What Happens If Your Medicare Plan Leaves The Market?

One certainty in life and Medicare is change. Sometimes these changes are outside of our control. Medicare plans are operated and offered by private insurance companies. By virtue of having private companies operate these plans, they have the freedom to modify, amend or remove plans from the market. Of course, they have to do so compliantly with Medicare, but this does happen. If your Medicare plan is being discontinued for the upcoming plan year, what do you need to do?

What Happens If My Medicare Plan Is Discontinued By My Insurance Company?

There are two possible scenarios in which your Medicare Part D plan or Medicare Advantage Part C plan is discontinued. First, your plan can terminate during the plan year; or second, your plan won’t be renewed for the upcoming year and you will be notified in advance of the Annual Enrollment Period starting on October 15th. If the latter occurs, the plan will terminate at the end of the plan year on December 31st. In both situations, it is important to understand if you do not take action, there is a chance you’ll be left without coverage. Knowing when you will be losing benefits, we will help you understand what steps you need to take to enroll in another plan.

The Plan Sponsor Drops The Medicare Part C or Part D Plan During The Year

At times, for one reason or another, a provider drops or stops providing a plan in your region. The plan sponsor must give you written notice of the impending termination of their contract within 60 days of the termination. This will give you ample notice to start researching other Medicare Advantage plans, or a suitable alternative such as Original Medicare with a Part D policy.

This type of plan termination grants you a Special Enrollment Period where you can choose your new Medicare plan. This enrollment period typically lasts for two months, starting either at when you receive notice or lose coverage, whichever comes later. Your letter should inform you of the beginning and end of this Special Enrollment Period.

The Plan Sponsor Refuses to Renew the Contract At the End Of the Annual Term

If you are impacted by a provider choosing to not renew their plan, you will get a notice in the mail from your current Medicare plan on or before September 30th. This notice will be titled the Annual Notice of Change or ANOC and will detail the plan end date and other important information.. If your letter indicates your plan will be discontinued, you will typically have two options. First, your current plan provider will, by default, enroll you in another one of their plans effective January 1. Second, you can research your options during the Annual Enrollment Period (AEP), which runs from October 15 until December 7 each year, and enroll in your chosen plan for a start date of January 1st. It is important that you research both options to identify the plan or plans that best suit your medical and financial needs. Applying for a new plan will automatically cancel the default plan you would have been automatically placed in if no action was taken.

Get the Medicare Plan Evaluation and Enrollment Assistance You Need

When it comes to your Medicare benefits, it is important you maintain the coverage you need as you age. If you receive a notice of your plan’s discontinuation, make an appointment to speak with an experienced, licensed Medicare insurance agent for assistance in evaluating your available plan options in your service area. It’s crucial to enroll in a new Medicare plan before the end of your SEP or AEP. Medicare has late enrollment penalties, especially for Part D, so maintaining continuous coverage for this benefit will avoid these potentially hefty lifetime penalties. Local Medicare insurance agents are skilled at helping beneficiaries evaluate their coverage needs and choose a plan that fits their health and budget.

For one-on-one Medicare plan consultations and enrollment assistance during the AEP or SEP, reach out to Medicare Portal today. Our team of agents are ready to help you – online, over the phone and in-person – contact us to get started.

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