How to Cancel a Medicare Advantage Plan

Medicare Advantage Plans, also known as Medicare Part C, represent an alternative way to receive Medicare benefits through private health insurance companies. These plans are regulated by the federal government and are required to cover all services provided by Original Medicare, which includes Part A for hospital insurance and Part B for medical insurance. Many Medicare Advantage plans also offer additional benefits not covered by Original Medicare, such as prescription drug coverage, vision, dental, and hearing services. Individuals enrolled in a Medicare Advantage Plan continue to pay their Medicare Part B premium.

Key Periods for Changing Your Plan

Beneficiaries can make changes to their Medicare Advantage Plan during specific timeframes throughout the year. The Annual Enrollment Period (AEP) offers a broad opportunity for adjustments. This period runs annually from October 15 to December 7, with any changes becoming effective on January 1 of the following year. During the AEP, individuals can switch from Original Medicare to a Medicare Advantage Plan, change between different Medicare Advantage Plans, or enroll in, disenroll from, or switch a Medicare Part D (prescription drug) plan.

Another important period is the Medicare Advantage Open Enrollment Period (MA OEP), which occurs from January 1 to March 31 each year. This period is specifically for individuals who are already enrolled in a Medicare Advantage Plan. During the MA OEP, a beneficiary can switch to a different Medicare Advantage Plan or disenroll from their current Medicare Advantage Plan to return to Original Medicare. If returning to Original Medicare, they can also enroll in a stand-alone Medicare Part D plan. Only one change is permitted during this three-month window, and the new coverage typically becomes effective on the first day of the month following the request.

Special Enrollment Periods (SEPs) provide additional opportunities for plan changes outside of these standard periods. SEPs are triggered by specific life events and circumstances. Examples of qualifying events include moving to a new service area, if a plan terminates its contract with Medicare, or if an individual qualifies for or loses Extra Help for prescription drug costs. There is also a “trial period” SEP for individuals who enrolled in a Medicare Advantage Plan when they first became eligible for Medicare Part A at age 65, allowing them to disenroll within their first 12 months. The duration of an SEP can vary, but it often provides a window of approximately two to three months from the qualifying event to make changes.

Methods for Disenrolling from Your Plan

One common way is through automatic disenrollment, which occurs when an individual enrolls in a new Medicare Advantage Plan. When a beneficiary selects and enrolls in a different Medicare Advantage Plan, their enrollment in the new plan automatically triggers disenrollment from their previous plan.

Similarly, automatic disenrollment also happens if a beneficiary chooses to return to Original Medicare and enrolls in a stand-alone Medicare Part D plan. The act of enrolling in the Part D plan will typically initiate the termination of the Medicare Advantage Plan.

For individuals who wish to disenroll from their Medicare Advantage Plan without immediately enrolling in a new one, such as when returning to Original Medicare, direct contact with the plan provider is an option. Beneficiaries can call their current Medicare Advantage Plan directly to request disenrollment. The plan may then require a written disenrollment notice or completion of a specific form, which can often be mailed or faxed back to them. Some plans also provide an online option for submitting a disenrollment request.

Another direct method for disenrollment involves contacting Medicare by phone. Beneficiaries can call 1-800-MEDICARE to initiate the disenrollment process. Representatives are available to guide individuals through the necessary steps and can assist with the transition back to Original Medicare. This hotline operates 24 hours a day, seven days a week, providing accessible support for beneficiaries.

Ensuring Continuous Coverage After Disenrollment

If a beneficiary disenrolls from their Medicare Advantage Plan without enrolling in another one, they will typically revert to Original Medicare, which consists of Medicare Part A and Part B. It is important to note that Original Medicare does not include all the supplementary benefits that some Medicare Advantage Plans may offer, such as routine dental, vision, or hearing services. Beneficiaries must continue to pay their Medicare Part B premium to maintain their Original Medicare coverage.

For changes made during the Annual Enrollment Period (October 15 to December 7), new coverage becomes effective on January 1 of the following year. If a change is made during the Medicare Advantage Open Enrollment Period (January 1 to March 31), the new coverage typically begins on the first day of the month after the new plan receives the enrollment request. Special Enrollment Periods also have specific effective dates designed to ensure a smooth transition of coverage.

When returning to Original Medicare, individuals will need to consider their prescription drug coverage. Original Medicare does not include a prescription drug benefit. To avoid a lapse in coverage and potential late enrollment penalties, it is often advisable to enroll in a stand-alone Medicare Part D plan. Late enrollment penalties for Part D are calculated based on the length of time an individual went without creditable prescription drug coverage. Enrollment in a Part D plan can occur during the Annual Enrollment Period, the Medicare Advantage Open Enrollment Period (when moving to Original Medicare), or through specific Special Enrollment Periods.

For those transitioning to Original Medicare, Medigap policies, also known as Medicare Supplement Insurance, can provide additional financial protection. These policies help cover out-of-pocket costs associated with Original Medicare, such as deductibles, copayments, and coinsurance. Beneficiaries generally have guaranteed-issue rights to purchase a Medigap policy in certain situations when leaving a Medicare Advantage Plan, particularly during specific trial periods or if their Medicare Advantage Plan terminates its contract. These guaranteed-issue rights typically provide a limited window, often 63 or 123 days, during which an insurer must sell a Medigap policy without medical underwriting. Missing this specific window could result in higher premiums or denial of coverage based on health conditions.