I would say it's always worth taking a look. The worst that will happen is that the new carrier says no, at least you can't lose nor jeopardize your current coverage. Your current plan can NEVER drop you based on any health related issues. The only way a supplemental or MedAdvantage Plan can drop you is if you don't pay your premiums. If you have a supplemental plan, you WILL have to pass health questions in order to get back into your supplemental plan.

If you have any questions, by all means reach out. I now have the ability to do Zoom on-line appointments, so you can see my screen and everything that I am looking at. So you can see the actual questions that need to be answered.

Thank you for your time and please be safe.

John Billetdoux