I've had a change in my health condition. How does this affect my current Medicare plan, and should I reconsider my coverage?
Answered by 25 licensed agents
If you have a severe or disabling condition that recently occurred and are enrolled in a Medicare Advantage plan you may qualify a (SEP) Special Enrollment Period.
If you have a Medigap plan most likely no changes will be needed.
That isn’t enough information for me to answer you. I don’t know what type of plan you have but either type should be sufficient. Give me more info on your plan and the change in your health for a more specific answer. Either type plan will perform as stated in the evidence of coverage.
Your current health condition has no effect on your Medicare itself comes down to the Medicare advantage plan that you have. Does it allow you to see the doctors and specialist that you wanna see
on Medicare Advantage Plans there is NO underwriting, so regardless of the health of someone, everyone can get a Medicare Advantage Plan is long is their Part A & B are in effect. Medicare Supplements require medical under writing and based on results could require much higher monthly premiums
It is always a GREAT idea to review your coverage. Plans change and as you know, how health care needs change. There may or may not be something better for you. I always encourage plan reviews.
Your health change could trigger a change of coverage. It depends on what those health changes are. Some Medicare advantage plans are specific to chronic diseases and can offer certain benefits that are tailored to the kind of healthcare you may need. If you have original Medicare with a Medicare Supplement. Than it’s highly recommended to stay with that, especially if you have had drastic changes in your health and are needing more visits to doctors and specialists. Same goes with hospitalization and rehab or skilled nursing facilities. It’s best to stay on original medicare
In most cases you do not need to worry as much if you have a Medigap plan. The change in your health could affect your medical costs under a Medicare Advantage plan or your Part D drug plan.
Your health should not change your Medicare plan. However, you should review your plan options to make sure your plan will adequately cover the health needs of your new condition.
Good Question. Health changes happen as we get older. How your health change can affect your Medicare plan will depend upon the type of Medicare plan you have. For instance:
1) If you have a Medicare Advantage plan, it would be wise to take a look at your plan in the Annual Enrollment Period (Oct 15- Dec 7th) to see if there is another Medicare Advantage plan that will cover your health condition better. Some Medicare Advantage plans have "Chronic" condition plans that would help with certain chronic conditions like diabetes, and heart disease.
If you have a qualifying chronic condition, you might be able to make a change to the new plan sooner that the Annual Enrollment period. Be sure to call a Medicare Insurance Broker to find out if you qualify to make a change.
2) If you have a Medicare Supplemental Plan (Metsup) then you do not have to make any changes. You can choose to see any Medicare specialist doctor for your health condition.
If you are confused, please be sure to reach out and get help from a Medicare Insurance professional that works with both types of plans.
You should absolutely reconsider your coverage. That doesn't necessarily mean you will change it, but we need to explore options before it's potentially too late. Sometimes there are only certain windows to make changes and we don't want to get outside any of those windows.
I always advise my clients to do an annual review but with a new condition you may want to do a benefit review early. Due to your new condition you might qualify for a SEP, but if you don’t qualify be ready for the Medicare annual enrollment October 15th through the December 7th.
Regardless of your current plan, health conditions shouldn't affect it or how it pays your bills at all. If you feel like you want additional coverage you may want to contact someone like myself to review your situation and see if you can change plans but it's not necessary due to a change in your current health situation.
Usually a change in medical health condition does not impact your plan. The exception might be chronic kidney failure or ALS.
In terms of reconsideration of your plan, each year, in the fall, people with Medicare Advantage plans are able to compare plans and make changes if they wish.
Contact your local agent and discus the changes to determine how your plan covers your new situation.
During the annual enrollment period, AEP, (10/15 - 12/7), it's always good to review your coverage. Your health may change, medications may change, and Medicare plan options may change. However, if your health changed prior to AEP, you may be eligible to change or update your plan sooner.
Depending on the plan, time of year, and the health condition it could possible to change plans.
My expertise can help you make the right decision for your continued health care.
If you are turning 65 or this is your first time on Medicare part B, it is imperative that you speak with a licensed agent to help you make the right decision regarding your health coverage.
A change in your health condition can impact how well your current Medicare plan meets your needs. It's important to review your coverage to ensure it still aligns with your healthcare requirements, including prescription drugs, specialists, or additional services you may need. You may wish to evaluate whether your plan’s provider network, benefits, and out-of-pocket costs remain appropriate given your new circumstances.
If your current plan does not cover certain treatments or specialists, or if your medication needs have changed, you might benefit from considering other Medicare options during the next enrollment period. Reviewing your plan documents or speaking with a licensed agent can help you determine the best course of action.
For further details about member rights and plan review processes, you may find this Member Rights documentation helpful.
A change in your health condition will not affect your current Medicare Plan. When the Annual Enrollment Period AEP begins, Oct 15 through Dec 7th you will want to review your upcoming coverage and decide if it is appropriate for the future or if you want to make a change. This will be the Annual time when you can make a change
It all depends on what coverage you have. Do you have Original Medicare, which is A and B with an additional D, or do you have Medicare Advantage or Medicare Supplement?
You should take a look at your plans at least once a year.
You need to meet with your agent to review the current coverage and to make sure that all of your doctors and specialists, hospitals are in the network that your current Medicare Advantage plan will cover, and you must also make sure that your MOOP can be covered by your savings. You may also want to get an indemnity plan.
Your Medicare plan could be greatly affected by your health. There are specialized plans tailored to chronic conditions in certain counties that are greatly beneficial.
A Chronic Condition Special Needs Plan is a Medicare Advantage plan designed for people who have a chronic or disabling condition.
Benefits of a C-SNP can include specialized care, transportation, meal delivery services, access to specialists, telehealth services, and more.
If you need help signing up for a C-SNP, a Medicare Advisor can assist. Contact us or schedule a time to chat.
So, whether your health condition has improved or declined, an Advisor can help you understand your options better, even if you already have a C-SNP.
A change in your health condition could affect which Medicare plan is best for you at the present time. Significant life events can cause your health needs and life circumstances to be better served with a particular plan. You should check the plan you already have and compare it to new options. An agent can help you decide if it would be better for you to pick a new plan. You can enroll in a new plan or update your existing coverage.
Having a change in your health status is always a great reason to take a closer look at your coverage. It may or may not be necessary, but it's always worth a look.
Your insurance cannot cancel your policy because of your health. Nor can they raise your premiums because you use the policy more. It would only make a difference if you were to try to change a Medicare Supplement. They could tell you no due to healrh questions . I hope that answered your questions
I believe it is always helpful to advocate for yourself, by reaching out to a licensed professional like myself to reevaluate your current coverage when health conditions change!
