Supplemental to Advantage Client - AEP - Situation Page

So we are prepared for your appointment, please click “Update My Info” below and login to our enrollment system with your username and password. Once inside, you can update your medications and current provider list.

Helpful Links:

Not sure what your username and password is? Email us at support@medicareschool.com to request what we have on file OR just create a new account.
Download this step-by-step guide or watch these video instructions for updating your information.

Step 2: Book a Call With Our Team

Review our process for scheduling an appointment bel0w so we can explore different Advantage Plan options. We’ll help you compare plans and enroll in the coverage that best suits you for next year.

Frequently Asked Questions

Click on a question below and the answer to the question will show.

What is the difference between Medicare Supplement (Medigap) and Medicare Advantage?

Medigap supplements Original Medicare by covering some of the out-of-pocket costs like copayments, coinsurance, and deductibles. Medicare Advantage (Part C) is an alternative to Original Medicare that bundles your Medicare benefits and often includes additional coverage like prescription drugs, dental, vision, and hearing services. [Click here] to watch a video of Marvin explaining the differences.

Can I have both a Medicare Supplement plan and a Medicare Advantage plan at the same time?

No, you cannot have both. If you decide to enroll in a Medicare Advantage plan, you will need to drop your Medigap policy.

Why should I consider switching from a Medicare Supplement plan to a Medicare Advantage plan?

You might consider switching to Medicare Advantage if the premiums for your Medicare Supplemental Plan (also known as Medigap plan) is too expensive for your monthly budget. Or, if you are looking for a plan that includes extra benefits like prescription drug coverage, dental, vision, or hearing services. Medicare Advantage plans have lower premiums than Medigap, but they do involve cost-sharing (copays, coinsurance) for nearly all services.

When can I switch from Medigap to Medicare Advantage?

You can switch from a Medigap plan to Medicare Advantage during the Annual Enrollment Period (AEP), which runs from October 15 to December 7 each year.

Will I lose my Medigap plan if I switch to Medicare Advantage?

Yes, once you switch to a Medicare Advantage plan, your Medigap plan will no longer provide coverage. It’s essential to cancel your Medigap plan after your Medicare Advantage coverage becomes effective.

What extra benefits do Medicare Advantage plans offer that Medigap does not?

Medicare Advantage plans often provide additional benefits that Medigap plans do not, such as:

Prescription drug coverage (Part D)
Some dental, vision, and hearing care
Fitness memberships

What are the costs involved in switching to Medicare Advantage from a Medigap plan?

Medicare Advantage plans typically do not have a monthly premium like a Medigap plan. However, you will often have higher out-of-pocket costs like copayments and coinsurance when you receive medical services.

Do I need to enroll in a separate prescription drug plan (Part D) if I switch to Medicare Advantage?

Generally no, most Medicare Advantage plans include prescription drug coverage.

What are the pros and cons of switching from Medigap to Medicare Advantage?

Pros:

Lower monthly premiums
Additional benefits like dental, vision, hearing, and fitness programs
Integrated prescription drug coverage

Cons:

May have higher out-of-pocket costs (copayments, coinsurance) when accessing care
Network restrictions: Medicare Advantage plans often require you to use a network of doctors and hospitals
Pre-authorization: Medicare Advantage plan insurers require pre-authorization for up to 70% of health services. This means the insurance company, not your doctor, has the final say on whether a recommended service will be covered.
Unless special circumstances apply, you cannot return to a Medigap plan without undergoing medical underwriting if you choose to switch later. Most people consider switching back when facing a serious health issue, but by then, it may be too late to qualify.

What are pre-authorizations in Medicare Advantage, and how do they differ from Medigap?

In a Medicare Advantage plan, pre-authorizations are often required for certain medical services, procedures, or tests. This means your doctor must get approval from the insurance company before providing the service.

In Medicare Advantage: The insurance company, not your doctor, has the final say on whether a service is covered. If they deny the pre-authorization, the service may not be covered, even if your doctor recommends it.
In Medigap: There are no pre-authorizations. Medigap supplements Original Medicare, which does not require pre-approvals for covered services. If Medicare approves the service, Medigap automatically covers the applicable out-of-pocket costs.

Will I need to go through medical underwriting if I want to switch back to a Medigap plan later?

Yes, in most states, if you decide to switch back to a Medigap plan after being enrolled in Medicare Advantage, you will likely need to go through medical underwriting. This means insurers can assess your health and may deny you coverage or charge higher premiums based on your health conditions.

Can I keep my current doctors if I switch to a Medicare Advantage plan?

It depends. Medicare Advantage plans have provider networks, and your doctor will need to be in-network to avoid additional costs. You should check whether your doctors and specialists are in the plan’s network before switching. Our team will be happy to help you do this.

Are there any restrictions on switching back from Medicare Advantage to Medigap?

Yes. If you switch from Medigap to Medicare Advantage and want to go back to Medigap later, you may be required to go through medical underwriting, which could lead to higher premiums or denial of coverage based on your health status. Certain states, such as New York and Connecticut, allow year-round switching without underwriting.

How do I find the right Medicare Advantage plan for me?

You should compare plans based on several factors:

Premiums and out-of-pocket costs
Provider networks
Additional benefits like dental, vision, and drug coverage
Prescription drug formularies (if you take regular medications)
Schedule an appointment with our team for assistance comparing and enrolling.

What are the out-of-pocket costs with Medicare Advantage?

Medicare Advantage plans typically have lower premiums but involve cost-sharing for medical services, such as copayments and coinsurance. These costs vary by plan and can include copays for doctor visits, specialists, and hospital stays. Medicare Advantage plans also have an annual out-of-pocket maximum, which limits the total amount you will pay in a year.

Can I get dental, vision, and hearing coverage with Medicare Advantage?

Yes, many Medicare Advantage plans offer additional benefits like routine dental, vision, and hearing coverage. These benefits are not typically covered by Original Medicare or Medigap plans.

Do you offer plans with flex cards, Part B premium reduction, etc.?

Yes, we do offer plans that may include additional benefits such as flex cards, Part B premium reductions, or similar perks. However, it’s important to understand that these plans, while heavily advertised, are not always widely available. In many cases, you may not qualify for the benefits based on your specific circumstances, such as income or health status. Additionally, these plans may not be offered in your geographic area. It’s essential to carefully review the details and availability of these benefits in your location before making any decisions. Our team can help you explore the options and verify eligibility.

Not what you are looking to do?

If you want to change your Supplemental Plan or Rx Plan Only click below for our guides for each.