What are Medicare Advantage Trial Rights?
Published: 04.30.2024
If you have clients who are interested in testing out a Medicare Advantage (MA) plan before fully making a long-term commitment to it, a trial right may be the answer.
How do Medicare Advantage Trial Rights work?
Your clients get 12 months to see if a Medicare Advantage plan is the right choice for them. If they like it, they can stay with it. If they are dissatisfied, they can switch back to Original Medicare and return to their former Medicare Supplement plan (if they were enrolled in one) or purchase a new Medicare Supplement plan, also known as Medigap.
Who qualifies for a Medicare Advantage Trial Right?
There are two situations in which your clients can qualify for a Medicare Advantage Trial Right.
- Clients who enrolled in a Medicare Advantage plan when they were first eligible for Medicare Part A upon turning 65, and who did so less than 12 months ago.
Your client may also enroll in a prescription drug plan and any Medicare Supplement plan available in their area without undergoing underwriting (subject to State/Carrier guidelines). However, they must apply for Medicare Supplement, as well as a prescription drug plan, no earlier than 60 calendar days before, and no later than 63 days after, the date their Medicare Advantage coverage ends.
- Clients who dropped a Medicare Supplement plan and joined a Medicare Advantage plan for the first time less than 12 months ago.
Just like the first trial right, your clients must apply for Medicare Supplement coverage and a prescription drug plan no earlier than 60 calendar days before, and no later than 63 days after, the date their Medicare Advantage coverage ends.
What happens when a client has already used their Trial Right?
If a client has already used their Medicare Advantage Trial Right, they will have to wait until the Annual Enrollment Period (Oct. 15 – Dec. 7), the Medicare Advantage Open Enrollment Period (if they qualify), or another qualifying Special Enrollment Period before they can make changes to their coverage. In this instance, if they would like to change their supplement coverage, they may be subject to medical underwriting.
How can I help my client disenroll from their plan and make sure they are satisfied with their options?
If your client is using the Medicare Advantage Trial Right, they should be choosing/applying for a Prescription Drug plan. This will cause an automatic disenrollment for their MAPD plan. If you have any questions, our team of experts and dedicated in-house contact center are ready to assist you and your Medicare clients.
