What Are Trial Rights for Medicare Advantage?
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, your clients have a 12-month period to test out a Medicare Advantage plan. (With a Medicare Supplement free look period, your client has 30 days to make a decision of whether they’d like to keep their new policy or not.) If they like it, great, they can keep it! If they have buyer’s remorse, they can switch back to Original Medicare and either return to their former Medicare Supplement (if they had one) or pick up a new Medicare Supplement. Permissible actions vary based on client-specific situations and state-specific regulations. (Some states extend the Medicare Advantage trial right period or offer additional Medicare Supplement guaranteed issue rights.)
Essentially, your clients have a 12-month period to test out a Medicare Advantage plan.
Who Has a Medicare Advantage Trial Right?
Two types of beneficiaries qualify for trial rights for Medicare Advantage. Let’s explore them below.
1. MA Clients (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.
Example: Denise enrolls in a Medicare Advantage plan when she turns 65. Her coverage has an effective date of June 1. Her trial period will end on May 30 of the following year.
When using this trial right, you may pick up a prescription drug plan and any Medicare Supplement available to them in their area without having to pass underwriting. However, they must apply for Medicare Supplement coverage no earlier than 60 calendar days before, and no later than 63 days after, the date their Medicare Advantage coverage ends.
2. Med Supplement Beneficiaries 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 would like to return to their previous plan (and Original Medicare), you can do so if their Medicare Advantage effective date is less than 12 months ago.
Example: Bob decided to leave his Medicare Supplement, prescription drug plan, and Original Medicare for a Medicare Advantage Prescription Drug plan during the Annual Enrollment Period. His new coverage has an effective date of January 1. His trial period will end on December 31 of the following year.
In this case, you will only have the right to rejoin the Medicare Supplement plan you had before the switch. If the 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 the 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.
Questions about the Medicare Advantage Trial Rights? Contact your Total Benefit Solutions account manager today at (215)355-2121