Department of Human Services

Q: Although I know that the Medicare Open Enrollment Period ended December 7, what is the Medicare Advantage Disenrollment Period that runs from January 1 through February 14?

A: If a Medicare beneficiary is enrolled in a Medicare Advantage plan instead of Original Medicare, and they are dissatisfied with their Medicare Advantage health plan, an annual "disenrollment" period allows them to switch to Original Medicare and a drug plan between January 1 and February 14. 

Medicare Advantage plans are health plan options like Health Maintenance Organizations, (HMOs) and Preferred Provider Organizations, (PPOs), approved by Medicare and offered by private companies. These plans are part of Medicare and are sometimes called "Part C," or "MA plans." Medicare pays a fixed amount for your care every month to the companies offering Medicare Advantage Plans. These companies must follow rules set by Medicare. Medicare Advantage plans provide your Medicare health coverage, including your Part B medical benefits, and your Part A hospital benefits, and sometimes, Medicare prescription drug coverage, Part D. They are not supplemental insurance plans, and when you are enrolled in a Medicare Advantage plan you do not need to have supplemental insurance. Not all Medicare Advantage Plans work the same way, so you are encouraged to find out the plan's rules before joining. Medicare Advantage Plans must cover all of the services that Original Medicare covers except hospice care. Original Medicare covers hospice care even if you are in a Medicare Advantage plan. And, Medicare Advantage Plans may offer extra coverage, such as vision, hearing, dental, and/or health and wellness programs that Original Medicare does not.

 

If a Medicare beneficiary decides that they would rather not continue with their Medicare Advantage Plan and they want Original fee-for-service Medicare, they should also consider joining a Medicare Prescription Drug Plan as Original Medicare does not cover prescription drugs. Again, this can be done during the Medicare Advantage disenrollment period of January 1, through February 14. The new coverage will begin the first day of the month after the plan gets your completed enrollment form.

During this period, you cannot do the following:

• Switch from Original Medicare to a Medicare Advantage Plan.
• Switch from one Medicare Advantage Plan to another.
• Switch from one Medicare Prescription Drug Plan to another.
• Join, switch, or drop a Medicare Medical Savings Account Plan.

This period, from January 1 through February 14, is only for disenrolling from a Medicare Advantage Plan to Original Medicare and adding a Medicare Prescription Drug Plan, which is Medicare Part D.

For more information, call 1-800-MEDICARE, which is,1-800-633-4227. Medicare's national toll-free helpline is available 24 hours a day, seven days a week, or visit www.medicare.gov.

Department of Human Services

City of St. Louis