One of the most important things to remember when enrolling in Medicare Advantage for the first time is that you have a Trial Right Period. During this 12-month period, you have the ability to change back to Original Medicare if you choose to do so. Today, we will discover the rules, requirements, and benefits of using this opportunity to evaluate your Medicare Advantage plan.
The Medicare Advantage trial period is a time frame during which individuals with Medicare who are enrolled in a Medicare Advantage plan have the opportunity to switch back to Original Medicare. The trial period typically lasts for twelve months and begins on the effective day of their Medicare Advantage plan. During the trial period, individuals who are not satisfied with their Medicare Advantage plan can switch back to Original Medicare without penalty, even if they have used health care services under the Medicare Advantage plan.
Once those 12 months have passed, you cannot make any changes to your plan until the upcoming Annual Enrollment Period, which runs from October 15 through December 7. During AEP, you can disenroll from your Medicare Advantage plan and go back to Original Medicare starting January 1.
The Medicare Advantage Trial Right only extends to beneficiaries who are trying a Medicare Advantage (Part C) plan for the first time since they initially enrolled in Medicare. This could be someone who enrolled in Part C when they turned 65 or someone who had previously only had a Medicare Supplement plan.
If you decide you want to switch back to Original Medicare during your Trial Right Period, you’ll need to keep in mind a few other things.
First, you may need to also enroll in Medicare Part D, the prescription drug plans offered by private insurance companies. Most Medicare Advantage plans have prescription coverage included in the plan, so you’ll need a stand-alone Part D plan to replace this coverage. Not enrolling in Part D will cause you to pay penalties down the road. You do not need a Part D plan if you have prescription coverage through other creditable programs like VA Healthcare of TRICARE for Life.
In addition, you should consider enrolling in a Medicare Supplement (Medigap) plan. These plans are quite different from Medicare Advantage plans. Instead of replacing your benefits under Original Medicare, they act as a secondary payor. As long as you are still within your 12-month Trial Right Period, you will be able to enroll in a Medicare Supplement plan without having to pass medical underwriting. However, unless you can pass underwriting, your choice will likely be limited to the plan you had prior to moving to Medicare Advantage. Each state has its own rules regarding which Medicare Supplements you can enroll in when utilizing your Trial Right Period.
Lastly, you may need to look at other coverage like a Dental, Vision, and Hearing plan unless you want to pay completely out-of-pocket for those services. Remember, Original Medicare (with or without a Medigap plan) does not have all the bells and whistles that Medicare Advantage plans do.
This trial period is intended to provide individuals with the flexibility to try a Medicare Advantage plan and determine if it is the right choice for their healthcare needs without being committed to the plan for an extended period of time. After the trial period, individuals who wish to switch back to Original Medicare will typically have to wait until the Annual Enrollment Period to make the switch.
As we mentioned above, this Trial Period also gives you the chance to enroll in a Medigap plan. While you can apply for Medigap plans at any time of the year, you must be healthy enough to pass underwriting to be issued a plan. The Trial Period eliminates the underwriting process and gives you guaranteed issue rights to coverage.
Medicare Advantage plans work differently than Original Medicare. The Trial Period gives beneficiaries the opportunity to see if one will work for them without tying them to a long-term contract.
Are you trying Medicare Advantage for the first time? If you aren’t happy with your current plan, there may still be time to change it! Or, if you’re ready to learn more about the advantages of Part C, talk with a local insurance agent near you to find out more.
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We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area which are United Healthcare, Aetna, Humana, Cigna, Blue Cross Blue Shield of Arizona, Centene, Devoted, and Scan. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program to get information on all of your options.