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Medicare Advantage: If A Plan Terminates


In recent years many Medicare Advantage Plans have either quit providing coverage altogether or have cut back the geographical areas they serve. Either situation forces  terminated members to seek other coverage.

A Medicare Advantage Plan must notify its members in writing no later than October 2 of each year if it intends to terminate coverage. In such cases, coverage will not terminate until December 31 of that year.

Keep your termination letter. If you choose to return to Original Fee-For-Service Medicare, the letter is proof of your right to purchase a Medigap coverage which would otherwise probably not be possible to purchase given your health history.  (Note: you only have 63 days after receiving your termination notice.)

Decide what type of coverage is best for you. To learn more, see: Medicare: How To Choose The Best Plan For You.  Then decide whether you want to start the new coverage before January 1 or on January 1. The steps to take depend on your decision. 

For additional information, see:

  • If You Decide To Be Covered By Original Fee-For-Service Medicare Before January 1  
    • Follow the instructions for disenrolling from a Medicare Advantage Plan (To learn more: see: Medicare Advantage: How To Disenroll).
    • If you want to purchase Medigap insurance, you have to obtain it within 63 days of the termination of your Medicare Advantage Plan or face the possibility of being rejected because of your health history. 
  • If You Decide To Be Covered By Original Fee-For-Service Medicare Starting January 1
    • You do not have to do anything. Starting on January 1 you will be covered under Original Medicare.
    • However, if you want to return to original Medicare and purchase Medigap insurance, you have to act quickly. In spite of your medical condition, you are guaranteed the right to obtain Medigap provided you do so within 63 days from the termination of your Medicare Advantage coverage. For more information on Medigap coverage, see Medicare: Medigap.  
  • If You Decide To Move To Another Medicare Advantage Plan On January 1
  • If You Decide You Want To Move To Another Medicare Advantage Plan Before January 1
  • If Your Medicare Advantage Plan Stops Doing Business, And You Do Nothing To Replace It
    • You will automatically be placed in Original Fee-for-Service Medicare. To avoid a gap in coverage, do not rely on this happening automatically. Make the call and get proof of  continuing coverage.

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