Hello Toni:

The first week my wife and I moved to Houston from Oklahoma, I had a wonderful surprise in my front yard: There was your Medicare column discussing different Medicare options for someone with health issues.

I am 70 years old and am seeking medical care for colon cancer. I enrolled in the Medicare Advantage HMO when I was in Oklahoma and was told that I could transfer to a Houston doctor when I moved on June 15. I made a big mistake in enrolling, because I did not know I could wait until I moved. Now I have discovered that my doctor does not accept this Medicare HMO plan.

I need to enroll in a Medicare Supplement, but I do not know how to disenroll from this Medicare Advantage plan and return to Medicare with a Medicare supplement. Time is ticking because my cancer treatment needs to begin soon. I need to do this fast.

— James from Spring, Texas

Hi James:

Thank you for the great compliment. I know how overwhelming it can be to understand the rules of Medicare, especially when you are mentally drained due to a serious illness. Let me explain how the Toni Says Medicare team helps clients who want to disenroll from their Medicare Advantage plan and return to Original/Traditional Medicare.

For certain life events or situations, there is a Special Enrollment Period, or SEP. The SEP allows you to join, switch and drop a Medicare Advantage Plan. These special situations are:

— Enrolled in Medicaid

— Qualify for extra help for prescription drugs

— Moving into a long-term care facility (such as a skilled nursing facility, assisted living facility, personal care home, Alzheimer’s assisted living facility, etc.)

— Loss of creditable prescription drug coverage (such as insurance through your employer)

— Moving out of area

James, when you moved out of Oklahoma to the Houston area, you qualified for an SEP, allowing you to disenroll from your Medicare Advantage Plan and return to Original Medicare. There is a 60-day time limit from the date one moves. Your last day to change, James, is Aug. 15.

When an SEP is granted, the trick to disenrolling from a Medicare Advantage Plan is to enroll in a stand-alone Part D plan. Then automatically you are disenrolled from your Advantage plan and re-enrolled in Original Medicare. Returning to Original Medicare will be effective on the first day of the next month.

Then you receive a Medigap/Medicare Supplement Open Enrollment period. James, because you enrolled in Part B beginning June 1, you are within your 6-month Medigap/Medicare Supplement open enrollment period, which ends November 30. This means you can receive your Medicare Supplement without having to answer health underwriting questions. Medicare states that during the Medigap Open Enrollment Period “an insurance company can’t use medical underwriting to decide whether to accept your application.”

The Medigap/Medicare supplement open enrollment period lasts for 6 months beginning the first day of the month in which you are either age 65 or older and have enrolled in Medicare Part B. Wait past 6 months from enrolling in Part B, and you must qualify by having to answer medical underwriting questions.

James, I’m glad you reached out to me with your question, because with Medicare, what you don’t know will hurt you.