Ritter Insurance Marketing, Craig Ritter

Opting out of Medicare Advantage

Have you got clients who are fresh enrollees in Medicare Advantage, but want to leave their plan and apply for a supplement? Don’t forget about your opt-out options.

Someone in an MAPD plan can disenroll and get a Prescription Drug Plan and a Med Supp guaranteed issue within 12 months of enrolling in their MA plan for the first time.

So let’s say your client enrolled in an MA plan when they were first eligible at age 65 and that plan became effective Jan. 1. A client can enroll in a PDP (or simply disenroll from the MA plan) within 12 months from that Jan. 1 effective date. They also have 12 months to get a Medigap plan.

You can use the Special Election Period for turning 65 (called SEP65), which is the 12-month period after the effective date of coverage in the MA plan. In SEP65, you can enroll in the PDP plan in addition to leaving MA and electing Original Medicare. Your client will also have guaranteed issue rights, called a trial right, when selecting a Medigap policy in that period.

Remember, it’s illegal to sell a Med Supp plan to someone with Medicare Advantage, so make sure the coverages do not overlap (even by one day)!  You should get a signed statement from the client that they started the disenrollment process and a copy of the disenrollment letter from your client to protect you.  Be sure to have documentation on the MA disenrollment, so that you are legally protected!!

Posted by filed under Enrollment Periods, Medicare Advantage, Medicare Supplement, Uncategorized .


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