What To Do When Your Medicare Advantage Plan Drops You?

As we are approaching the start of the Annual Election Period (AEP), many people are getting letters in the mail from their Medicare Advantage plans containing coverage details for the following calendar year. Big changes are coming on some of the plans. However, others are getting a letter that can be even more ominous – a “Non-Renewal Action Notice”. This notice is required by Medicare when your Advantage plan is leaving the program altogether, not renewing their plans in your area, or making some other change that will end your coverage under that plan.

While this can be unsettling to some, there are protections in place, and you do still have options. Read on to learn more about what to do when your Medicare Advantage drops you.

What Type of Plan Can You Get When Your Medicare Advantage Non-Renews?

When your Medicare Advantage plan drops you, you have two options for coverage moving forward. We’ve detailed both of those options below:

A New Medicare Advantage Plan: One option that you have when your Medicare Advantage plan non-renews is to choose a new Medicare Advantage plan that IS going to be offered in your county for the following calendar year. You can do this during the annual election period (October 15-December 7) and it would take effect on January 1 of the following year. The transition would be seamless in that the current plan will cover you through the end of the calendar year, and the new plan would start on 1/1. 

It is very important, when considering/comparing Advantage plans, that you do your due diligence to make sure that the plan you are choosing is accepted by your doctors, covers your medications and just altogether meets your medical coverage needs. There are many variables to consider when comparing this type of plan.

Return to “Original” Medicare with a Medigap Plan: The 2nd option that you have when your Medicare Advantage plan non-renews is to return to “original” Medicare (Part A – hospital coverage; Part B – doctor/outpatient coverage) and add a Medigap plan, sometimes called a Medicare Supplement. Medicare gives you a mandated “guaranteed issue” right into certain Medigap plans, when your Medicare Advantage drops you through no fault of your own. So, many Medicare beneficiaries take the opportunity, when dropped by their Advantage plan, to get the comprehensive Medigap coverage that they may have not otherwise qualified for. 

Normally, to switch from an Advantage plan to a Medigap plan, you would have to go through medical underwriting and get approved. However, this is one of the few instances that would allow you to make this change with no medical underwriting or restrictions. Medigap plans pay the 20% that Medicare does not cover, and the most comprehensive Medigap plans (Plan F and Plan G) essentially pay all of your medical costs with no co-pays or out of pocket (with the exception of the Medicare Part B deductible of $240/year on the Plan G). Moreover, the Medigap plans do not ever non-renew and don’t change from year to year. They also do not have networks so you can go anywhere in the country that accepts Medicare. 

How Do You Get Another Plan After Your Medicare Advantage Plan Drops You?

So, if your Medicare Advantage drops you for 2025, you have options to get another plan. Here are a few tips:

• You should save all documentation that comes to you via mail regarding your plan’s changes, as you may need it to prove your eligibility for another plan.
• Make sure you read any documentation carefully and observe all deadlines and requirements.
• When choosing a new Advantage plan, make sure that the Advantage plan is accepted by your doctors/hospital. Also, make sure that your medications are covered under it and review any restrictions on coverage. 
• If choosing a Medigap plan, the plans are standardized (same coverage with every company) so you should compare the rates and pick the one with the best rates and ratings. A Medigap broker can provide you with a list of all the options. 

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65Medicare.org is a leading, independent Medicare insurance agency for people turning 65 and going on Medicare. If you have any questions about this information, you can contact us online or call us at 877.506.3378.