Options for those who enrolled in a Medicare Advantage Plan by mistake or because of misleading information

Changing Medicare coverage

If you enrolled in a Medicare Advantage Plan or Part D plan by mistake or after receiving misleading information, you may be able to disenroll and change plans. Typically, you have the right to change plans if you:

  • Joined unintentionally: You may have enrolled believing you were joining a Medigap plan to supplement Original Medicare. Or, you meant to sign up for a stand-alone Part D plan and accidentally joined Medicare Advantage
  • Joined based on incorrect or misleading information: You may have been misled for example if a plan representative told you that your doctors are in the plan’s network but they are not, or you were promised benefits that the plan does not really cover.
  • Through no fault of your own, ended up or were kept in a plan you do not want: If you tried to switch plans during an enrollment period but were kept in your old plan. You can also make a change if you were enrolled in a plan because of an administrative or computer error.

Your disenrollment steps process depends on whether or not you have used services.

  • If you used any service since joining the plan (for example, saw a doctor or filled a prescription) and received a denial of coverage, you should request retroactive disenrollment, meaning disenrollment back to the date you enrolled in the plan. Depending on your situation, you may then wish to select Original Medicare (with or without a Part D plan) or a different Medicare Advantage Plan. If you are granted retroactive disenrollment, be sure to ask your providers to re-file claims with your new plan.
  • If you have not used any services since joining the plan, you may want to request a Special Enrollment Period (SEP) to disenroll from your plan. This option may be processed faster than retroactive disenrollment. If your request is granted, you will be disenrolled from your plan at the end of the month in which you made the request. To prevent gaps in coverage, sign up for new coverage immediately after you are disenrolled from the plan you did not want.

To request retroactive disenrollment or an SEP, call 1-800-MEDICARE and explain to the customer service representative exactly how you joined the plan by mistake.