MA-DP Deadline Quickly Approaching

Medicare Advantage Disenrollment Period, deadline is quickly approaching.
The MADP, which begins January 1st and runs until February 14th and replaces the Open Enrollment Period, is an opportunity for beneficiaries to return to Original Medicare. It is not an additional enrollment period nor is it an opportunity for Medicare Advantage members to switch to different MA Plans.
Allowable Actions during the MADP:

People enrolled in an MA-PD plan may disenroll from the MA-PD and will have the opportunity to enroll in a standalon Prescription Drug Plan (PDP). Important: MA-PD members who enroll in a standalone PDP during this period will be automatically disenrolled from their current MA-PD and will not have the option of enrolling in another Medicare Advantage Plan.

Members who are in a Medicare Advantage only plan may request disenrollment from the MA plan and will then receive a Special Election Period (SEP) to enroll in a PDP standalone plan. The SEP is available from the time the disenrollment request is made until the member enrolls in a PDP or after February 14, whichever comes first.

Members who have both a standalone MA and a standalone PDP may disenroll from the MA plan, but may not make a change to their current standalone PDP.

A beneficiary who disenrolls from an MA or MA-PD plan using the opportunity afforded by the MADP may enroll in a Medicare Supplement policy upon returning to Original Medicare. However, using the MADP does not give the beneficiary guaranteed issue rights under federal law to prevent health-based underwriting of the Med Supp policy. In some cases, State Medigap laws may offer additional guaranteed issue rights to beneficiaries who are affected by the MADP.

Members who have a standalone PDP, but are not enrolled in an MA plan may not make any change to their current PDP plan and may not enroll in an MA plan.

People with Original Medicare who are not enrolled in any Part C Medicare Advantage plan have no options under MADP to make any change in their Medicare coverage.

Note: The effective dates of the MA disenrollment under the MADP and the PDP enrollment under the coordinating Part D SEP do not have to be the same. If a beneficiary disenrolls from an MA plan, he or she has until the end of the SEP (February 14th) to enroll in a PDP. Thus an individual could disenroll from an MA plan in January (effective February 1) and not choose a PDP until February (effective March 1). However, the individual must make a PDP election by the end of this SEP or wait until the next valid Part D election period in order to enroll in a PDP. In all cases, the effective date for the enrollment in a PDP may not precede the date of the MA disenrollment.


2 comments on “MA-DP Deadline Quickly Approaching

  1. This is very interesting! Why aren’t insurance companies informing members of their rights to make changes like this?! I deal with my mother’s insurance needs now that my father has passed away and I was unaware of this. I’ve been taking care of my mother for the past couple years and there are a few things about her Medicare Advantage plan that we really don’t like. For instance all the copays she has to make. Seniors are living on limited income; how can insurance companies expect them to pay every time they need a service? Where do they think the money is coming from? From what I gather from reading this article, my mother has to stay in this plan until the next AEP. Is that correct, or can we make changes now?

    Thank you in advance,
    Kelly Fields Indianapolis, IN.

    • Hello Kelly, my name is Calvert Louden and I am a Licensed Health Care Professional/Quality Development Specialist at a health insurance consulting firm. First and foremost, I am sorry to hear about your father passing away; its always tough losing a loved one.
      Managed Care Consulting can be a very useful tool to have your questions and concerns addressed regarding Medicare and health care management. With regards to your questions, many independent providers don’t want to inform members of these types of eligibility or entitlement rights because inevitably it may result in a loss of funds for the insurance company. If they are required to inform one member, then they are obligated to inform all members. And if one member is unhappy with their current plan, the likelihood of others feeling the same way is quite high. That being said, insurance companies will leave the education of its members up to them. If a member wants to insure they have the best plan for themselves, then they will have to do the research.
      Since the MADP has now past, unfortunately, yes, your mother will have to remain in her plan until the next AEP which begins Oct. 15th 2012. Until then, please use Managed Care Consulting as your resource guide to have the concerns of your mother’s health care management alleviated. Any and all questions are welcome. Take care and best of luck.

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