Medicare Advantage plans, also known as Medicare Part C, are private health plans that can give Medicare beneficiaries other options to choose from when they are setting up their additional Medicare coverage.
Beneficiaries can enroll in a Medicare Advantage plan during the Medicare Annual Enrollment Period (AEP) that happens from Oct 15 through Dec. 7 of every year. This is the time you can change your plan and have an effective date of January 1 the following year.
You enroll using the AEP selection on an application for a new plan on October 17th. This will mean your new plan will become effective on January 1st of the following year.
When you select a new policy, you don’t have to notify your old plan of the change. The change will happen automatically on the first day of the new year.
It’s during this period that recipients can enroll in a new Medicare Advantage plan or change plans.
However, if you decide you no longer want a Medicare Advantage plan after this period, you’ll have one more chance to change.
Medicare Advantage Disenrollment Period
You can drop or switch your Medicare Advantage plans once between January 1 through March 31st. Medicare Advantage Disenrollment Period (MADP) will no longer exist and the Medicare Open Enrollment will take its place.
This new enrollment period will happen each year and during this time, recipients can do the following:
- Switch from one Medicare Advantage plan to another.
- Disenroll from a Medicare Advantage plan and return to Traditional Medicare, with or without a Prescription Drug plan.
This new Open Enrollment period won’t allow Medicare Beneficiaries to change from one Prescription plan to another. You can only make one change during this period. So, once a change is made, you can’t make adjustments until AEP.
After Switching, When Does Coverage Begin?
As with several government programs, when disenrolling from a Medicare Advantage plan, coverage doesn’t begin immediately. It starts on the 1st day of the month following the date the new enrollment 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.
What if I Miss Both the Medicare OEP 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 Period (SEP) where, if granted, individuals would be allowed to enroll, disenroll and switch their Medicare Advantage plans but they would have to qualify to be considered. Such qualifications consist of the following:
- Have full Medicare AND Medicaid coverage;
- 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 a SEP, coverage will start the first day of the month after the application has been submitted and accepted.
For example, if you applied for coverage on March 15th, the soonest you would have coverage would be April 1st.
You may only use the same SEP once per year.
If I Drop my Medicare Advantage plan 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 disenrolled from an MA plan, you can enroll in a Medigap policy. It’s very important to make sure your Medicare Advantage plan is canceled 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 an MA that also includes prescription drug coverage (MAPD).
PDPs only offer prescription drug coverage, recipients might choose a PDP if they already have enough health insurance coverage.
Before choosing either, it’s important to check whether 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 Medicare Advantage Plan 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.
Click or Call to Learn More About the 2019 Medicare Advantage Disenrollment Period Changes
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 educate you, we help make this process simple.
Call us with your questions and concerns and we’ll help guide you through the process from beginning to end.