Did Your Health Plan Terminate in December? You Have Rights to New Coverage Before 2/29/16

Did Your Health Plan Terminate in December? You Have Rights to New Coverage Before 2/29/16

If your MA plan terminated at the end of last year, you have the right — regardless of age or health condition — to join another MA plan if one is available where you live, or to return to Original Medicare and join a Part D plan. Your Special Election Period (SEP) started December 8, 2015 and goes through the end of February 2016.

Note that this SEP gives you another chance to enroll in an MA or Part D plan in addition to the Annual Election Period, also known as Open Enrollment, that runs each year from October 15 through December 7. If you switch to a new MA plan, make sure your doctor, the medical group that provides your care and your local hospital are all in the new MA plan network. If you find you need to switch doctors, make sure the doctor you choose is taking new patients.

If you return to Original Medicare, you also have the guaranteed-issue right to buy a standardized Medicare supplement policy, also known as Medigap. You may apply for a guaranteed issue Medigap policy through May 2, 2016. Your choice of plans include Medigap plans A, B, C, F (as well as Plan F with the high deductible), K, L, M or N.

Insurance companies must let you buy 1 of these 8 standardized Medigap plans regardless of your health condition, unless you are younger than 65 and have end-stage renal disease (ESRD).

Because you have a guaranteed-issue right to buy 1 of these 8 Medigap policies, companies selling the policies cannot impose a waiting period before covering your pre-existing health conditions or charge you a higher premium than what is paid by other people your age. Some companies that sell both MA plans and Medigap policies may offer you the right to enroll in their Medigap policy, but if your MA plan stops providing benefits in your area, you may choose any Medigap policy. Learn more about guaranteed-issue periods.

If you return to Original Medicare, you may enroll into a Part D Prescription Drug Plan (PDP) for your drug coverage. Learn more about California’s 2016 plans in our prescription drugs section.

If you have any questions or would like assistance in reviewing your coverage options, contact your local Health Insurance Counseling and Advocacy Program (HICAP) at 1-800-434-0222.

Our blogger Karen J. Fletcher is CHA's publications consultant. She provides technical expertise, writing and research on Medicare, health disparities and other health care issues. With a Masters in Public Health from UC Berkeley, she serves in health advocacy as a trainer and consultant. See her current articles.