Can You Cancel a Medicare Advantage Plan at Any Time?

Medicare Advantage plans, offered by private companies approved by Medicare, provide health coverage as an alternative to Original Medicare, which includes Part A (Hospital Insurance) and Part B (Medical Insurance). These plans often combine hospital and medical coverage, and may include prescription drug benefits (Part D) and extra services like dental, vision, or hearing coverage. While these plans offer comprehensive benefits, the ability to change or disenroll is subject to specific timeframes and conditions.

Understanding Disenrollment Periods

Medicare Advantage plans cannot typically be canceled at any time. Disenrollment is generally permitted during specific enrollment periods throughout the year. These defined windows ensure an organized process for individuals to manage their health coverage.

One such period is the Annual Election Period (AEP), which occurs each year from October 15 through December 7. During this time, individuals can switch from one Medicare Advantage plan to another, return to Original Medicare, or enroll in a standalone Part D plan. Any changes made during the AEP become effective on January 1 of the following year.

Another opportunity for disenrollment is the Medicare Advantage Open Enrollment Period (MA OEP), which runs from January 1 to March 31 annually. This period allows individuals already enrolled in a Medicare Advantage plan to make a single change. They can switch to a different Medicare Advantage plan or disenroll from their current plan and return to Original Medicare. If an individual uses this period to return to Original Medicare, they are also granted a Special Enrollment Period (SEP) to enroll in a standalone Part D plan.

Beyond these regular periods, Special Enrollment Periods (SEPs) allow for changes outside of the standard enrollment windows, triggered by specific life events. These circumstances include moving outside the plan’s service area, losing other health coverage, or qualifying for Extra Help to pay for prescription drug costs. Other SEPs may apply if a plan’s contract with Medicare ends, or if an individual moves into or out of a long-term care facility.

Steps to Disenroll

Disenrolling from a Medicare Advantage plan involves specific procedural actions to ensure a smooth transition of coverage. The process typically begins with formally notifying the current Medicare Advantage plan of the intention to disenroll. Individuals can initiate this by contacting their plan directly, submitting a written request, or calling 1-800-MEDICARE.

When an individual intends to switch to a different Medicare Advantage plan, enrolling in the new plan often automatically disenrolls them from their previous plan. Similarly, enrolling in a standalone Part D plan, particularly when returning to Original Medicare, can also trigger automatic disenrollment from the Medicare Advantage plan. This automatic process helps prevent gaps in coverage.

The effective date of disenrollment is typically the first day of the month following the month in which the disenrollment request is made. For example, a request submitted in January would generally result in disenrollment effective February 1. It is important to continue using the current plan’s network providers and services until the disenrollment becomes effective to ensure coverage for medical services.

Transitioning Coverage

After disenrolling from a Medicare Advantage plan, understanding the immediate impact on health coverage is important. When an individual disenrolls from a Medicare Advantage plan and does not enroll in another, they typically default back to Original Medicare. This transition ensures continued coverage for hospital and medical services.

If returning to Original Medicare, individuals will generally need to secure separate prescription drug coverage by enrolling in a standalone Part D plan. A Special Enrollment Period is often available for this purpose, allowing enrollment in a Part D plan to align with the return to Original Medicare. Coordinating this enrollment is important to avoid a gap in prescription drug coverage.

Individuals returning to Original Medicare may also consider purchasing a Medigap (Medicare Supplement Insurance) policy. Medigap plans help cover some of the out-of-pocket costs associated with Original Medicare, such as deductibles, copayments, and coinsurance. Guaranteed issue rights for Medigap policies may apply in specific situations, such as when moving out of a Medicare Advantage plan’s service area, if the plan terminates coverage, or during a trial period after initially joining a Medicare Advantage plan. These rights ensure that an insurer cannot deny coverage or charge a higher premium due to health conditions.