Can You Be Dropped from a Medicare Advantage Plan?

Understanding Original Medicare and Medicare Advantage

Understanding Your Medicare Advantage Plan

A Medicare Advantage Plan, also known as Medicare Part C, is an alternative to Original Medicare. These plans are offered by private companies and cover everything that Medicare Parts A and B cover. Most also include prescription drug coverage, which can be a significant advantage. However, one common concern is whether you can be dropped from your Medicare Advantage Plan.

Reasons You Might Be Dropped from Your Medicare Advantage Plan

There are several reasons why you might lose your Medicare Advantage Plan:

Non-Payment of Premiums: If you do not pay your premium on time, you risk being dropped from your plan.
Moving Out of the Plan’s Service Area: If you relocate to an area not covered by your plan, you may need to join another plan.
Plan Leaving Medicare: Sometimes plans choose to stop participating in Medicare. If this happens, you will need to switch to another plan or return to Original Medicare.

Special Enrollment Periods

When you are dropped from your plan, you usually qualify for a Special Enrollment Period (SEP). This allows you to enroll in a new plan outside the regular enrollment periods. Some scenarios that trigger an SEP include:

Moving to a new address
Losing other health coverage
Changes in your current plan’s contract with Medicare

What Happens If Your Plan Ends?

If your Medicare Advantage Plan ends, you have options:

Return to Original Medicare: You can choose to go back to Parts A and B.
Enroll in Another Medicare Advantage Plan: You can join a plan that fits your needs.
Sign Up for a New Drug Plan: If you return to Original Medicare, you will need to enroll in a drug plan for prescription drug coverage.
Consider Medigap: If you return to Original Medicare, you might want to get a Medigap Plan to cover out-of-pocket expenses.

Enrollment Periods

There are specific times when you can enroll in or change Medicare Plans:

Initial Enrollment Period: When you first become eligible for Medicare.
Open Enrollment Period: From October 15 to December 7, you can change Medicare Advantage Plans or switch to another plan.
Medicare Advantage Open Enrollment Period: From January 1 to March 31, you can switch to a different Medicare Advantage Plan or return to Original Medicare.

What to Do If You’re Dropped from Your Plan

If you find yourself dropped from your Medicare Advantage Plan, take these steps:

Contact Your Plan: Find out why you were dropped and if there’s anything you can do to be reinstated.
Check Your Enrollment Options: Look into SEPs or the next available enrollment period to join a new plan.
Consult with Casa Arteaga Insurance: We can help you understand your options and find a plan that fits your needs.