The Medicare Advantage Disenrollment Period 2018 is coming soon. This annual period runs from January 1st to February 14th. It is a time of year when people dissatisfied with their 2Medicare Advantage plan can return to Original Medicare.
Why is there a Medicare Advantage Disenrollment Period?
Medicare Advantage plans have networks and work very differently from Original Medicare plus a Medigap plan. Once you enroll in a Medicare Advantage plan, you are generally locked in for the calendar year.
Years ago, when Medicare Advantage plans first came into the marketplace, there were many Medicare beneficiaries who enrolled in them without realizing how the plans worked. Sometimes they didn’t know the plans had a provider network or a lock-in period.
Often they would find out in January that their doctor was not in the network or that their plans’ drug formulary did not include important medications.
This created a great deal of strife and anxiety for Medicare beneficiaries, especially those treating for serious health conditions. Imagine enrolling in a plan and finding out in January that your oncologist is not in the network. Now you are locked into a plan for 12 months that impedes treatment with your trusted providers.
So Medicare created an annual Medicare Advantage Disenrollment Period. Beneficiaries can use it for any reason to leave their Medicare Advantage plan and return to Original Medicare.
Rules for the Medicare Disenrollment Period
You cannot use the Medicare disenrollment period to change from one Medicare Advantage plan to another. Medicare beneficiaries already have an Annual Election Period for this every year in the fall. The Medicare Advantage Disenrollment Period was designed for people who use the Annual Election Period to join an Advantage plan and now are experiencing problems with their new plan once the lock-in period has begun.
Anyone in an Advantage plan can use the disenrollment period to leave a Medicare Advantage plan. They will be returned to Original Medicare on the first of the month after they have disenrolled.
Beneficiaries also get a Special Election Period to join a Part D drug plan. This is because many Advantage plans have Part D built in. When you disenroll, you lose that Part D coverage, so Medicare gives you the opportunity to enroll in a stand-alone Part D plan.
The Disenrollment Period Does NOT Guarantee Acceptance into Medigap
Most people who return to Original Medicare will want to enroll in a Medigap plan to pay for the deductibles and coinsurance that Medicare does not cover. However, exercising the Medicare Advantage Disenrollment Period does NOT guarantee you the right to buy a Medigap plan. You must apply for a Medigap plan and answer health questions. The insurance company can accept or decline you based on your health history and medications during the underwriting process.
We should mention one exception. If you are unhappy with your Medicare Advantage plan during your first 12 months of coverage, you can use a Special Election Period to leave that plan and return to Original Medicare IF you have never enrolled in a Medicare Advantage plan before. (You can only use this special election period only once in your lifetime).
This scenario also creates a guaranteed issue period for you to enroll in a Medicare supplement. If you had a Medicare supplement in force before you joined the Advantage plan, you must return to that specific plan. if you were new to Medicare, you can choose any supplement plan.
Pro Tip: Apply for the Medigap plan BEFORE you disenroll from the Medicare Advantage plan. Make you they approve your application before you disenroll from your Advantage plan. For example, if you apply for a Medigap plan in early January and request a February 1st effective date, you will have time to see if you are approved. Then you may notify the Medicare Advantage company that you are leaving.
Once the Medigap company approves your application, make sure that you cancel your Medicare Advantage plan. Your coverage will end on the last day of the month in which you disenroll.
How to Disenroll from Your Medicare Advantage Plan
The easiest way to leave your Medicare Advantage plan is to use your Special Election Period to enroll in Part D. This enrollment will boot you out of your Medicare Advantage plan.
Be sure to always confirm that the Medicare Advantage company has disenrolled you. Your agent cannot do this for you.
You can also cancel your Medicare Advantage plan by contacting the plan in writing to disenroll. Your plan’s Evidence of Coverage booklet will have detailed information on how to contact the plan to disenroll.
A third option is to contact 1-800-MEDICARE to disenroll.
Are There Other Medicare Disenrollment Periods?
You can disenroll from a Medicare Advantage plan using a Special Enrollment Period. These periods exist for special circumstances, such as gaining or losing Medicaid or moving out of a plan’s service area. There is also a SEP to leave a Medicare Advantage plan because you are switching to a five-star Medicare Advantage plan.
You can learn more about the various Medicare enrollment periods here.
Do you have questions about what election periods you might qualify for? Our team of Medicare experts helps people with things like this on a daily basis. Contact us to discuss your coverage, and we can help you determine if you are eligible to make a change.