When Can I Change My Medicare Advantage Program
You can make changes to your plan at any time during the Medicare Advantage open enrollment period from January 1 through March 31 every year. This is also the Medicare general enrollment period. The changes you make will take effect on the first day of the month following the month you make a change.
When Can You Switch From Original Medicare To Medicare Advantage
If youre enrolled in Original Medicare and interested in making changes to your Medicare plan, you can typically only do this once a year. During the Annual Election Period , which is every fall between Oct. 15 and Dec. 7, you can switch from Original Medicare to a Medicare Advantage plan, or vice versa. Coverage will be effective on Jan. 1.
There is also a built-in safety net for circumstances that are often beyond your control that allow you the flexibility to switch from Medicare Advantage to Original Medicare or enroll for the first time. The Special Election Period gives you the opportunity to change your Medicare Advantage and prescription drug plans or go back to Original Medicare outside of the normal time restraints.
Situations that qualify for SEP might include a move outside the area your current plan covers, becoming eligible for a low-income subsidy, losing creditable prescription drug coverage from your employer or if your plan is no longer available.
Is Your Healthcare Plan Still Meeting Your Healthcare Needs
Are changes to your current Medicare plan costing you a little bit more this year? Are you taking any new drugs that may cost less on another plan? Is your doctor still in your plans network? Plans can change from year to year. Maybe its time to consider your options. Our can help you compare our plans costs and coverage with your current plans to help you make sure youre getting the most from your healthcare dollar.
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If I Have Medicare How Can I Enroll In Medicare Advantage
There are several time frames during which you can enroll in or switch to Medicare Advantage:
- During your Initial Enrollment Period: If you are newly eligible for Medicare because of your age or disability status, you can enroll in a Medicare Advantage plan.
- During the Open Enrollment Period: During Medicare Open Enrollment, which extends from October 15 to December 7 each year, you can change Medicare plans, including switching to Medicare Advantage. You can also change or add a Part D prescription drug plan.
- During the Medicare Advantage Open Enrollment Period: From January 1 to March 31, if you already have a Medicare Advantage plan, you can switch to a different Advantage plan or return to Original Medicare.
Each Medicare Advantage plan offers different benefits, so itâs important to review the plans available in your area.
Consider your medical needs, which services you have used most frequently over the past several years, and whether those needs might change. Then weigh the benefits of various types of Medicare Advantage plans.
A Special Needs Plan might be a great option if you have a chronic illness and the right plan is available in your region, while HMO plans can be an affordable option if you like the doctors included in the planâs network.
The official U.S. government website for Medicare can help you compare different plans and apply for the Medicare Advantage coverage thatâs right for you.
Can You Switch Between Medicare Advantage And Medigap
If you originally sign up for Medicare Advantage and decide it isnt right for you, you can switch to Medigap supplemental coverage. You can also switch from Medigap to a Medicare Advantage plan.
However, you have to follow certain rules and there may be some problems if you decide to switch down the line.
If you are in a Medicare Advantage plan, you can make a switch to a different Medicare Advantage plan during Medicares open enrollment period, which runs from October 15 through December 7 each year.
You may also not be able to get a Medigap policy if you give up your Medicare Advantage plan. If you are new to Medicare, insurers are required to sell you a Medigap policy. But after that initial enrollment, theres no guarantee that they will sell you one.
Insurers can also charge you more for a Medigap policy if you have serious medical problems when you decide to switch from a Medicare Advantage plan.
A handful of states protect your ability to switch back to Original Medicare with Medigap coverage.
States That Allow You to Switch Year-Round
Rules guaranteeing your ability to switch vary between each of these states. You should check with your states rules to determine what applies in your case.
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Enrollment Periods For Medicare Supplements
Just like Medicare has special enrollment periods throughout the year, Medicare Supplements have a special window where you need to purchase a plan.There is really only one Enrollment period for Medicare Supplements. It is referred to as the Initial Enrollment Period. This window is from 3 months prior to your 65th birthday and 3 months after.
During this period you can enroll in a Medicare Supplement without being subject to medical underwriting and policies are guaranteed issues
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You Cannot Have Both So Choose Wisely
When switching from a Medicare supplement to another plan, it is easier to switch within programs rather than switch programs altogether. You cannot have an Advantage plan and a Medicare Supplement plan simultaneously, so you need to make an informed decision based upon your needs.
For instance, Medicare Advantage provides both part A and B benefits, and some of part D, which sounds great, but there are some drawbacks. According to Investopedia:
Medicare Advantage Plans do not offer the same level of choice as a Medicare plus Medigap combination. Most plans require you to go to their network of doctors and health providers. Since Medicare Advantage Plans cant pick their customers , they discourage people who are sick by the way they structure their copays and deductibles.
If you are someone who has chronic illness, or just tends to be ill more often, then Medicare Advantage may not be for you because of their copay structure. That does not mean it is a bad plan, it just is not for everyone.
Medigap coverage tends to cost more than most Advantage plans, but Medigap has a wider network of physicians covered.
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Whats The Difference Between Traditional Medicare And Medicare Advantage
For those 65 years and older on Medicare, the critical open enrollment season, which allows participants to change their plan, comes to an end Dec. 7.
Some health insurance companies are trying to persuade Medicare recipients to change plans and opt for Medicare Advantage to get extra benefits. There are even commercials featuring celebrities making the case for Medicare Advantage. The problem is, Medicare Advantage has proven controversial.
Sabri Ben-Achour: All right, so youve got Medicare, thats health insurance for people 65 and older. And then there is something called Medicare Advantage. What is the difference?
Chris Farrell: OK, so Medicare Advantage plans these are private health plans paid by the federal government to provide Medicare covered benefits. So theyre commercially offered managed care plans and its an alternative to traditional Medicare, which is fee for service and Part D, prescription drug plans.
Ben-Achour: So why might someone opt for the Medicare Advantage versus Medicare?
Farrell: The plans can offer additional benefits such as dental care and vision services. And another reason is the Advantage plans, they offer a bundle of services so theyre streamlined. And by the way, Advantage plans are sold by for-profit insurance companies, and they have multimillion-dollar ad budgets.
Ben-Achour: If these are privately run, I assume you have to pay extra for them?
Can I Change From Medicare Advantage To Medicare Supplement
This situation is a little more difficult if you expect not to be subject to medical underwriting when you make the change.
If you purchased Medicare Advantage when you initially were eligible for Original Medicare and you are not satisfied with your coverage, you will have special rights to purchase a Medicare Supplement policy if you return to Original Medicare coverage within twelve months of purchasing your Medicare Advantage plan.
If you decide to move to another state or another part of your state that your Medicare Advantage plan doesnt serve, you have special rights to go back to Original Medicare and then purchase a Medicare Supplement plan.
Typically, if the above-mentioned scenarios do not apply in your situation, you can purchase Medicare Supplement insurance that will be subject to medical underwriting.
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Think Hard Before Giving Up Your Medigap Plan
You’re first eligible for a Medicare Supplement Insurance, or Medigap, plan once you’re 65 or older and you have Medicare Part B. This six-month Medigap open enrollment period happens only once, and you can buy any policy you want, regardless of your health. After that, you may not be able to get a Medigap plan or it might cost more.
Medigap pays many of the out-of-pocket costs of Original Medicare. If you have a serious or chronic health condition, that can lead to significant cost savings. Some people switch to Medicare Advantage plans during open enrollment, not realizing they might not be able to switch back to a Medigap plan later.
“Our clients are sitting at home, they’re seeing these commercials on television talking about the free gym membership, zero premiums and they go ahead and make changes on their own,” said Emily Gang, owner of The Medicare Coach. “They realize early in the year that they made a mistake and we can’t go back.”
How To Switch To Medicare Advantage From Original Medicare
In this situation, you have Original Medicare and want to switch to a Medicare Advantage plan. You may also currently have a stand-alone Part D prescription drug plan.
Most Medicare Advantage plans are all-in-one plans. They cover your Medicare Part A and Part B benefits plus prescription drugs and other health services and items not included with Original Medicare. Examples of these other items include coverage for dental health, vision, hearing and gym memberships. Medicare Advantage plans also have an annual out-of-pocket limit to protect you from high costs.
You can switch to a Medicare Advantage plan from Original Medicare during the Annual Enrollment Period each fall, October 15 through December 7. And depending on the Medicare Advantage plan you get, if you have a stand-alone Part D plan, you may no longer need it.
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If You Want To Change Your Medicare Plan Its Not Too Late
I signed up for a new Medicare Advantage plan during open enrollment in the fall, but now that Im using the plan, I found out that it doesnt cover some of my doctors. Can I switch to another Medicare plan before the next open enrollment?
Yes, if you act by February 14. But there are restrictions. You can only switch to an original Medicare plan, not to another Medicare Advantage plan. Since you would be leaving Medicare Advantage, you would also have the option to choose a Part D prescription-drug plan.
If you miss the February 14 deadline, you generally need to wait until the next open-enrollment period October 15 to December 7, 2012 to make changes to your coverage for the following year . See Understanding Medicare Enrollment Periods for more information about these special situations and about the general rules for enrolling in and changing plans.
Take Your Time And Be Skeptical
During the current open enrollment period, which opened October 15 and ends December 7, seniors can switch from traditional Medicare to Medicare Advantage, or change the Medicare Advantage plan they’re on. They can also switch back to Original Medicare.
It’s not the only chance to make changes for seniors who are already enrolled in Medicare Advantage. People already in these plans can also switch their Advantage plan between January 1 and March 31, although they can only switch plans once during that time period.
But experts caution seniors against rushing into a Medicare Advantage plan with the hopes of saving money or getting freebies like gym memberships. First, deceptive marketing abounds from insurance agents wrongly describing coverage and celebrity-filled TV ads touting benefits to marketing mailers disguised as “official” government mail.
Seniors “are being inundated with aggressive marketing tactics as well as false and misleading information,” Sen. Ron Wyden’s office concluded in a report last month.
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Medicare Advantage Open Enrollment Period January 1 Through March 31
During this time, you can:
- Switch from a Medicare Advantage plan without drug coverage to a Medicare Advantage plan with drug coverage
- Switch from a Medicare Advantage plan with drug coverage to a Medicare Advantage plan without drug coverage
- Switch from your Medicare Advantage plan and return to Original Medicare, with the option to join a stand-alone Medicare prescription drug plan
If you enrolled in a Medicare Advantage plan when you first became eligible for Medicare , you can change to another Medicare Advantage plan or go back to Original Medicare within the first 3 months after you enrolled.
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What Happens If You Need To Change Plans During A Period You Cannot Change Plans
The only way to change Medicare Advantage Plans outside of the standard annual enrollment periods is by qualifying for a Special Enrollment Period. include, but are not limited to:
- Moving outside of your current plans service area.
- Moving to a new address within your current plans service area but which has new plan options.
- Moving into or out of a skilled nursing facility or long-term hospital care.
- You are eligible for both Medicare and Medicaid.
- Becoming ineligible for Medicaid.
- If Medicare takes an official action because of a problem with your current plan that affects you.
- If Medicare terminates or does not renew your current plans contract.
- You joined a plan or chose not to join a plan due to an error by a federal employee.
You generally have 2 months to make a change to your Medicare Advantage Plan during a SEP.
For a complete list of special circumstances that qualify you for a SEP, click here: Special circumstances .
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Can You Enroll In Medigap
If youre switching from Medicare Advantage to Original Medicare, you can also purchase a plan Medicare Supplement plan. This kind of plan, also known as a Medigap policy, pays for gaps in Medicares coverage.
For instance, Medicare Part B pays 80% of covered costs after you pay your annual deductible. A Medigap policy would pay the remaining 20% due. But if youve missed your Medigap Open Enrollment Period, an insurer could deny you coverage due to your health history.
Moving Between Or Changing Medicare Plans
Improved coverage may be a reason for people to consider moving from one Medicare plan to another one. People can change the providers of their Part D or Medicare Advantage plans, but only during set enrollment periods.
Part D
A person who wants to add Medicare Part D to their original Medicare coverage should contact a plan provider.
Medicare Advantage
A person can enroll in Medicare Advantage during enrollment periods. They can complete an online application via the plans website or call the plan provider and either apply over the phone or ask for a paper enrollment form. People can also call Medicare at 1-800-MEDICARE.
People keep their Medicare Part A and Part B benefits after moving to Medicare Advantage. However, enrolling in a new Medicare Advantage Plan with a drug plan automatically cancels a Medicare Part D drug plan.
Previous plans end when the new plan begins, without people needing to cancel their original plans. Plan providers send letters to their new members to advise them when the coverage begins.
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Medicare Advantage Open Enrollment
You can make changes to your plan at any time during the Medicare Advantage open enrollment period from January 1 through March 31 every year. This is also the Medicare general enrollment period.
The changes you make will take effect on the first day of the month following the month you make a change.
Why Switch To Medicare Advantage
Medicare Advantage provides all the benefits offered by Medicare Part A and Part B, and most Medicare Advantage plans also include prescription drug coverage. If youre relatively healthy or you dont frequently use healthcare, switching to Medicare Advantage could end up saving you money.
Beyond potential savings, many people switch to Medicare Advantage for supplemental benefits.
Supplemental benefits are items and services that Original Medicare doesnt provide. They can include the typical vision, dental, and hearing benefits, or even a membership to SilverSneakers or Silver& Fit. Recently, however, plans are going beyond typical supplemental benefits and including extras such as an allowance for over-the-counter medications, transportation services, and meal delivery. Many plans offer these benefits as a free perk, while other plans require an additional premium for extras such as dental and vision.
Here is a list of supplemental benefits available through Medicare Advantage and the percentage of Medicare Advantage enrollees who have that benefit as part of their plan:
| Supplemental benefit |
|---|
Data from Kaiser Family Foundation. Updated 5/18/201
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Special Enrollment Available For 5
Medicare utilizes a star rating system for Medicare Advantage and Part D Prescription Drug Plans. Each Medicare contract is assigned a rating of one to five stars, with the best contracts receiving five stars. If you live in an area where a 5-star Part D or Advantage plan is available, you can join or switch to the 5-star plan up to once per year, between December 8 and November 30.
For 2023, there are a total of 62 Medicare contracts nationwide that have a 5-star rating . Three are Medicare cost plans, two are stand-alone Part D plans, and the rest are Medicare Advantage plans.
Most plans do not receive five stars, and in most years, most areas of the country do not have 5-star plans available. But there was a significant uptick in the number of five-star Medicare Advantage plans in 2022, potentially making the five-star enrollment window available to more people. The number of five-star plans has dropped for 2023, but is still quite a bit higher than it was in 2021.
