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Patrick joined a MAPD in December during Annual Enrollment. It is January 8th and he is not happy with his plan and no longer wants to be enrolled in it. Can he disenroll at this time and how long does he have to drop his plan? Will he get a Part D penalty if he does this?

1 Answer

5 votes

Final Answer:

No, Patrick cannot disenroll from his MAPD plan at this time, as the Annual Enrollment Period (AEP) has ended. However, he may qualify for a Special Enrollment Period (SEP) under certain circumstances, allowing him to make changes to his plan. If he qualifies for an SEP, Patrick can drop his plan within the specified timeframe without incurring a Part D penalty.

Step-by-step explanation:

During the Annual Enrollment Period (AEP), which typically runs from October 15 to December 7 each year, Medicare beneficiaries can join, switch, or drop their Medicare Advantage plans, including Medicare Advantage Prescription Drug (MAPD) plans. As Patrick joined in

December during AEP, he is bound by the choices made during that period unless he qualifies for a Special Enrollment Period (SEP). SEPs are triggered by life events such as moving, losing other health coverage, or becoming eligible for Medicaid. If Patrick experiences such an event, he may be eligible for an SEP, allowing him to disenroll from his current MAPD plan and select a new one.

If Patrick qualifies for an SEP, the timing of his disenrollment matters. Generally, he has two full months from the date of the qualifying event to make changes to his plan. If he uses this window, he can drop his MAPD plan without incurring a Part D penalty.

However, if he misses this timeframe and decides to drop his plan later, he may be subject to the Part D late enrollment penalty unless he qualifies for an exception, such as having creditable prescription drug coverage elsewhere. It is essential for Patrick to be aware of the specific circumstances that trigger an SEP and the associated timelines to avoid penalties and make informed decisions about his Medicare coverage.

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