What happens to a consumer enrolled in both a Medicare Supplement Insurance Plan and a PDP when they enroll in an HMO MAPD plan?

Disable ads (and more) with a membership for a one time $4.99 payment

Prepare for the United Healthcare Certification Exam. Use our resources to enhance your understanding with detailed questions and answers. Master the exam content with confidence!

When a consumer enrolls in a Health Maintenance Organization (HMO) Medicare Advantage Plan with Prescription Drug coverage (MAPD), they typically have to reconsider their existing coverage options. In this case, upon enrollment in the HMO MAPD plan, individuals will be automatically disenrolled from their stand-alone Prescription Drug Plan (PDP).

This is due to the fact that Medicare Advantage plans that include prescription drug coverage, like the HMO MAPD, provide comprehensive benefits that typically include all the coverage provided by both Medicare Parts A and B, along with prescription drug coverage. Since the MAPD takes over the role of the PDP, the previous prescription drug plan becomes unnecessary, leading to the automatic disenrollment from the PDP to prevent overlap or redundancy in coverage.

The other options suggest scenarios like keeping all plans unchanged or retaining certain coverages, but these wouldn't apply as enrolling in a MAPD inherently modifies the consumer's previous plan arrangements, particularly with regard to dedicated prescription drug coverage.