What occurs when a member of a Medicare Advantage (MA) Plan enrolls in a Medicare Supplement Insurance Plan?

When a member of a Medicare Advantage Plan chooses to enroll in a Medicare Supplement Insurance Plan, they are automatically disenrolled from the Medicare Advantage Plan. This is because Medicare Supplement Insurance, also known as Medigap, is designed to fill in the gaps of Original Medicare (Parts A and B) and cannot be used in conjunction with Medicare Advantage. The rules set by Medicare specify that if an individual enrolls in a Medigap policy, it implies that they are opting out of the managed care structure provided by the Medicare Advantage Plan.

The process ensures that beneficiaries are not duplicating coverage, as Medicare Supplement plans are structured to supplement Original Medicare benefits directly rather than those provided through an MA Plan. Enrolling in one means effectively relinquishing the benefits and structure of the other, leading to automatic disenrollment from the MA Plan.

Thus, the automatic disenrollment is a necessary administrative step to prevent coverage conflicts and ensure that members are aligned with the type of healthcare coverage suitable for their needs.