People Dropping 'Medicare Advantage' Urged to Analyze Options

WEDNESDAY, Jan. 5 (HealthDay News) — People enrolled in Medicare Advantage private health plans have until Feb. 14 to leave those plans, but a national consumer group urges a careful review of options before making any decision.

During what the Medicare agency calls the Medicare Advantage Disenrollment Period, people who leave a private plan can switch only to traditional Medicare coverage administered by the federal government.

“People with Medicare who become unhappy with their Medicare Advantage plan have one more opportunity to change their coverage before being locked in until next fall,” Joe Baker, president of the nonprofit Medicare Rights Center, said in a news release from the center. “Because the window is shorter than in past years, consumers should review their coverage options carefully and consider all of the implications of making a change before doing so.”

Traditional Medicare does not cover the full cost of care so many consumers who enroll in traditional Medicare buy supplementary coverage, called Medigap plans, to help pay out-of-pocket costs. However, people who switch from a Medicare Advantage plan to traditional Medicare may be limited in their ability to purchase supplemental coverage because of variations in state laws, according to the Medicare Rights Center.

The group advises consumers to call their State Health Insurance Assistance Program to find out if they can buy Medigap policies.

It also warns that some people who leave a private plan may have to join a stand-alone Medicare prescription drug plan to maintain drug coverage.

When choosing a drug coverage plan, the group says, people should consider:

  • Premium and co-payment costs
  • Whether medications they take are included on the plan’s list of covered drugs
  • Whether the plan has restrictions, such as quantity limits, prior authorization or step therapy

More information

The Medicare Rights Center has more about understanding Medicare.