Medicare Advantage (Part C)
Help! My Doctor Left My Medicare Advantage Plan’s Network
Dear AMAC,
I enrolled into a new Medicare Advantage plan a couple months ago, but I just found out my doctor is dropping out of the network. Funny enough, he will be in the plan I had before, but I fear I am too late to switch back. Do you have any advice on what I can do?
-Sally (Bohemia, NY)
Hello Sally,
I am sorry to hear that your doctor no longer participates in your plan’s network, but I do have some good news- It is not too late to go back to your previous Medicare Advantage Plan! The Medicare Advantage Open Enrollment Period (which will allow you to make this change) is happening right now, but there are some important pieces of information you must know about this enrollment period.
The Medicare Advantage Open Enrollment Period (MA OEP) runs from January 1st to March 31st each year, and this allows anyone who already has a Medicare Advantage plan to make a one-time change to their coverage if they are unhappy with it.
During the MA OEP you can do one of the following:
- Switch to a different Medicare Advantage plan (with or without drug coverage)
OR
- Drop your Advantage plan and go back to Original Medicare. If you drop your plan you can pick up a stand-alone prescription drug plan (Part D)
If you make a change during this time, your new coverage will begin on the first of the month following the month you enrolled. For example, let’s say on January 4th you enrolled into a different Medicare Advantage plan, then your new coverage will start February 1st and you will be automatically disenrolled from your current plan on January 31st.
Some people may use this as an opportunity to drop their Advantage plan and enroll into a Medicare Supplement plan (Medigap), however, keep in mind that the MA OEP does NOT guarantee your acceptance into a Medicare Supplement plan. In most cases, medical underwriting will still apply.
Note: Since you are in the state of New York, the rules are different. Medical underwriting does not apply since your state has year-round open enrollment for Medicare Supplement plans.
Thank you for taking the time to write to us Sally. Don’t forget you can also call us for any future Medicare-related questions; we are always happy to help!
For any Medicare related questions, contact AMAC’s Medicare Advisory Service at 1-855-611-4856.
