Last Chance to Disenroll from Medicare Advantage
Plan is Valentine’s Day
Special disenrollment period ends but seniors should
have details before they cancel
Feb. 13, 2014 - Medicare beneficiaries who are
dissatisfied with their Medicare Advantage (Medicare private health)
plans, have until Friday, February 14, to disenroll. Beneficiaries have
had the opportunity to drop their private plan and enroll in Original
Medicare since January 1, when the Medicare Advantage Disenrollment
Period (MADP) began, according to the Medicare Rights Center.
After the MADP, most people with Medicare will be
unable to make another change to their health coverage until the Fall
Open Enrollment Period, which begins on October 15, 2014.
“Time is running out for beneficiaries to take
advantage of the Medicare Advantage Disenrollment Period,” said Joe
Baker, president of the Medicare Rights Center.
“People who are unhappy with their plan and wish to
make the change back to Original Medicare should do so promptly, but
also thoughtfully. The window of opportunity is closing, but you should
review your coverage options carefully before you disenroll.”
What are my options during the Medicare
Advantage Disenrollment Period?
If you have:
• A Medicare Advantage private health
plan with prescription drug coverage, you can switch to Original
Medicare plus a prescription drug plan OR Original Medicare without a
prescription drug plan
• A Medicare Advantage Private
Fee-For-Service (PFFS) plan that does not include prescription drug
coverage and a stand-alone prescription drug plan, you can switch to Original
Medicare, but you must keep your current prescription drug plan
•Original Medicare or Original
Medicare and a prescription drug plan, you cannot make any
changes during this time
Original Medicare, the traditional fee-for-service
program offered through the federal government, covers most necessary
services and is accepted by most doctors and facilities across the
country. However, it does not cover the full cost of care. Many people
who enroll in Original Medicare choose to purchase supplemental coverage
to help pay for out-of-pocket costs such as deductibles and coinsurance.
Beneficiaries who disenroll from their Medicare
Advantage plan should be aware that they may have limited ability to buy
coverage that supplements Original Medicare.
State laws vary on when beneficiaries can purchase
Medicare supplemental policies, also known as Medigaps. Call your State
Health Insurance Assistance Program (SHIP) to find out if and when you
can enroll in a Medigap plan in your state. You can find the number for
your local SHIP by visiting
www.shiptalk.org or calling
Beneficiaries who disenroll from their Medicare
Advantage plan may need to join a stand-alone Medicare prescription drug
plan in order to maintain drug coverage. Medicare Rights advises
beneficiaries who are choosing a plan to consider not only premium and
copayment costs, but also whether the drugs they take are on the plan’s
formulary (list of covered drugs) and whether they can use the
pharmacies they prefer. Beneficiaries should also check to see whether
the plan places any restrictions on the drugs they take. Restrictions
can take the form of quantity limits, prior authorization and step
therapy. To learn more about choosing a Medicare prescription drug plan
that best meets your needs, visit Medicare
There is a special enrollment period which allows
beneficiaries to switch their coverage even after February 14th
when the MAPD ends. Beneficiaries can make a one time switch into a
Medicare Advantage plan or stand alone prescription drug plan with a
five-star rating. This star rating is an overall performance rating that
the government gives to all Medicare plans based on measures such as
customer service, pricing and member satisfaction. To learn more about
special enrollment periods visit
“It is important that someone thinking about
switching into a five-star plan consider how the switch will affect
their access to health care,” said Baker. “Even if a plan has five
stars, you should always check to make sure that it fits your needs, for
example, that your drugs are on the plan’s formulary or your doctors are
in the plan’s network.”
Learn more about changing your Medicare Advantage
plan, and evaluate your coverage options, on Medicare
Find the number for your local State Health
Insurance Assistance Program (SHIP) at www.shiptalk.org.
Find answers to Medicare questions at Medicare
the Medicare Rights Center’s free counseling tool.
To disenroll from your private plan and enroll in a
stand-alone prescription if necessary, call 800-MEDICARE.
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