HMO Guide for Seniors - Office of the Patient Advocate - State of ...

11
Questions & Answers
My HMO is leaving the
Medicare program. Will
I lose my Medicare?
No. You have a Special
Enrollment Period to join
another Medicare HMO
or another kind of Medicare
Advantage plan or return to
Original Medicare.
What if I move out of
my HMO’s service area?
If you move, you must tell
your HMO. You have a
Special Enrollment Period
to join a Medicare HMO
or other Medicare Advantage
plan in your new area or
return to Original Medicare.
Can I join a Medicare
HMO if I have a
pre-existing condition?
Medicare HMOs must
accept you even if you have
a pre-existing condition,
such as diabetes or heart
disease. However, if you
are on kidney dialysis, your
choices may be limited.
Call 1-800-Medicare.
things you can do
To Change Your Medicare Advantage Plan
You can change to another Medicare HMO or
Medicare Advantage plan during one of the enrollment
periods listed on page 10.
To change plans, just join a new plan. Your
new plan will notify your old plan of the change.
To join a plan, fill out an enrollment form. To get
a form, call the plan, look on its website, or call
1-800-Medicare.
Continue to use your old plan until your new plan
tells you that your new coverage has started.
To Return to Original Medicare
Leaving a Medicare HMO is called disenrolling.
If your current HMO has prescription drug coverage,
you can return to Original Medicare by
enrolling in a Part D prescription drug plan. When
you do this, you will be disenrolled from the HMO
and enrolled in Original Medicare.
Or you can call 1-800-Medicare.
Medigap
If you return to Original Medicare, you can buy a
Medigap policy to cover some of the costs that
Original Medicare does not cover. There are certain
times when you may be able to buy a Medigap
policy without a health screening for pre-existing
conditions. Call HICAP.
where to find help
1-800-Medicare
Information and help with Medicare
1-800-633-4227 www.medicare.gov
HICAP (Health Insurance Counseling & Advocacy)
Free counseling and information on Medicare
1-800-434-0222 www.aging.ca.gov/hicap