Clear Spring Health recently announced that it is withdrawing its Medicare Advantage Prescription Drug Plans (MAPD) in South Carolina and Virginia in 2025.
If you or someone you know is enrolled in one of these Plans and you don’t take action now, you will lose your creditable coverage by next year.
In this article, we’ll look at why Clear Spring Health is leaving some Medicare Advantage Markets, how this will affect beneficiaries, and a step-by-step process you can follow to enjoy a smooth transition to a new health insurance plan for 2025.
What’s Happening? Why Clear Spring Health is Withdrawing From Medicare Advantage Markets
Clear Spring Health is one of several insurance companies leaving select Medicare Advantage markets in 2025. The exit comes after the CMS continues to tighten regulations surrounding Medicare Advantage Plans, including a funding cut for 2025.
Several Medicare Advantage Plans (such as BlueCross BlueShield, Aetna, Humana, and Centene) have also stated rising medical costs as the reason for withdrawing some of their plans in 2025.
Who Will Be Affected?
Everyone currently enrolled in a Clear Spring Health Medicare Advantage Prescription Drug Plan in either South Carolina or Virginia will be affected. However, people with Clear Spring Health Medicare Advantage Plans in other states (such as Illinois, Georgia, and Colorado) should not be affected by this change.
Those enrolled in a Clear Spring Health prescription drug plan (PDP) shouldn’t be affected by this change either.
What Happens if You Lose Your Plan?
Suppose you are enrolled in a Clear Spring Health Medicare Advantage Prescription Drug Plan (MAPD) in South Carolina or Virginia, and you don’t get new creditable coverage before 2025, your health insurance will revert back to Original Medicare on January 1, 2025.
However, if you enroll in another plan during the Annual Enrollment Period (October 15 – December 7), your current coverage will end on December 31, and your new plan’s coverage will begin on January 1.
If you miss the Annual Enrollment Period, you will still have until December 31 to change plans. If you don’t, you’ll be without drug coverage starting January 1, 2025.
4 Steps to Take If You Are Losing Your Medicare Advantage Plan Next Year
If your Medicare Advantage Plan is closing down in 2025, here are four steps you can take to prepare and transfer to a new Medicare health insurance plan for next year!
Step #1: Confirm Your Plan is Shutting Down
Remember, not all Clear Spring Health Medicare Advantage Plans are canceling. Before taking action, be sure to confirm whether your plan is actually ending next year.
If you are affected, your insurance company should send you a Non-Renewal Notice before September 30 that they are not renewing your plan. If you haven’t received a notice yet, you can call your insurance company to inquire.
You can also call us directly by clicking here and we’ll look at it for you. As licensed insurance agents, we can walk you through your options — and it doesn’t cost you anything to work with us.
Step #2: Switch Plans During the Annual Enrollment Period (or Special Enrollment Period)
If your Medicare Advantage plan is shutting down, or if you’re unhappy with its changes for 2025, you can switch plans during the Annual Enrollment Period. This period runs from October 15 to December 7 every year.
During the Annual Enrollment Period, you can switch to any other Medicare Advantage Plan in your area. Any changes you make during this period will take effect on January 1 of the following year.
Note: you can change your plan several times during the Annual Enrollment Period. The last plan you enroll in before the window closes is the one that will take effect on January 1 of the following year.
If you are losing your coverage because your Medicare Advantage Plan is ending, you also may qualify for a Special Enrollment Period. This period runs from December 8 to the last day of February of the following year. During this time, you can enroll in another Medicare Advantage Plan available in your area.
Step #3: Consider Using Your Guaranteed Issue Rights for a Medicare Supplement Plan
Suppose you are losing your Medicare Advantage Plan because your insurance company is leaving the Medicare Advantage market. In that case, you can typically enroll in a Medicare Supplement Plan A, B, C, D, F, G, K, or L without undergoing medical underwriting.
You can switch to one of the Medicare Supplement Plans mentioned above 60 days before your Medicare Advantage Plan closes and up to 63 days after your Medicare Advantage Plan closes.
After this period, you may have to undergo medical underwriting to enroll in a Medicare Supplement Plan.
Note: This guaranteed issue rights period does not include Medicare Supplement Plans M and N. You may still need to undergo medical underwriting to enroll in Medicare Supplement Plan M or N, even if you just lost your Medicare Advantage Plan.
Step #4: Contact a Licensed Insurance Agent for Help
If you’re confused or want professional help finding the right plan for you, you can contact a licensed insurance agent. Licensed insurance agents can help you with any questions you have concerning your plan and assist you in comparing your options.
Licensed insurance agents work with several insurance companies to assist you in finding the right fit for you without bias. They are also paid by commission, so you can get their help at no cost to you.
If you’re looking for an unbiased licensed insurance agent, call or text us at +1 877-360-6565 (TTY: 771), and we’ll be happy to assist you!
Conclusion – Don’t Panic!
It can be scary to hear that you’re losing your Medicare Advantage coverage. However, if you don’t panic and follow the steps above, you should be able to enroll in a new Medicare plan in time and enjoy a smooth transition into 2025.
So take a deep breath, double-check if your insurance plan is ending, and if so, enroll in a new plan in the given time-frames to avoid lapses in creditable coverage.
And remember! If you need assistance during these confusing times, help is just a text or a phone call away!