« Back to News List

Medicare Advantage Disenrollment Period

February 01, 2011

We all know the Patient Protection and Affordable Care Act (PPACA) changed many things in our industry. As always, we want to make sure you have the information you need to serve your customers well. This bulletin contains information regarding the changes to the former Medicare Advantage open enrollment period (OEP).

PPACA replaced the OEP with an annual Medicare Advantage Disenrollment Period (MADP), which started January 1, 2011 and will end February 14, 2011. Please keep these in mind during the new MADP:

  • A Medicare Advantage member can disenroll from his or her Medicare Advantage plan and return to Original Medicare.
  • If a member does disenroll from Medicare Advantage, he or she is eligible for a special enrollment period (SEP) for a stand-alone Part D plan, regardless of whether or not the Medicare Advantage plan included Part D drug coverage.
  • Members enrolled in both a stand-alone Part D plan and a Medicare Advantage Private Fee-for-Service (PFFS) plan without drug coverage may use the MADP to disenroll from the Medicare Advantage PFFS plan and return to Original Medicare. Please note: these members cannot disenroll from a Part D plan, nor enroll in a different Part D plan. Additionally, members enrolled in a stand-alone Part D plan must stay with their current plans.
  • A member who disenrolls from a Medicare Advantage plan during the MADP may be able to buy a Medigap policy upon returning to Original Medicare. However, using the MADP does not give the member guaranteed issue rights under federal law. In some cases, state Medigap laws may offer additional guarantee issue rights to members affected by the MADP.

Example 1: John Smith enrolled in a Medicare Advantage PPO plan with Part D prescription drug coverage during the recent annual election period (AEP) for an effective date of January 1, 2011. He is not happy with the plan’s provider network and wants to drop this coverage. He can use the MADP to disenroll from the Medicare Advantage plan and return to Original Medicare. He will also have an SEP to enroll in a stand-alone Part D prescription drug plan, if desired.

Example 2: Jane Doe had a Medicare Advantage PFFS plan that was not renewed, but she did not take any action to actively enroll in another Medicare Advantage plan. Jane goes to the pharmacy January 6, 2011 to get her prescriptions filled and finds out she does not have drug coverage. Jane can enroll in a stand-alone prescription drug plan up to February 14.

Important Dates:

  • The effective date of the disenrollment from the Medicare Advantage plan is the first day of the month following the date we receive the disenrollment request. For example, requests we receive in January will be effective February 1. Requests received February 1–14 will be effective March 1.
  • The effective date of the enrollment in the prescription drug plan is the first day of the month following the date we receive the enrollment request.
  • An individual must make the Part D election no later than February 14. After February 14, an individual must wait for the next valid Part D election period.
  • The effective dates of the MAPD and the Part D SEP do not have to be the same.

Individuals CANNOT take these actions during this period:

  • Switch from Original Medicare to Medicare Advantage
  • Switch from one Medicare Advantage plan to another
  • Switch from one prescription drug plan to another

Please contact your marketing representative with any additional questions.

View a printer-friendly version of this bulletin.

« Back to News List