Yes. The Centers for Medicare and Medicaid Services (CMS) provides a
Special Enrollment Period (SEP) for people who left their Medicare Supplement (Medigap plan) -- joined a Medicare Advantage plan for the first time -- and within the first 12 months these people wish to leave the new Medicare Advantage plan and return to their original Medicare Supplement.
Medicare beneficiaries will use the SEP to leave their Medicare Advantage plan and return to their Medicare Supplement (or an equivalent Medigap plan if the original Med Supp is no longer available).
CMS also provides a corresponding Special Enrollment Period (SEP) to join a stand-alone Medicare Part D prescription drug plan (PDP) - but only when leaving a Medicare Advantage MAPD during the 12-month trial period.
Important: A similar "
trial right" Special Enrollment Period is also available for people who enrolled in a Medicare Advantage when they were first eligible for Medicare and during the first 12 months, they wish to leave the Medicare Advantage plan, return to Original Medicare and join a Medicare Supplement - explained in more detail below.
Where can we find this Special Enrollment Period?
The Special Enrollment Period is defined in Chapter 2 of the Medicare Managed Care Manual
"Medicare Advantage Enrollment and Disenrollment":
"For Medicare beneficiaries who terminated a Medigap policy when they enrolled for the first time in
an MA plan, §1882(s)(3)(B)(v) of the Act provides a guaranteed right to purchase another Medigap
policy if they disenroll from the MA plan while they are still in a “trial period.” In most cases, a trial
period lasts for 12 months after a person enrolls in an MA plan for the first time.
This SEP is for individuals who are eligible for “guaranteed issue” of a Medigap policy under
§1882(s)(3)(B)(v) of the Act upon disenrollment from the MA plan in which they are enrolled. This
SEP allows a qualified individual to make a one-time election to disenroll from their first MA plan to
join Original Medicare at any time of the year. The SEP begins upon enrollment in the MA plan and
ends after 12 months of enrollment or when the beneficiary disenrolls from the MA plan, whichever is
earlier."
Medicare Managed Care Manual, Chapter 2 - Medicare
Advantage Enrollment and Disenrollment, Section 30.4.4- SEPs for
Exceptional Conditions, 6. SEP for Individuals Who Dropped a Medigap
Policy When They Enrolled
For the First Time in an MA Plan, and Who Are Still in a “Trial Period”,
42 CFR 422.62(b)(4) (Rev. 1, Issued: July 31, 2018;
Effective/Implementation: 01-01-2019) (Updated: August 19, 2011
(Revised: November 16, 2011, August 7, 2012, August 30, 2013, August 14,
2014, July 6, 2015, September 1, 2015, September 14, 2015, December 30,
2015, May 27, 2016, August 25, 2016, June 15, 2017, July 31,
2018 & August 12, 2020))
*The last sentence in Section 1851(e)(4) of the Social Security Act, "Special Election Periods" notes:
"Effective as of January 1, 2006, an individual who, upon first becoming eligible for benefits under part A at age 65, enrolls in a Medicare+Choice [Medicare Advantage] plan under this part, the individual may discontinue the election of such plan, and elect coverage under the original fee-for-service plan, at any time during the 12–month period beginning on the effective date of such enrollment."
(https://www.ssa.gov/OP_Home/ssact/title18/1851.htm)
More about the two "trial rights" allowing a person to leave a
Medicare Advantage plan and join (or return to) a Medicare Supplement
CMS provides two Medicare Advantage plan "trial periods" allowing a
Medicare beneficiary
to return to a Medicare Supplement policy with guaranteed issue rights (no medical underwriting) - and, depending on where you live, your state may provide additional guaranteed issue rights for joining a
Medicare Supplement (for example, California, Connecticut, Massachusetts, Maine, and New York may provide Medicare beneficiaries additional rights).
Trial Right #1 -
You join a Medicare Advantage plan when you are first eligible for Medicare and within the first 12 months, you wish to leave the Medicare Advantage plan, return to Original Medicare and join a Medicare Supplement.
If you joined a Medicare Advantage plan (
MA or MAPD) when you were first eligible for Medicare (you turned 65) and within
12 months
of joining the Medicare Advantage plan (your trial period), you decide
to leave the Medicare Advantage plan, you are provided a guaranteed
issue right to join any Medicare Supplement that is available in your
state.
As noted by the Centers for Medicare and Medicaid Services (CMS):
"[If
y]ou joined a Medicare
Advantage Plan or Program of
All‑inclusive Care for the Elderly
(PACE) when you were first eligible
for Medicare Part A at 65, and
within the first year of joining,
you decide you want to switch to
Original Medicare - You have
the right to buy [a]ny Medigap policy that's sold in your state by any
insurance company.*
You can/must apply for a
Medigap policy [a]s early as 60 calendar days before
the date your coverage will end,
but no later than 63 calendar days
after your coverage ends.
Note: Your rights may last
for an extra 12 months
under certain circumstances."
If you are outside of this 12 month "trial period", you may be subject
to medical underwriting (again, some states provide for more generous
"guaranteed issue" rights).
Trial Right #2 -
You left your Medicare Supplement and joined a
Medicare Advantage plan and within 12 months decide to leave your
Medicare Advantage plan and return to your Medigap plan.
If you were enrolled in a Medicare Supplement and leave your
Medicare Supplement to join a Medicare Advantage plan, you will be
granted a Special Enrollment Period to return to your Medigap plan (or
other plan if no longer available) within the first 12 months of
Medicare Advantage plan enrollment.
CMS allows the "trial period" if:
"[y]ou
dropped a Medigap [or Medicare Supplement] policy to join a Medicare
Advantage Plan (or to switch to a Medicare SELECT policy) for the first
time, you’ve been in the plan less than a year, and you want to switch
back - you have the right to buy [t]he Medigap policy you had before you
joined the Medicare Advantage Plan or Medicare SELECT policy, if the
same insurance company you had before still sells it."
If your former Medigap policy isn’t available, you can buy Medigap Plan A, B, C*, D*, F*, G*, K, or L that’s sold in your state by any insurance company.
If your former Medicare Supplement is no longer in existence, you will
be permitted to join Medicare Supplement Plan A, B, C, F, K, or L "that’s sold in your state by any insurance company".
(Remember that
Medigap Plan C and Plan F will
no longer be accepting enrollments starting in 2020.)
You can/must apply for a
Medigap policy [a]s early as 60 calendar days before
the date your coverage will end,
but no later than 63 calendar days
after your coverage ends.
Note: Your rights may last
for an extra 12 months
under certain circumstances."
*Note: Plans C and F are no longer available to people new to Medicare on or after January 1, 2020. However,
if you were eligible for Medicare before January 1, 2020 but not yet enrolled, you may be able to buy Plan C or
Plan F. People new to Medicare on or after January 1, 2020 have the right to buy Plans D and G instead of Plans
C and F.
(Source: Choosing a Medigap Policy: A Guide to Health Insurance for
People with Medicare, Centers for Medicare and Medicaid Services, https://www.medicare.gov/Pubs/pdf/02110-medicare-medigap-guide.pdf;
https://www.medicare.gov/media/9486)
Corresponding Special Enrollment Period (SEP) to join a stand-alone Medicare Part D prescription drug plan (PDP) when leaving a Medicare Advantage MAPD during Trial Right #2.
Medicare
also provides a corresponding Medicare Part D Special Enrollment Period
(SEP) for people leaving a Medicare Advantage plan that includes drug
coverage (MAPD) during the 12-month “trial” period to also join a
stand-alone Medicare Part D prescription drug plan as the re-join their
previous Medicare Supplement.
From the CMS Medicare Part D plan Enrollment/Disenrollment Guidance:
Section 8. Part D SEPs to Coordinate With MA Enrollment Periods
“The following Part D SEPs are established to coordinate with election periods in the MA program. More information about MA election periods can be found in MA Enrollment and Disenrollment Guidance (MMCM Chapter 2) [cited above].”
. . .
B. SEP for Individuals Who Terminated a Medigap Policy When They Enrolled For the First Time in an MA Plan, and Who Are Still in a “Trial Period” 42 CFR 423.38(c)(24)
“Individuals who terminated a Medigap policy when they enrolled for the first time in an MA plan are provided a guaranteed right to purchase another Medigap policy if they disenroll from the MA plan while they are still in a “trial period" [Trial RIght #2].
In most cases, a trial period lasts for 12 months after a person enrolls in an MA plan for the first time. If the individual is using this [trial right] SEP to disenroll from an MA-PD plan, there is a Part D SEP to permit a one-time enrollment into a PDP. This [PDP] SEP opportunity may only be used in relation to the MA SEP described here and begins the month they disenroll from the MA-PD plan and continues for two additional months.” [formatting added]
Medicare Prescription Drug Benefit Manual, Chapter 3 - Eligibility, Enrollment and Disenrollment, Updated: August 19, 2011 (Revised: November 16, 2011, August 7, 2012, August 30, 2013, August 30, 2014, July 6, 2015, September 1, 2015, September 14, 2015, December 30, 2015,May 27, 2016, August 25, 2016, June 15, 2017, July 31, 2018 & August 12, 2020)