How to Get Out of a Medicare Advantage Plan

You were railroaded into getting a Medicare Advantage plan, probably by answering the phone and being misled by a pushy salesperson. Now, you realize your mistake and don’t want the plan.

How do you get out?

Luckily, there are options:

  1. If you dropped a Medicare supplement to join an Advantage plan for the first time, the Medicare Advantage Trial Right Period gives you the opportunity to cancel the Advantage plan and return to the Medicare supplement you previously had, if the same insurance company you previously had still sells it. You may do this for the first 12 months of having the Advantage plan, and you don’t have to wait for the Annual Enrollment Period to do it. This is a federally guaranteed right and is available to you one time only. See page 23 of this document.

  2. You can wait for the Annual Enrollment Period (AEP) (October 15-December 7) and switch back to Original Medicare and add a Prescription Drug Plan. You may also apply for a Medicare supplement, but you will be required to pass all the health questions and underwriting. Insurance companies have different underwriting guidelines, and some are more particular than others. If you are denied, you will be responsible for the charges not covered by Medicare.

    What happens if you leave your Advantage plan but don’t qualify for a Supplement? Well, in that case you need to review which Medicare Advantage plan suits you best, unless you’re willing to be exposed for the various charges and 20% Medicare doesn’t cover. I recommend starting by verifying that your doctors and medicines would be adequately covered! After that, you may get more picky about the extra benefits such as dental, vision, hearing, OTC benefits, gym membership, etc.

In the world of Medicare, what you may do and when you may do it all starts with having a valid Election Period*.

To that end, here are a couple more situations:

  1. If you enrolled in a Medicare Advantage plan during AEP because it sounded awesome…and have now learned it doesn’t work for you…so you want to make a change, you have one opportunity to do so during the Medicare Advantage Open Enrollment Period (OEP). OEP runs from January 1st - March 31st. During this period, you can switch to a different Medicare Advantage plan or drop your current Advantage plan and return to Original Medicare and add Part D plan.

  2. At any time of the year, you can switch from your current Medicare Advantage plan to an Advantage plan with a 5-star rating.

While I may be biased, I believe you would do yourself a favor to get the help of a seasoned broker. We’ve seen a lot and will help you avoid common pitfalls.

*a little light reading for you Medicare nerds: https://www.medicare.gov/basics/get-started-with-medicare/get-more-coverage/joining-a-plan/special-enrollment-periods