HELP I've lost my Plan C, it's not offered anymore!!

WHAT TO DO WHEN YOUR PLAN IS TERMINATED                                                      


Advice for a Medicare Advantage C Plan TERMINATION.

The plan terminations can be initiated by Medicare (CMS), State Insurance Departments, or the Plan Provider company. Each year, private Medicare insurance plans and CMS evaluate their ability to effectively provide Medicare insurance. As the Medicare rules change from time to time, private Medicare insurance companies have to make decisions about whether to continue to offer the same insurance plans or terminate plans. Private Medicare Provider plan carriers can simply made the decision to terminate their Medicare Advantage plan for business profitability reasons. The plans have a year to year contract, so the terminations are on Jan 1st thus allowing a member to switch during the usual AEP. Because of a plan closing any other time of year, you will need to enroll in a new plan during your enrollment special election period (SEP). If your plan has been unexpectedly shut-down, Medicare will assign you a SEP to enable you re-enroll in a new Advantage Plan or go-back to your Medicare A & B, buy a Med-Sup (Supplement), and enroll in a Part D. Your goal is to enroll in similar plan-type coverage with the ability to see the same physicians, specialist, go to the same hospitals, and get the same medications.  

When enrolled in a Medicare Advantage plan that has been cancelled for next year or any time, the member will receive information in the mail from his or her Medicare insurance carrier with instructions regarding his or her options. Generally, the Original Medicare plan A&B with a Medigap Supplement with a Part D or another company's Medicare Advantage C plan may provide the Medicare member with the closest experience to the lost plan. The plan member is not required to remain with the same carrier if his or her plan was cancelled. The member may select a plan offered by the same insurance carrier or pick a new plan from a different insurance carrier in the area. The most careful considerations to the new plan's Details of Coverage and Summary of Benefits is needed. 

TYPICALLY, WHAT TO REMEMBER : PLAN THE PROVIDER MUST NOTIFY YOU, THEN YOU ARE GIVEN A SPECIAL ELECTION PERIOD (SEP).  YOUR SEP CHANGE PERIOD IS 2 MONTHS BEFORE AND ENDS 1 MONTH AFTER YOUR PLAN'S CONTRACT ENDS. IT'S BEST TO HAVE A NEW PLAN COVERAGE DATE EFFECTIVE THE SAME DATE AS YOUR PREVIOUS PLAN'S CLOSING. SO HAVE YOUR NEW PLAN ALREADY SIGNED AND IN PLACE PRIOR TO THE OLD PLAN CLOSING. 





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