Additional Information: When Medicare Advantage Plans Terminate Coverage
Beneficiaries with Disabilities
Under California law, companies that sell Medigap policies are required to offer 1 of the 6 policies to people younger than 65 if their MA plan terminates coverage, unless they have end-stage renal disease (ESRD). Companies may, however, charge higher premiums than those charged to people age 65 and older.
Beneficiaries with End-Stage Renal Disease (ESRD)
If you have ESRD, you have the right to join another MA plan in your area if your current MA plan terminates coverage. However, you are not guaranteed the right to buy a Medigap policy.
If you develop ESRD while you are in an MA plan, you can continue your coverage in that MA plan. However, if you have ESRD and are not already enrolled in an MA plan, you generally cannot enroll in one. In addition, insurance companies are not required to sell you a Medigap policy when you go on Medicare if you are younger than 65. In this case, having Original fee-for-service Medicare may be your only option, unless you: 1) have low income and assets, and qualify for Medi-Cal; or 2) live in a county that offers an ESRD MA Demonstration Plan. See our fact sheet Medicare and People with End-Stage Renal Disease (ESRD) (PDF) for more information.
If you receive your MA plan benefits or supplemental insurance through a current or former employer, union or group, and your plan terminates coverage, contact a benefits representative to find out your options.
Do not disenroll from your MA plan until you have spoken to a representative. You may have options that are specific to your plan, and you may not be affected in the same way as individuals who are not in your employer or retirement group.
Updated Jan. 13, 2009