Introduction
You’ve finally enrolled in a Medicare Advantage plan but don’t fall for these two common Medicare Advantage misconceptions…
Acting on these misconceptions can cause significant headaches and cancel your coverage.
Misconception #1: You don’t need Medicare Part B if you’re on Medicare AdvantageMedicare Advantage plans are also advertised as ‘$0 premium’ plans and many people think they can ‘save’ by disenrolling from Medicare Part B – after all Medicare Advantage is an ‘alternate’ to Original Medicare – right? No – whether you’re on Medicare Advantage or Original Medicare you must be enrolled in Part B and pay the premium. |
The Rules
All Medicare Advantage beneficiaries must be actively enrolled in both Parts A and B to stay enrolled in a Medicare Advantage plan. Disenrolling from Part A or B means you’re no longer eligible for your plan.
The Consequences
If you made the mistake of canceling Part B, two things would automatically happen:
- You will be disenrolled from your Medicare Advantage plan.
- You cannot re-enroll into a Medicare Advantage plan until you have re-enrolled in Part B.
However, Medicare has fixed enrollment windows that dictate when you can enroll
- If you disenroll from Part B, the first opportunity to re-enroll is the General Election Period (GEP) which occurs from January 1 to March 31
- Coverage will only start on July 1 of that year, leaving you at significant risk of having a health insurance gap for an extended period.
Misconception #2: You can buy another Part D drug plan to get ‘better’ coverageYou’re in Medicare Advantage but you’re not happy with your drug coverage – easy, there are standalone Prescription Drug Plans (PDPs) you’ll just buy one of those? Wrong – you can only be in one Part D drug plan at a time and are not allowed to buy a separate standalone Part D drug plan if you are on Medicare Advantage. |
There are two reasons Medicare beneficiaries think they can do this:
- They’ve found a PDP plan which offers better coverage or a PDP plan with a better star rating than their current Medicare Advantage plan
- They think a PDP can act as supplementary coverage to their current Medicare Advantage plan
The Rules
You cannot enroll in a separate standalone PDP if your Medicare Advantage plan already includes prescription drug coverage. PDP plans are designed only for people who have chosen to receive their Medicare coverage under Original Medicare.
If you enroll in Medicare Advantage, you must use the Part D prescription drug coverage that comes with your plan.
The Consequences
If you enroll in PDP while enrolled in a Medicare Advantage plan:
- You will be disenrolled automatically from your Medicare Advantage plan
- Your coverage will return to Original Medicare
Bottom Line: Your Medicare Advantage plan is your plan, and it is not ‘free’
You can’t supplement your Medicare Advantage coverage and you must pay your Part B premium. It is critical to check any implications before making changes to your Medicare coverage. If you need clarifications, consult with a trusted advisor such as CoverRight.
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Don’t be a statistic. Do you understand your Medicare coverage?
