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What if Medicare Advantage doesn't work for you?

Getting ready to sign up for Medicare? Thinking about a Medicare Advantage plan but not sure that’s what you really want. What if something goes wrong? You need to know about the Medicare Advantage trial period, a test run for a Medicare Advantage plan. 

Medicare beneficiaries have a 12-month period to try out a Medicare Advantage plan. If they are dissatisfied, they can disenroll from (drop out of) the plan anytime during that period, prior to the one-year anniversary of the effective date. They can rejoin Original Medicare, and still have a guaranteed issue right to purchase a Medigap policy. The Medigap insurance company cannot deny you coverage, no matter your health status. 

Beneficiaries are eligible for this trial period in one of two situations: 

  • They joined a Medicare Advantage plan when first eligible for Medicare at age 65.

In October 2019, George Griffin turned 65 and elected a Medicare Advantage plan with coverage that took effect October 1. His trial period will run until September 30, 2020.

  • They signed up for Original Medicare with a Medigap policy but then switched to a Medicare Advantage plan. This trial right applies only to the first time they drop a Medigap policy to try out Medicare Advantage. There are limitations on the type of Medigap policy one can get when returning to Original Medicare.

George’s wife, Gayle, opted for Original Medicare at age 65 but then, at age 70, switched to a Medicare Advantage plan during Open Enrollment in 2019. That switch became effective January 1, 2020. Her trial period will end December 31, 2020. 

There are several ways to disenroll from a Medicare Advantage plan. Calling (800) MEDICARE or contacting the plan directly are probably the most frequently used.

What about beneficiaries who stayed with a Medicare Advantage plan for more than 12 months or already used the one trial period? They can switch to Original Medicare during the fall Open Enrollment Period or the January Medicare Advantage Open Enrollment Period. However, insurance companies offering a Medigap policy in most states can apply medical underwriting. The company can charge more, or delay or deny coverage. 

Individual states play an important role in switching coverage. A few states have more generous guaranteed issue rights. For example, beneficiaries in New York have a guaranteed issue right year round (called a continuous open enrollment period) to get a Medigap policy. However, there are specific times for dropping an Advantage plan—the Open Enrollment Period, October 15-December 7, and the Medicare Advantage Open Enrollment Period, January 1-March 31. 

Some states and insurance companies also offer. One example: Maine law extends the Medicare Advantage "trial period" from one year to three years.

Last updated: 01-27-2020