Did you enroll in the wrong plan?


Did you enroll in a Medicare Advantage Plan or Part D drug plan by mistake or were you misled?

 

One of today's options is to use The Medicare Advantage Disenrollment Period.

You can switch from your Medicare Advantage Plan to Original Medicare during this period. You can only make this coverage change if you have a Medicare Advantage Plan. The Disenrollment Period occurs each year from January 1 to February 14.

If you have a Medicare Advantage Plan you will be able to switch to Original Medicare with or without a stand-alone prescription drug plan. Any changes made during this period will become effective the first of the following month.

For example, if you switched from a Medicare Advantage Plan to Original Medicare and a stand-alone prescription drug plan in February, your new coverage would begin March 1st.

Note: If you are enrolled in a PFFS plan with a stand-alone drug plan, you must keep your stand-alone prescription drug plan if you switch to Original Medicare during the Annual Disenrollment Period.

What if you miss the annual disenrollment period?

 

You ALSO have the right to disenroll and change plans if you...

  • ...joined unintentionally. For example, you may have enrolled believing you were joining a Traditional Medicare Supplement (Medigap plan) or a stand-alone Part D plan that would supplement Original Medicare. You did not realize you were joining a Medicare Advantage plan with a limited doctor network through which you must get all of your Medicare health benefits.
  • ...joined based on incorrect or misleading information. You may have been misled, for example, if a plan representative told you that your doctors are in the plan’s network but they are not, or if you were promised benefits that the plan does not really cover.
  • Through no fault of your own, ended up or were kept in a plan you do not want. For example, if you tried to switch plans but were kept in your old plan, you have the right to disenroll and change plans. You can also make a change if you were enrolled in plan through an administrative or computer mistake.

How you should request disenrollment depends on whether or not you have use services.

  • If you have used health services since you joined your plan (for example, you saw a doctor or filled a prescription), and your plan has denied coverage for services, you may want to request retroactive disenrollment or disenrollment back to the date you enrolled in the health plan. Retroactive disenrollment allows you to be disenrolled from a Medicare Advantage or Part D plan as if you had never joined it. Depending upon your situation, you may then wish to select Original Medicare (with or without a Part D plan) or a Medicare Advantage Plan with or without drug coverage. If you are granted retroactive disenrollment, once the request has officially gone through, you should ask any doctor who gave you care during the time when you were enrolled in the plan to refile the claims with Original Medicare and/or, your new Medicare Plan(s).
  • If you have not used any health services since you’ve had your Medicare Advantage Plan, you may want to request a special enrollment period to disenroll from your plan and make a new choice going forward. If your request is granted, you will be disenrolled from your plan at the end of the month in which you made the request. Such requests are generally processed faster than retroactive disenrollment requests. To prevent gaps in coverage, you should sign up for new coverage right away so that it starts as soon as you are disenrolled from the plan you did not want.

To request a retroactive disenrollment or a special enrollment period, call 1-800 MEDICARE and explain to the customer service representative exactly what happened to cause you to join the plan by mistake.

Would you like my help?

If you would like to talk to me or schedule a meeting to discuss your options, you can reach me at 207-370-0143 or use my simple form on the CONTACT ME page of this site to send me an email message.

You will not pay anything for my help.  I am paid by the insurance companies in the form of a commission when you enroll in a plan.  You do not pay any more than anyone else for your insurance and you are under no obligation whatsoever to enroll or change plans if you meet with me.  

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