What to Do If You Signed Up for the Wrong Medicare Plan

Choosing the right Medicare plan is an important decision, and it can feel overwhelming. For many people, especially those transitioning from employer-sponsored insurance, the differences in coverage, costs, and provider networks can come as a surprise. Fortunately, if you realize the Medicare plan you signed up for isn’t the right fit - whether you’re new to Medicare or made changes during the Annual Election Period, you’re not necessarily stuck. There are options available to help you adjust and find coverage that better suits your needs.

At Twin City Underwriters, we have helped thousands of Medicare enrollees compare their Medicare plan options and enroll in a suitable plan tailored to their unique needs. In this article, we'll explain what to do if you signed up for a medicare plan only to find out it wasn't the right plan for you.

How to Tell If You're in the Wrong Medicare Plan

First off, how do you know you've signed up for the wrong Medicare plan? Sometimes it’s clear as day that the plan you’ve chosen isn’t the right fit. Other times, the signs might be less apparent. Maybe a few things are working well, while other areas of your plan aren’t living up to expectations. Let’s look at some of the ways to tell if your Medicare plan isn’t working for you.

Signs Your Coverage Doesn't Fit Your Needs

Some of the most common signs that your Medicare coverage is not meeting your needs are that it is not covering your most basic health care services. Here are some problems you might experience:

• You're paying more out of pocket than expected for doctor visits, prescriptions, or hospital care
• Your current doctors or specialists are not in your plan's network
• Your prescription medications aren't covered, aren't on the formulary, or cost more than you expected
• Your plan doesn't cover services or treatments you need
• You've experienced changes in your health that require different coverage
• You've moved or plan to move, and your plan doesn't offer the same access in your new area
• Your plan makes it difficult to get referrals or see specialists
• You're confused by the billing process or your explanation of benefits
• You're unhappy with the plan's customer service or provider availability

Learn About Medicare Star Ratings and Why They Are Important

Common Mistakes Made When Enrolling in Medicare

So, how might these problems occur when enrolling in a medicare plan? There are several different ways to receive your Medicare coverage, and there are often dozens of supplemental Medicare plans available in the area you live; these plans can vary in the coverage they offer and other aspects, from costs, access to care and covered services. If you don't take the time to compare Medicare plan options and understand each plan's specific benefits, you could end up enrolled in one that doesn't align with your healthcare or financial needs.

Starting with the basics and building a strong Medicare education can help you make informed decisions about the different types of plans and how to choose the right one for your needs. One of the best ways to get started is by attending our free Medicare 101 workshop, available both in person across the Minnesota Twin Cities and online.

Can You Switch Medicare Plans?

If you discover that the Medicare plan you signed up for is not right for you, you'll want to know, can I change my Medicare plan? The good news is yes, you can change Medicare plans; however, depending on when and what type of plan you have enrolled in, when you can make a change will vary.

When Can I Change My Medicare Plan?

There are specific times each year when you can make changes to your Medicare coverage. The most common opportunities include:

• Annual Election Period (AEP) – From October 15 to December 7, you can make changes to your Medicare Advantage (Part C) or Part D prescription drug plan, switch between Original Medicare and Medicare Advantage, or change from one Advantage plan to another.
• Medicare Advantage Open Enrollment Period – From January 1 to March 31, if you’re already enrolled in a Medicare Advantage plan (MAPD), you can switch to a different Advantage plan or return to Original Medicare and join a Part D plan.
• Special Enrollment Periods (SEPs) – If you experience a qualifying event, you may be able to change plans due to an SEP. Some examples include: moving to a new area, losing employer coverage, or qualifying for Medicaid. These allow you to make changes outside of the standard timeframes.

Understanding the Medicare Enrollment Periods

However, there are some exceptions.

If you signed up for the wrong Medicare Advantage or Part D plan by mistake or due to misleading details, you may qualify to leave that plan and switch to one that better suits your needs.

As described by the NCOA, here are a few scenarios where you have a right to change plans:

• You enrolled in a plan unintentionally.
• You enrolled in a plan based on incorrect or misleading information.
• You accidentally enrolled in the same plan or stayed in a plan you didn't want.

Steps to Take If You Chose the Wrong Medicare Plan

1. Review Your Current Coverage

Determine what parts of your plan are working and what's not working.

2. Determine When You Can Change

Is there currently an ongoing enrollment period, such as the AEP or MA OEP, that will allow you to make a change? Even if there is not, you may be eligible for a Special Election Period (SEP).

3. Compare Available Options

Look at all your Medicare plan options. Rather than looking at just one insurance carrier or a couple of different plans, you want a comprehensive review of plans available to you.

4. Enroll in a Different Medicare Plan

Once you have researched your options and find a suitable plan for your budget and healthcare needs, you can switch by enrolling in the new plan. Depending on your existing coverage, you may or may not need to notify the insurance company you have your current plan through.

A licensed Medicare agent, such as the team at Twin City Underwriters, can help you throughout the entire process. 

How to Avoid Mistakes Next Time

Once you make the mistake of enrolling in a Medicare plan that doesn't work for your needs, you'll want to make sure you take precautions to not let it happen again. Here are some best practices when making Medicare plan changes.

Review Plans Carefully

As we've indicated, Medicare plans can be very different from one another. It's critical to review plans carefully to understand what's covered and what's not, so you go into the plan with clear expectations of your costs, coverage and benefits.

Work with a Medicare Broker for Support

Working with a licensed Medicare broker can provide you with guidance and resources as you compare and enroll in your Medicare plan. Medicare brokers represent multiple insurance carriers and can help you understand the plan details that may be overlooked. They can also help you enroll in a plan that meets your health and financial needs.

Schedule an Annual Plan Review

Taking time each year to review your Medicare plan is highly recommended. Medicare and Medicare plans can change every year, so staying informed on those changes is an important part of knowing if your plan will still be a suitable option for you in the next year.

Do you have more questions about your existing Medicare plan or making a change? Reach out to our team of professional Medicare agents for unbiased advice and recommendations on your Medicare. 

Reach out to us today to get started.

Choosing a Medicare plan can be difficult. Twin City Underwriters helps Medicare recipients in Minnesota, Wisconsin, North Dakota, South Dakota, Iowa and Florida find the Medicare plan that meets their unique needs. Schedule a one-on-one meeting with one of our Medicare insurance brokers to get your questions answered!

Do you need help with Medicare, insurance and health plans? Explore your options with Allina Health Aetna, BlueCross BlueShield of Minnesota, Medica, UCare, United HealthCare and more. We work with you to find the best plan for your needs and budget. Contact us today to get started.