What Are Trial Rights for Medicare Advantage?
If you enrolled in a Medicare Advantage plan but want to go (back) to Original Medicare, you may qualify for a Medicare Advantage trial right! This would allow you to update their coverage outside of the Annual Enrollment Period.
Medicare Advantage trial rights work similarly to Medicare Supplement free look period rights, but they have different qualifying criteria and a longer time frame associated with them. Essentially, you have a 12-month period to test out a Medicare Advantage plan. (With a Medicare Supplement free look period, you have 30 days to make a decision of whether you’d like to keep your new policy or not.) If you like it, great, you can keep it! If you have buyer’s remorse, you can switch back to Original Medicare and either return to your former Medicare Supplement (if you had one) or pick up a new Medicare Supplement. Permissible actions vary based on your specific situation and state-specific regulations. (Some states extend the Medicare Advantage trial right period or offer additional Medicare Supplement guaranteed issue rights.)
Who Has a Medicare Advantage Trial Right?
Two types of Medicare beneficiaries qualify for trial rights for Medicare Advantage.
1. MA members (or PACE members) who Enrolled Upon Turning 65 & Less Than 12 Months Ago
If you enrolled in a Medicare Advantage plan upon joining Medicare Part A at age 65, you may switch to Original Medicare as long as you do so within a 12-month period.
When using this trial right, you may pick up a prescription drug plan and any Medicare Supplement plan available to you in your area without having to pass underwriting. However, you must apply for Medicare Supplement coverage no earlier than 60 calendar days before, and no later than 63 days after, the date your Medicare Advantage coverage ends.
2. Med Supp Clients Who Switched to MA (or Medicare SELECT) for the First Time Less Than 12 Months Ago
What if you joined a Medicare Supplement plan when you became eligible for Medicare, then decided to try out a Medicare Advantage Prescription Drug plan? If you’d like to return to your previous plan (and Original Medicare), you can do so if your Medicare Advantage effective date is less than 12 months ago.
In this case, you will only have the right to rejoin the Medicare Supplement plan you had before the switch. If your previous Medicare Supplement plan is no longer offered (i.e., the insurance company no longer sells it), you may buy a guaranteed issue plan sold by a different company in your state. You must apply for Medicare Supplement coverage no earlier than 60 calendar days before the date your Medicare Advantage coverage will end and no later than 63 days after that date. You can also pick up a stand-alone prescription drug plan.
How Are MA Trial Rights Different Than the MA OEP?
Generally speaking, Medicare Advantage trial rights are for clients who enrolled in a Medicare Advantage plan for the first time ever less than 12 months ago. (Remember, your state may provide additional rights.) Like trial rights, the Medicare Advantage Open Enrollment Period (“OEP”) helps people who have recently enrolled in a Medicare Advantage plan switch their coverage if they’re dissatisfied with it. Here’s how the MA OEP works differently than the trial rights:
- The MA OEP allows beneficiaries who join Medicare Advantage upon becoming eligible for Medicare a period of three months after their Part A and B entitlement to switch their coverage.
- The MA OEP also allows beneficiaries who enroll in a Medicare Advantage plan during AEP (plan effective date of January 1) a three-month period (January 1 to March 31) to switch their coverage.
- Clients who qualify for the MA OEP can switch MA plans, switch back to Original Medicare, or pick up or drop Part D coverage. (Trial rights don’t allow Medicare Advantage clients to switch Medicare Advantage plans, only switch back to Original Medicare.)
- Additionally, the MA OEP is not available to those who enroll in Medicare Medical Savings Accounts (“MSA”) or other Medicare health plan types, such as cost plans or PACE. (Medicare trial rights apply to MSA plans or PACE members.)
Please note beneficiaries who use the Medicare Advantage Open Enrollment Period will be subject to underwriting for a Medicare Supplement if they do not have a guaranteed issue right. You can read more about the Medicare Advantage Open Enrollment Period here
What If I Already Used My Trial Right?
If you have already used your Medicare Advantage trial right, you will have to wait until the Annual Enrollment Period, the Medicare Advantage Open Enrollment Period (if you qualify), or another Special Enrollment Period that allows you to make changes to your coverage.
How Can I Disenroll from My Plan?
You can leave your Medicare Advantage plan by submitting a request to your plan or calling 1-800-MEDICARE (1-800-633-4227).
The one-year Medicare Advantage trial period is an important right that many Medicare beneficiaries likely don’t know exists. Now that you know more about it, we hope you feel more prepared to make coverage changes that provide better coverage for your specific circumstances!