A Medicare beneficiary who loses coverage because a Medicare Advantage plan discontinues its plan in the beneficiary's area has:
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Answer & full 3-part explanation (select an option above, or peek)
Why A is correct
Under California law (CIC §10192.12), a beneficiary who loses Medicare Advantage coverage because the plan discontinues or leaves the service area has guaranteed issue rights to purchase certain Medigap policies without medical underwriting. Guaranteed issue protects beneficiaries whose coverage ends through no fault of their own by allowing them to buy Medigap regardless of health status. This protection is exactly what option A describes, making it the correct statement of the beneficiary's right. Similar guaranteed issue protections also arise when a beneficiary moves out of the plan's service area or when the plan significantly changes its terms.
Why the other options are wrong
- B) Guaranteed issue rights protect beneficiaries whose coverage ends regardless of age; the right is not limited to persons under 65. Guaranteed issue protects beneficiaries of any age whose coverage ended through no fault of their own.
- C) The guaranteed issue right applies to Medigap policies, not merely to Part D drug plans, though the beneficiary may separately choose Part D. The protected purchase is a Medigap policy; Part D is a separate and optional choice.
- D) Guaranteed issue enrollment is not tied to the Part B general enrollment period; the right arises from the qualifying event of losing MA coverage. The right attaches to the qualifying event of losing MA coverage, not to a calendar window.
Memory hook
Lost your MA plan through no fault of your own? California hands you a no-health-questions Medigap ticket.