Medicare Advantage (“MA”) plans (also known as “Medicare Part C”), are private health plans that give Medicare recipients other options to choose from when setting up their Medicare benefits. Beneficiaries can enroll in an MA during the Medicare Annual Enrollment Period (“AEP”) that happens from Oct 15 – Dec. 7. If you wish to alter your current MA plan, it’s during this period that recipients can enroll or disenroll from their MA plans. However, if recipients decide they no longer want an MA plan after this period has lapsed, they’ll have one more chance to drop their plan.
2018 Medicare Advantage Disenrollment Period
You can drop an MA plan and switch back to Original Medicare during the 2018 Medicare Advantage Disenrollment Period (“MADP”). This period happens from Jan 1 to Feb 14 each year and during this time, recipients can do the following:
- Switch back to Original Medicare and drop their MA plan
- Switch to Medicare Part D, which provides prescription drug coverage (or drop prescription coverage if they have it)
After Switching, When Does Coverage Begin?
As with a number of government programs, when dis enrolling from a MA plan, coverage doesn’t begin immediately. It starts on the 1st day of the month following the date the disenrollment request was received. For example, those requests received in January will become effective on February 1, and those received in February will become effective March 1. This period is only for disenrollment, it cannot be used to switch or choose other MA plans.
What if I Miss Both the MADP and the AEP periods – Would I Have to Wait Until Next Year to Change My MA?
No. There’s an interval of time called the Special Election (or Enrollment) Period (“SEP”) where, if granted, individuals would be allowed to enroll, disenroll and switch their MA plans but they would have to qualify to be considered. Such qualifications consist of the following:
- Must have full Medicare AND Medicaid coverage;
- Must reside in a rehabilitation hospital, nursing home or skilled nursing facility;
- Must qualify for Low (or Limited) Income Subsidy (Extra Help) program; and/or
- If you’ve moved out of your plan’s service area.
When making changes during an SEP, coverage will start the first day of the month after the application has been submitted and accepted.
How Many Times Can I Access the SEP to Make Changes to My MA Plan?
You may only use the SEP once per year.
If I Drop MA and Switch back to Original Medicare, Would I Be Able to Enroll in a Medigap Plan?
To be clear, a Medigap plan is a supplemental policy that helps cover the deductibles and coinsurance payments not covered by Original Medicare. Traditionally, recipients can’t have both a Medicare Advantage plan and a Medicare Supplement (Medigap) plan. However, once you’ve dis enrolled from an MA plan, you can enroll in a Medigap policy. It’s very important to make sure your MA plan is cancelled BEFORE your Medigap plan has become effective.
What is a Stand-Alone Medicare Part D Prescription Drug Plan and How Does it Relate to MA Plans?
Prescription drug coverage for Medicare recipients is available through a stand-alone Medicare Part D prescription drug plan (“PDP”) or through a MA that also includes prescription drug coverage (“MAPD”). PDPs only offer prescription drug coverage, recipients might choose a PDP if they already have sufficient health insurance coverage. Before choosing either, it’s important to check whether or not the specific drugs you need are covered under the plans you’re considering. Also keep in mind that a PDP only covers outpatient prescription drugs.
What About a MA With Prescription Drug Coverage?
Medicare Advantage plans that include prescription drug coverage is a plan that will also have health care coverage but recipients MUST check to be sure that the plan they’re considering includes their selected physicians, hospitals, pharmacies, etc. It must also be noted whether the recipients’ chosen healthcare providers are included under the preferred or non-preferred networks. Another point to be aware of is that MAPDs have a right to change their healthcare providers’ network throughout the year, which means a recipient’s physician, pharmacy, hospital or specialist could be dropped from the plan.
How Can I Compare Costs for a PDP and Medicare Supplement Plan vs. a MAPD Alone?
Whenever someone is choosing healthcare plans or setting up medical benefits, they’ll choose according to their specific circumstances and preferences. Also to be considered will have to be the costs involved because health insurance can become a heavy financial burden. Some plans have $0 premium costs but hefty deductibles, while others have significant premium payments and lower deductibles. However, there are advantages to combining a PDP along with a Medicare Supplement plan as these plans, along with Original Medicare, can provide comprehensive healthcare coverage for many recipients. Click here for a complete list and description of all the Medicare Enrollment Periods.
Click or Call to Learn More About the Medicare Advantage Disenrollment Period for 2018
For further information on comparing rates for combining a PDP and a Medicare Supplement plan, call the number at the top of our website or fill out our online form. Whatever questions you may have regarding Medicare plans can be answered at MedicareFAQ. We’re here to service and educate Medicare beneficiaries, turning that which could become a potentially stressful and agonizing process into a more understandable procedure. Call us with your questions and concerns and we’ll help guide you through the process from beginning to end.