Rectifying Medicare Advantage Enrollment Errors: Know Your Options

By Brian Krantz - June 11, 2023

nyc medicare agent

Correcting Mistakes in Medicare Advantage Enrollment

Enrolling in a Medicare Advantage plan is a significant decision that affects your healthcare coverage. However, sometimes mistakes happen, or misleading information can lead to enrollment in a plan that doesn’t meet your needs. In this article, we’ll discuss the available options for those who have mistakenly enrolled in a Medicare Advantage plan or were misled during the enrollment process. Our goal is to provide guidance on how to rectify these situations and secure the right healthcare coverage for you.

Understanding the Issue: Mistaken or Misinformed Enrollment

Mistaken or misinformed enrollment in a Medicare Advantage plan can occur for various reasons, such as:

  • Misunderstanding plan details and coverage
  • Falling victim to misleading marketing tactics
  • Receiving incorrect information from a sales agent

Regardless of the cause, it’s essential to know your options for correcting the situation and ensuring you have the appropriate healthcare coverage.

Option 1: Utilize the Medicare Advantage Open Enrollment Period

The Medicare Advantage Open Enrollment Period (OEP) runs from January 1st to March 31st each year. During this time, you can:

  • Switch to a different Medicare Advantage plan
  • Disenroll from your current Medicare Advantage plan and return to Original Medicare

If you’ve mistakenly enrolled in a Medicare Advantage plan or received misleading information, the OEP offers an opportunity to correct the situation and choose a plan that better suits your needs.

Option 2: Request a Special Election Period

If the Medicare Advantage Open Enrollment Period isn’t an option, you may be eligible for a Special Election Period (SEP) based on your specific circumstances. If you can prove that you were misled during the enrollment process or that the plan you enrolled in doesn’t meet your needs, you may be granted an SEP to make changes to your Medicare coverage.

To request an SEP, contact the Social Security Administration, the Centers for Medicare & Medicaid Services (CMS), or your State Health Insurance Assistance Program (SHIP). They will guide you through the process and help determine your eligibility for an SEP based on your situation.

Option 3: File a Complaint

If you believe you were misled or provided with incorrect information during the Medicare Advantage enrollment process, you can file a complaint with CMS. This will initiate an investigation into your claim, and if your complaint is valid, you may be granted an opportunity to change your Medicare coverage.

To file a complaint, visit the website or call 1-800-MEDICARE (1-800-633-4227).

Know Your Options and Take Control of Your Healthcare Coverage

Mistakenly enrolling in a Medicare Advantage plan or being misled during the enrollment process can be a frustrating experience. However, by understanding your options and taking appropriate action, you can correct the situation and ensure you have the right healthcare coverage to meet your needs. Don’t hesitate to reach out to the team of local NY Medicare Agents for assistance in navigating this process and securing the best possible healthcare coverage for your unique circumstances.


Speak to a Licensed Advisor in Medicare today

Book an Appointment Call: 516-900-7877