When is a Medicare Advantage company required to comply with Medicare rules?

A Medicare Advantage company is required to comply with Medicare rules at all times. This is because Medicare Advantage plans, also known as Medicare Part C, are a type of health plan offered by private insurance companies that are approved by Medicare. To maintain their status and receive funding from the Medicare program, these companies must adhere to specific regulations and guidelines set forth by Medicare throughout the year.

These rules encompass a wide range of requirements, including how they manage beneficiary enrollment, the benefits they provide, their disclosure practices, and how they handle claims. Noncompliance can result in penalties or even loss of their contract with Medicare.

While there are specific periods, such as open enrollment or annual review processes, when beneficiary options and plan features may change, this does not affect the continuous obligation of Medicare Advantage companies to follow Medicare rules and regulations at all times.