If you’ve just learned that your Medicare Advantage (MA) plan will no longer be available, you may be feeling uncertain or even a little overwhelmed. The good news is you are not left without coverage. Medicare provides important protections and special rights to ensure you continue to have access to the healthcare you need.
Why Do Medicare Advantage Plans Terminate?
Medicare Advantage plans may leave the market or discontinue for several reasons:
- Insurance companies decide not to renew contracts in certain areas.
- Plans consolidate or merge with other offerings.
- The Centers for Medicare & Medicaid Services (CMS) may choose not to renew a plan’s contract.
While this situation is not common, it does happen, and knowing your rights is key.
What Are Your Rights if Your Plan Terminates?
When your Medicare Advantage plan is discontinued, you gain access to a Special Enrollment Period (SEP). This SEP allows you to:
- Enroll in another Medicare Advantage plan available in your area.
- Return to Original Medicare (Parts A & B) and, if desired, add a standalone Part D drug plan.
- Purchase a Medigap (Medicare Supplement) policy in many cases, with guaranteed issue rights.
When Does the SEP Begin and End?
If your plan terminates on January 1, your SEP is as follows:
- Start Date: December 8 (the day after the Annual Enrollment Period ends).
- End Date: The last day of February (two full months after your plan terminates).
This gives you nearly three months to carefully review your options and make a decision. However, the earlier you act, the smoother your transition will be.
Guaranteed Issue Rights for Medigap
One of the most important protections you may have is a guaranteed issue right. This means you can purchase a Medigap (Medicare Supplement) plan without medical underwriting, regardless of your health history. To use this right:
- You must apply within 63 days of losing your Medicare Advantage coverage.
- Not all Medigap plans may be available, but several standard options must be offered to you.
This protection ensures that you won’t be denied coverage because of preexisting conditions.
Key Takeaways
- Don’t panic — you will not be left without Medicare coverage.
- Your SEP begins December 8 and ends the last day of February if your plan ends on January 1.
- You have the flexibility to join another MA plan, return to Original Medicare, or apply for a Medigap plan with guaranteed rights.
- Act quickly to avoid gaps in coverage and to give yourself the best choice of options.
Need Help Navigating Your Options?
At Healthcare American, we specialize in guiding clients through transitions like this. We’ll review your coverage, explain your rights, and help you select the plan that best meets your needs for 2025 and beyond.
📞 Call us today at 443-929-0433 for a free, no-obligation consultation.
👉 Ready to explore your Medicare options? Contact us today for a free consultation.