What happens when a Medicare Advantage plan leaves?

Suzie and I have been working with Health and Medicare Plans for years. What happens when my medicare advantage plan leaves? It comes up frequently during the initial enrollment period. The quick answer is we go through the different options and select a different one at that time.

We have seen Molina & Premera paid plans leave our Chelan County. Lifewise leave and come back, Moda leaves the state, Soundpath Health Medicare Advantage wave goodbye to North Central Washington. We have been taking care of the entire Washington state for over eleven years.

It is tough when a plan that you are comfortable with cannot continue in your area. Not every county in Washington state has Medicare Advantage plans. The insurance company has to identify that there is enough people who qualify, obtain contracts with providers in the area, and have enough profits that can be made in the area to continue to operate.

Every year, some Medicare Advantage plans may leave the Medicare program by Dec. 31. You should receive a letter from the plan by Oct. 2 explaining your options. Surprises in health insurance, especially in Medicare can be rough.

talk with Suzie

 

Suzie has been around long enough that she worked with Soundpath Health Medicare Advantage Customers when that Insurance Plan left in 2019. Suzie has worked with a wide variety of insurance companies from around the state and we built out action plans over the years to work through a customer’s option so that a transfer from one company to the next is as easy as possible.

When can I join a new Medicare Advantage plan?

The three most common Medicare Advantage plan enrollment periods are the:

• Initial Coverage Enrollment Period when you first join Medicare Parts A and B usually around your 65^th birthday.
• The Annual Enrollment Period, Oct. 15 – Dec. 7.
• Medicare Advantage Open Enrollment Period, Jan. 1 – March 31 each year if you have a Medicare Advantage Plan then you can change to another plan.

In addition to these three enrollment periods, because your plan is leaving Medicare, you also get a Special Enrollment Period in which you have two options:

1.    Join a different Medicare Advantage plan from Dec. 8 to the last day of February.

or

2.    Join a new Medicare Part D stand-alone plan from Dec. 8 to the last day of February (this automatically enrolls you in Original Medicare). This also allows you to enroll in a Medigap (Medicare Supplement) plan within 63 days after your Medicare Advantage plan ends.

 

The company offering the Medigap plan must take you if you choose a B-N plan and you don’t have to take a health screen.

Note:  If you’re under age 65 on Medicare due to disability, you might not be able to get a Medigap.

Whichever option you choose, your new plan starts the first day of the month after you switch. To avoid a coverage gap you should sign up with a new plan before Dec. 31.

Whenever Suzie sees a large shift Medicare Shift, we recommend setting an appointment as early as possible. We have seen people miss the deadlines and it makes for a tough year. For the appointment, you will need:

1. Fill out a Scope of Appointment at least 24 hours in advance
2. Bring your red, white, and blue Medicare Card
3. Bring any doctor’s names or medications that you would like for us to look up

If you enroll during the Annual Enrollment Period in a Medicare Advantage Plan and discover that it is not a good fit then we change during the Medicare Advantage Open Enrollment which runs January 1^st through March 31^st.  Yes, you have options before the next Annual Enrollment Period

talk with Suzie

If you find yourself with a Medicare Advantage plan leaving your area in Washington state then talking with Suzie can help sort out your options. 

Topics: Medicare, Medicare Advantage, Suzie, Wenatchee Insurance, Hospital Insurance, Prescription Drug Coverage, Part D, Medical Insurance, Disability, Medicare Part C, Chelan County, Grant County, Douglas County, Okanogan County,

office is on 413 N Mission, Wenatchee