Every fall some people leave a Medicare Advantage plan, return to Original Medicare, and then find they cannot buy the supplement policy they assumed was waiting for them.
The reason is that Medicare runs on two separate rulebooks, and Open Enrollment governs only one of them.
From October 15 to December 7, anyone on Medicare can switch Medicare Advantage plans, switch or drop Part D drug coverage, or move between Original Medicare and Medicare Advantage. Those changes then take effect January 1.
What the window does not do is open the door to a Medicare supplement. Supplement policies, also called Medigap, are sold under state insurance law rather than the federal enrollment calendar. In most states a company may ask health questions and may decline an application, and Open Enrollment does nothing to change that.
So someone who drops Medicare Advantage in November can discover in January that Original Medicare is paying its usual 80 percent of doctor bills with no supplement standing behind it, and no company willing to write one.
There is one sizable exception. A person who joined a Medicare Advantage plan for the first time has 12 months to change course, return to Original Medicare, and buy a supplement with no health questions asked. It is called a trial right, and it comes around once.
Rick Good spent ten years in the newspaper business, including with The News & Observer (Raleigh, NC) and The Greenville News (Greenville, SC). He co-wrote, with Melinda Coleman, Rutledge to Riley: Governors of South Carolina, 1776–Present (Published by The Greenville News), and is the author of Mind Games Trivia #1 (Amazon). He has recently spent 15 years creating original trivia content through Sounds Good Mobile Entertainment and continues that with his new company, SGME Software. He edits The Smart Reader’s money, real estate, and business coverage.
