);

Medicare Advantage Disenrollment Period (MADP) Explained

Written by ryankimble



January 3, 2011

Now that the Annual Election Period (AEP) is behind us, it’s time to focus on 2011. Unlike the last few years, the Open Enrollment Period (OEP) will not be available. For 2011, the OEP has been replaced by the Medicare Advantage Disenrollment Period (MADP).

The MADP runs from January 1 – February 14^th. It’s the period of time when Medicare Advantage enrollees can dis-enroll from their current Medicare Advantage plans and return to original Medicare. They will be able to enroll into a new Medicare Part D (PDP) plan regardless if they had a stand alone Medicare Advantage (MA) plan or an integrated Medicare Advantage Prescription Drug (MAPD) plan.

Here is a link to CMS’s MADP Memo. It explains the MADP in detail.

Over the coming days, most companies will come out with agent guidelines on the MADP. Below is a pretty good summary from Universal American:

Explaining the Medicare Advantage Disenrollment Period, January 1 – February 14, 2011

Beginning on January 1, 2011, Medicare will initiate its new Medicare Advantage Disenrollment Period (MADP), which replaces the Open Enrollment Period (OEP) that previously began on January first of each year. MADP runs from January 1- February 14, 2011.

It is important for agents and members to understand that the purpose of MADP is to give Medicare Advantage members an opportunity to return to original Medicare. It is not an additional enrollment period nor is it an opportunity for Medicare Advantage members to Switch to different MA Plans.

During MADP:

People enrolled in a Medicare Advantage Prescription Drug Plan (MA-PD) may disenroll from the MA-PD and will have the opportunity to enroll in a standalone Prescription Drug Plan (PDP). VERY IMPORTANT: MA-PD members who enroll in a standalone PDP during this period will be automatically disenrolled from their current MA-PD and will not have the option of enrolling in another Medicare Advantage Plan.

Members who are in a Medicare Advantage only plan may request disenrollment from the MA plan and will then receive a Special Election Period (SEP) to enroll in a PDP standalone plan. The SEP is available from the time the disenrollment request is made until the member enrolls in a PDP or after February 14, whichever comes first.

Agents who enroll these individuals into a standalone PDP must write “SEP-MADP” on the “Other” line at the bottom of section 6 of the Community CCRx enrollment form. Be sure to also check the box.

Members who have both a standalone MA and a standalone PDP may disenroll from the MA plan, but may not make a change to their current standalone PDP.

Members who have a standalone PDP, but are not enrolled in an MA plan may not make any change to their current PDP plan and may not enroll in an MA plan.

People with Medicare who are not enrolled in any Part C Medicare Advantage plan have no options under MADP to make any change in their Medicare coverage.

Members who use the MADP to disenroll from their Medicare Advantage plans will have their disenrollment effective on the first day of the month following their disenrollment request. Those disenrolling from Medicare Advantage HMO, PPO or Network PFFS, must continue to use network providers until their disenrollment takes effect. Otherwise neither Medicare nor their MA plan will cover out-of-network expenses, other than under the terms of their existing MA plan.

Those who are leaving MA could chose to apply for a Medicare Supplement policy providing they qualify under the terms of the policy they wish to purchase.

The Medicare Advantage Disenrollment Period was created under the Affordable Care Act of 2010. CMS has released a memo explaining how the MADP works. Click here for the memo.