What happens on the plan effective date when a member enrolled in a Medicare Supplement and stand-alone PDP enrolls in a Medicare Advantage plan that includes drug coverage?

What happens on the plan effective date when a member enrolled in a Medicare Supplement and stand-alone PDP enrolls in a Medicare Advantage plan that includes drug coverage?

• A. The Medicare Advantage plan becomes effective and Medicare Supplement and PDP coverage terminate.
• B. Medicare Supplement and PDP coverage continue alongside the Medicare Advantage plan.
• C. Only the PDP continues.
• D. All coverage ends and a new enrollment must occur.

Answer: (A)

When a member switches to a Medicare Advantage plan that includes drug coverage, the new plan replaces the separate coverages. On the plan’s effective date, the Medicare Advantage with drug coverage becomes the primary plan, and the old policies—Medicare Supplement (Medigap) and the standalone Prescription Drug Plan (PDP)—terminate. This happens because MA plans with integrated drug coverage cover Part A, Part B, and drug benefits in one package, so holding Medigap and a separate PDP alongside the MA-PD would create duplicate coverage, which isn’t allowed. So the correct result is that the MA plan becomes effective and Medigap and PDP coverage end. The other options imply continuing duplicate coverage, keeping only one part of the original coverage, or ending all coverage, which aren’t consistent with how MA-PD replaces separate policies.

When a member switches to a Medicare Advantage plan that includes drug coverage, the new plan replaces the separate coverages. On the plan’s effective date, the Medicare Advantage with drug coverage becomes the primary plan, and the old policies—Medicare Supplement (Medigap) and the standalone Prescription Drug Plan (PDP)—terminate. This happens because MA plans with integrated drug coverage cover Part A, Part B, and drug benefits in one package, so holding Medigap and a separate PDP alongside the MA-PD would create duplicate coverage, which isn’t allowed.

So the correct result is that the MA plan becomes effective and Medigap and PDP coverage end. The other options imply continuing duplicate coverage, keeping only one part of the original coverage, or ending all coverage, which aren’t consistent with how MA-PD replaces separate policies.