What must a member do if they want to remain in a MA-only plan after enrolling in a stand-alone PDP?

To remain in a Medicare Advantage (MA) plan after enrolling in a stand-alone Prescription Drug Plan (PDP), a member must disenroll from the MA-only plan. This is because Medicare regulations stipulate that an individual cannot be enrolled in both an MA-only plan and a stand-alone PDP simultaneously.

When a member enrolls in a stand-alone PDP, it indicates an intention to receive their Medicare coverage through a different structure that includes prescription drug coverage through the stand-alone plan rather than through the MA plan. This situation leads to the rule where the MA plan must be canceled in order to prevent overlap and potential confusion regarding coverage. Therefore, to comply with Medicare rules and ensure that the member is correctly enrolled in the suitable plan, disenrollment from the MA-only plan is necessary.

If the member wishes to keep their Medicare Advantage benefits while also having drug coverage, they would typically switch to a Medicare Advantage plan that includes drug coverage (MA-PD) instead. This ensures that they have both medical and prescription drug coverage properly coordinated under one plan.