Medicare annual disenrollment period

During the period of Jan. 1 to Feb. 14, an existing Medicare Advantage member can dis-enroll from their Medicare Advantage plan and go back to original Medicare and a standalone part D plan if they do not have other creditable coverage (meaning Rx coverage at least as good as the standard Part D plan offered by Medicare).

An MA-PD plan is a Medicare Advantage plan that includes prescription drug coverage (Part D) as part of their plan. If the member is in a MA-PD, they can either submit a disenrollment request to their MA-PD plan and then enroll in a Part D plan, or simply enroll in a Part D plan, which automatically dis-enrolls them from their MA-PD.

A Medicare Advantage Plan can also exclude Part D as an MA only plan. If a Medicare beneficiary is in a MA only plan, they must first request disenrollment from their MA plan to trigger a "Special Enrollment" to join a Part D plan.

If the client uses their "Special Enrollment to enroll in a stand-alone Part D plan, that SEP ends as soon as they enroll into a Part D plan. The new Part D plan becomes effective the first of the following month.

If the client dis-enrolls during the Medicare Advantage Disenrollment Period (MADP), (January 1 –February 14), the change will be effective the first day of the following month.

Medicare beneficiaries need to remember that if they are dis-enrolling from a MA or MAPD plan during the Annual Disenrollment Period, they must continue to use current plan providers and services as required by the plan until the date their disenrollment becomes effective.