People who began 2022 enrolled in a Medicare Advantage (MA) plan have an additional opportunity to switch MA plans or disenroll from an MA plan and enroll in traditional Medicare with a Part D plan during the first 3 months of the calendar year, ending on March 31st. Note that this enrollment opportunity, called the Medicare Advantage Open Enrollment Period (MA-OEP), is not available to individuals who are in traditional Medicare and enrolled in a stand-alone Part D plan.
In addition, there are certain rights to use a Special Enrollment Period (SEP) to change or get out of a private Medicare plan in certain circumstances. There are a number of SEPs, including when someone receives inaccurate or misleading information from the Medicare Plan Finder, customer service representatives at 1-800-MEDICARE, or an MA or Part D plan (or its agents). For a full list of available SEPs, see, e.g., for MA SEPs: Medicare Managed Care Manual, Chapter 2 (2021 update available here) and Title 42, Code of Federal Regulations §422.62(b); for Part D SEPs see Medicare Prescription Drug Manual, Chapter 3 (2021 update available here) and Title 42, Code of Federal Regulations §423.38.
As discussed in a previous CMA Alert and an October 2021 Special Report on the Medicare annual enrollment period, there is unequal access to different coverage options in Medicare and Medicare Advantage, and there are flaws in several means of comparing such options (including the MA quality star ratings, discussed elsewhere in this weekly CMA Alert).
January 6, 2022 – D. Lipschutz