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.