Medicare Advantage Plan disenrollment period

Note to readers: The Chester County Department of Aging, through its APPRISE program of trained Medicare counselors, helps Medicare beneficiaries to understand the health care options specific to their health needs and financial resources. This article was prepared by APPRISE counselors to help Medicare beneficiaries navigate this complex system.

Do you have a Medicare Advantage Plan (Medicare Part C) that you want to drop and return to Original Medicare, but you missed your chance during the Medicare Annual Enrollment Period (AOEP) which runs from Oct. 15 to Dec. 7 every year? Did you sign up during the AOEP for a Medicare Advantage Plan and now have changed your mind and want to return to Original Medicare and a standalone Prescription Drug Plan? If so, you have the ability to disenroll from your Medicare Advantage Plan and return to Original Medicare during the Medicare Advantage Disenrollment Period (MADP) which runs from Jan. 1 to Feb. 14. Medicare Advantage Plans include HMO (Health Maintenance Organization), PPO (Preferred Provider Organization), and PFFS (Private Fee-for-Service) plans.

During MADP you can only disenroll from your Medicare Advantage Plan, either with or without drug coverage, and return to Original Medicare. You then have until Feb. 14 to join a Part D plan for drug coverage. If you have a Private-Fee-ForService (PFFS) plan and a stand-alone prescription drug plan, you can drop the PFFS plan, but you cannot change your prescription drug plan. In addition, you cannot use this enrollment period to change from one stand-alone drug plan to another stand-alone drug plan, switch from one Medicare Advantage Plan to another, or switch from Original Medicare to a Medicare Advantage Plan.

Note that people with limited income and resources who qualify for help with their prescription drug costs through the Extra Help program may change plans at any time, not only during AOEP or MADP. An APPRISE counselor can help you evaluate your eligibility and apply for this program.

Before you decide to drop your Medicare Advantage Plan, you need to think about ways to protect yourself against costs associated with Original Medicare, such as deductibles, coinsurances, and copayments. If you wish to purchase a Medicare Supplement, also known as Medigap, to cover the gaps in Medicare, there is no guarantee that you will be able to obtain one. The MADP does not give you the right, according to Federal law, to purchase a Medicare Supplement policy with guaranteed issue, which means that an insurance company may or may not accept you if you have underlying medical conditions. However, different insurance companies have different requirements. It always pays to investigate this option before you drop your Medicare Advantage Plan. Contact APPRISE for further information about this.

Any coverage changes that you make during the MAPD go into effect the first day of the month following your disenrollment.

APPRISE counselors are available to answer your Medicare-related questions. You can contact a counselor by calling your local senior center to set up an appointment or through the APPRISE help line at 610-3445004. You can also email us with questions at apprisechesco@outlook. com.