Vol. 14, Issue 24 – November 30 2015
What should I do if my Medicare Advantage Plan is ending at the end of this year? Dear Marci,

I received a notice from my Medicare Advantage Plan telling me that the plan is ending as of December 31, 2015. What should I do? How will I keep getting Medicare benefits?

– Frank (St. Cloud, MN)


Dear Frank,

Since your Medicare Advantage Plan is ending at the end of this year, you will need to make a few decisions.

First, you should decide if you want to switch to Original Medicare or choose another Medicare Advantage Plan. Depending on your choice, you have different options for enrolling.

Option 1: Switch to Original Medicare

If you decide you want to switch to Original Medicare, you will be automatically enrolled when your Medicare Advantage Plan ends. Your coverage will begin January 1, 2016. If you need prescription drug coverage, you will need to sign up for a stand-alone Part D plan. Choose a Part D plan by the end of 2015 to avoid potential gaps in coverage. The cut-off date for choosing a Part D plan is February 29, 2016.

If you switch to Original Medicare from your current plan, you may want to purchase a Medigap as well. Medigaps help pay for gaps in Original Medicare coverage. You will have special rights to purchase a Medigap policy because your Medicare Advantage Plan is ending; during this special enrollment period, plans cannot impose a waiting period for pre-existing conditions. Remember, you can only have a Medigap if you have Original Medicare. Contact your State Department of Insurance or State Health Insurance Assistance Program (SHIP) to learn more about the Medigap rules and regulations in your state.

Option 2: Choose Another Medicare Advantage Plan

If you decide to choose another Medicare Advantage Plan, it is best to sign up for a new plan during Fall Open Enrollment. If you choose a new plan by December 7 (the end of Fall Open Enrollment), it will take effect on January 1, 2016. If you choose a new plan outside of Fall Open Enrollment, you should sign up by February 29, 2016. The new plan will then take effect on the first of the month after you sign up. However, to avoid potential gaps in insurance coverage, you should choose a new Medicare Advantage Plan by December 7.

To pay the least for your health care costs, you should make sure that your doctors accept your new plan, and that the pharmacy you go to is a preferred pharmacy.

The main point is that although your plan is not being renewed next year, you have options, and if you take appropriate steps, you will not have any gaps in insurance coverage.


Health Tip
Adults 65 and older are at higher risk for complications related to the flu. It is estimated that in recent years, between 80 and 90 percent of flu-related deaths occurred in this age group. Because of the risks, the Centers for Disease Control (CDC) strongly recommends getting the flu vaccine as the first action step to staying healthy during flu season. Flu vaccines are usually available each year starting in October, and Medicare covers one flu shot per season. The CDC also urges people to visit the doctor if they feel they have developed flu-like symptoms, seeking treatment before a condition gets worse. Flu-like symptoms include fever, cough, sore throat, body aches, and fatigue. Preventive action is important for staying healthy during the winter. Click here to read more about the CDC’s flu prevention recommendations.
Need to Know
Fall Open Enrollment is here!During Fall Open Enrollment (October 15-December 7), you may make changes to your Medicare health and drug coverage. If you need help deciding your Medicare coverage for 2015, call the Medicare Rights Center’s free, national consumer helpline at 800-333-4114.

Dear Marci is a biweekly e-newsletter designed to keep you — people with Medicare, social workers, health care providers and other professionals — in the loop about health care benefits, rights and options for older Americans and people with disabilities.

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