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MA plans can eliminate your coverage at the end of the year if its contract is not renewed with Medicare. These plans may decide to drop select service areas, or it may decide to discontinue the entire plan.

A plan may involuntarily disenroll you for failure to pay premiums timely, for causing a disruption in the plans ability to deliver health care services, or if it cannot meet your medical needs. If you are involuntarily disenrolled, you are automatically returned to coverage under original Medicare at the beginning of the month following your involuntary disenrollment.

A Medicare Advantage plan is required to notify members of Medigap guaranteed issue rights when disenrolling to Original Medicare during a Special Enrollment Period (SEP) if they are terminating or reducing their service area. In a majority of cases, the plan must send written notice to all Medicare members at least 60 days before the effective date. Nevertheless, if CMS initiates a termination, members will be notified 30 days before the effective date. In certain situations a Medigap issuer may require the beneficiary to provide further documentation of their guaranteed issue rights as a result of disenrollment.

If you are involuntarily disenrolled from Medicare Advantage because the Medicare Advantage plan nonrenews its plan, you have the right to apply for a Medicare supplement policy, as long as you do so within 63 days of notice of the nonrenewal.

If you decide a Medicare Advantage plan is not right for you and you voluntarily disenroll, you may have a right to Medicare supplement coverage as long as you have not been covered by a MA plan before and you disenroll from your current Medicare Advantage plan within the first 12 months of coverage. You will be limited to the same Medicare supplement you had before enrolling in the Medicare Advantage plan, excluding any outpatient prescription drug coverage. If you do not have a right to get your previous Medicare Supplement coverage, you will have to qualify medically for your Medicare supplement and the insurance company has the ability to deny you coverage.

Guaranteed Issuance Rights: Enrollment in an MA plan at age 65 If you enroll in a Medicare Advantage plan when first becoming eligible for Medicare, you have guaranteed issuance rights when disenrolling from the MA plan within the first 12 months. Your Medicare Supplement Guarantee Issue Period starts 60 days prior to disenrollment and ends 63 days after disenrollment. You are also eligible for all Medicare Supplement policies.

Guaranteed Issuance Rights: If you are over age 65, enrolled in a MA plan for the first time and disenroll within the first 12 months You must have had a Medigap policy prior to Medicare Advantage enrollment. Your Medigap Guarantee Issuance Period starts 60 days prior to disenrollment and ends 63 days after disenrollment. If the Medigap policy you owned prior to enrollment in the Medicare Advantage plan is still being sold, you may return to that policy. Otherwise, you can choose from plans A, B, C, F, K or L.

The Medigap issuer cannot impose conditions on coverage or discriminate in pricing based on your age or health status except as permitted by state rating regulations. They also cannot charge pre-existing condition exclusions, even without creditable coverage. Keep in mind, you must exercise your Guaranteed Issuance rights within 63 days of the disenrollment date from the Medicare Advantage plan.

Our licensed insurance agents are available to help answer any specific or detailed questions you have.