There are only a handful of situations in which you can get a Medicare Supplement policy without having to pass medical underwriting. To pass medical underwriting you have to be able to answer "no" to around a dozen questions about diagnoses that run the gamut of diseases common to the senior population. The older you get, the less likely it is that you can pass medical underwriting and get a Medicare Supplement. So, if a guaranteed issue right comes your way unexpectedly, you best take a look at it and see if it's an opportunity you want to jump on! This article is about one such guaranteed issue right: involuntary disenrollment from a Medicare Advantage (Part C) plan.
Why Would I Want a Medicare Supplement?
Being on Original Medicare with a Supplement is your ticket out of managed care. (All Medicare Advantage/Part C plans, including HMOs, PPOs, etc., are managed care plans.) When you're on Original Medicare you don't have to wonder if the doctor you want to see is in or out of network "for your plan". Your plan is Original Medicare and Original Medicare is your network. Around 98% of providers in the United States participate in Original Medicare. Say goodbye to prior authorization, too. On Original Medicare, if you and your doctor decide on a course of treatment that is covered by Medicare, you DO NOT have to get permission (prior authorization) from an insurance carrier to proceed. This could potentially save you days of waiting for a prior authorization and many more hours on the phone filing an appeal if the prior authorization is denied. Finally, on Original Medicare, you can get routine care anywhere in the United States, not just emergency care as is the case with managed care plans.
Why Would I Have a Guaranteed Issue Right for 2025?
As I have written here before, 2025 is shaping up to be a disruptive year for Medicare Advantage plans. (See my article: What Lies Ahead for Medicare Advantage Plans in 2025?) Because of the headwinds facing Medicare Advantage plans in 2025, it's possible that carriers will elect to discontinue some plans in some areas. If you happen to be on a plan that is terminated for plan year 2025, you will be getting a letter from your plan stating the plan will no longer be available to you in 2025. The letter may be a standard disenrollment letter or it may be a SAR (Service Area Reduction) notification. Either way, your plan won't be available to you in the new year. This is called an involuntary disenrollment. And that disenrollment/SAR letter is your golden ticket to a guaranteed issue Medicare Supplement!
What Should I Do if I Get a Disenrollment Letter from My Medicare Advantage Plan?
Simple: CALL ME! I will review your options for transitioning your Medicare coverage from Medicare Advantage to Original Medicare with a Supplement. And if a Medicare Supplement is out of reach because of the monthly premium, we will find a suitable Medicare Advantage plan to move you to. Questions? I'm just a phone call away!
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