Annual Medicare Advantage Open Enrollment Period
For Medicare Advantage enrollees who are no longer in their trial period, theres an annual Medicare Advantage open enrollment period that became available starting in 2019. It runs from each year, and allows Medicare Advantage enrollees to switch to Original Medicare or to a different Medicare Advantage plan.
The ability to switch plans during the January March enrollment period is limited to one plan change per year. This open enrollment period replaced the Medicare Advantage disenrollment period that was used from 2011 to 2018, and provides more flexibility to Medicare Advantage enrollees .
When Medicare Advantage enrollees switch to Original Medicare during the January-March open enrollment period, theyre also eligible to purchase a Part D Prescription Drug Plan. But a person who has Part D coverage with Original Medicare cannot switch to a different Part D plan during the January March open enrollment period, since this window only applies to Medicare Advantage enrollees.
Alternatively, you can switch to a different Medicare Advantage plan during this period, if the one you have is not meeting your needs.
Do Medicare Supplement Plans Cover Pre
For the first six months after you enroll, a Medicare Supplement plan can cover the Part A coinsurance when the visit doesnt relate to the pre-existing condition. A visit relating to a pre-existing condition wont have coverage.
Although Medicare will pay some of the hospital bills, you pay the rest. This is because Medicare doesnt have a pre-existing condition waiting period like Medigap. Those with a pre-existing condition enrolling in or changing Medigap plans outside of the OEP need to budget to ensure theyre able to cover any medical costs for six months.
Can I Change Medicare Advantage Plans Anytime During The Medicare Open Enrollment Period
The Medicare Advantage Open Enrollment Period is October 15 through December 7 each year. During this period you can switch from a Medicare Advantage plan to another Medicare Advantage plan or switch from a Medicare Advantage plan back to Original Medicare. There is generally no limit on how many times you can switch Medicare Advantage plans if you do it during the Medicare Open Enrollment Period.
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Medigap & Medicare Advantage Plans
Medigap policies cant work with Medicare Advantage Plans. If you have a Medigap policy and join a
, you may want to drop your Medigap policy. Your Medigap policy cant be used to pay your Medicare Advantage Plan copayments, deductibles, and premiums.
If you want to cancel your Medigap policy, contact your insurance company. If you leave the Medicare Advantage Plan, you might not be able to get the same, or in some cases, any Medigap policy back unless you have a trial right.
If you have a Medicare Advantage Plan, its illegal for anyone to sell you a Medigap policy unless youre switching back to
. Contact your State Insurance Department if this happens to you.
If you want to switch to Original Medicare and buy a Medigap policy, contact your Medicare Advantage Plan to see if youre able to disenroll.
If you join a Medicare Advantage Plan for the first time, and you arent happy with the plan, youll have special rights under federal law to buy a Medigap policy. You have these rights if you return to Original Medicare within 12 months of joining.
|If you dont drop your Medicare Advantage Plan and return to Original Medicare within 12 months of joining, generally, you must keep your Medicare Advantage Plan for the rest of the year. You can disenroll or change plans during the Open Enrollment Period or if you qualify for a Special Enrollment Period. Depending on the type of Special Enrollment Period, you may or may not have the right to buy a Medigap policy.|
Why You Might Switch Medicare Advantage Plans
There are several reasons why you might consider changing from your current Medicare Advantage plan to another during Medicare Advantage open enrollment:
Lower prescription costs: One of the big differences between Medicare Advantage plans is the cost of prescription drugs from plan to plan. If you take maintenance medications, compare prices between plans. “One medication can make a difference of about $4,000,” says Martha Gonzales, founder of brokerage firm CHM Insurance Services, who also notes that drug pricing is very individual. “I can have a husband and wife right in front of me and make completely different recommendations.”
Lower copays: If prescription costs are comparable, consider how many times a year you see a doctor or specialist.
Doctors in-network: Sometimes, people choose a plan during Medicare open enrollment without knowing whether their doctor is part of that network, according to Gonzales. The Medicare Advantage open enrollment period gives them a chance to correct their mistake.
Better benefits: Medicare Advantage plans usually offer additional benefits, which may include some coverage for vision, hearing and dental care. Coverage from plan to plan will differ, and the best plan for you will depend on your needs. If you think you may need hearing aids this year, for instance, do some checking. Hearing aids “are high-ticket items,” Gonzales says. “If your plan doesnt have hearing aid coverage and another one does, that can be a motivating factor.”
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Can I Change Medicare Advantage Plans Anytime
You can generally change Medicare Advantage plans only during certain enrollment periods. Heres a list of the main enrollment periods for changing Medicare Advantage plans.
- The Annual Election Period , also called Fall Open Enrollment, October 15 December 7 every year.
- The Medicare Advantage Open Enrollment Period, January 1 March 31 every year, starting in 2019.
- The 5-Star Special Enrollment Period. You can switch to a Medicare Advantage plan with a 5-star rating between December 8 one year and November 30 the next year. Read more about the 5-star special enrollment period.
- Other Special Enrollment Periods, if applicable. You might be eligible for a Special Enrollment Period in some cases for example, if you move out of your plans service area.
You may be able to make other coverage changes during some of these enrollment periods.
If You Lose Your Medicaid Eligibility:
If youre covered by both Medicare and Medicaid and then you lose eligibility for Medicaid, you can switch from Medicare Advantage to Original Medicare up to three months from the date you lose Medicaid eligibility, or the date youre notified, whichever is later.
- If youre told in advance that youll lose your Medicaid coverage for the following year, you can switch to Original Medicare between January 1March 31.
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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.
In 2021, there are a total of 28 Medicare contracts nationwide that have a 5-star rating. Two are Medicare cost plans, five 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. For 2021, however, theres a UnitedHealthcare contract with a five-star rating, available in most of the US.
When Can You Change Medicare Advantage Plans
How and when to change a Medicare Advantage plan is a very important concept to understand especially if you have already selected a Medicare Advantage plan. If you have already enrolled in a plan, that does not mean that you are locked into that plan if you decide it does not fit your needs. For those who already have a Medicare Advantage plan, a common question asked is, When can I change Medicare Advantage plans?
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Plans That Vary From Area To Area Or That May Require You To Use An In
- Medicare Part D prescription drug plans
- Medicare Part C, otherwise known as Medicare Advantage
- Medicare Cost Plans
- Medicare SELECT, a special type of Medigap plan that uses a provider network. As of 2018, there were about 582,000 Medicare SELECT enrollees, versus a total of almost 14 million Medigap enrollees nationwide.
If you have Medicare Part A and Medicare Part B, you need to notify the Social Security Administration of your change of address, but you wont need to change plans just because youre relocating.
If you have a Medicare Part D plan, a Medicare Advantage plan, a Medicare Cost Plan, or a Medigap Medicare SELECT plan, you need to determine if your new address is still within that plans service area. If it isnt, you may need to choose a new plan that serves residents of your new area.
What Happens To Your Medigap Plan If You Move
You should check with your Medigap provider to see if your Medigap plan will transfer to a new state or territory if you move.
Medigap also called Medicare Supplement insurance are policies sold by private insurers that contract with Medicare. Medigap covers your out-of-pocket expenses, filling in gaps that Medicare does not cover.
If you have a plan thats available in the state where youre moving, you may be able to take your Medigap plan with you.
There are 10 standardized Medigap plans available in every state. Some states also offer more Medigap plans that are not available in all states.
Medigap Plan Availability in States
- Available in all states Plans A, B, C, D, F, G, K, L, M, and N
- Available in some states High-deductible Plan F and Plan G
- Available in some states or specific areas within a state Medicare Select plans
If your plan is not available where youre moving, you will need to change your plan ahead of your move to one thats available in your new location. That way, youll not miss coverage.
Don’t Leave Your Health to Chance
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Health Care Costs For Seniors
Considering options to supplement traditional Medicare is a wise move. Health care costs continue to rise and household spending for people with Medicare can be more than you expect.
The Kaiser Family Foundation studied the costs between Medicare households and non-Medicare households and the differences are surprising:
This study makes it clear that costs are high and finding ways to supplement those costs even within Medicare is important to most seniors
Have You Notified Social Security About Your Address Change
Make sure you notify Social Security of your change of address. The Social Security Administration handles Medicare enrollment. If you receive Social Security benefits, you can change your address online by accessing My Social Security and answering a few security questions prior to making the change if you have set up a My Social Security account.
Alternatively, you can call the Social Security Administration at 1-800-772-1213 and speak to one of their representatives from Monday through Friday, from 7AM to 7PM. You can also visit the Social Security office nearest you and fill out a change of address form.
If you receive your retirement or disability benefits from the Railroad Retirement Board , notify the agency either through its website or by calling 1-877-772-5772 Monday through Friday, 9AM to 3:30PM, to speak to an RRB representative.
Do you have questions about Medicare when moving to another state? Learn more about me by clicking the View profile link below. There are also links that let you schedule a phone appointment or have me email you more information. Want to compare plans on your own? Use the Find Plans button on this page.
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Approval For Medigap Is Not Guaranteed
If you are considering switching from Medicare Advantage to Medigap, you are not guaranteed to be approved for some plans.
There are four basic options when it comes to switching from Medicare Advantage to Medigap, and two of them are guaranteed approval.
Guaranteed Approval options:
1.) If you are trying to switch from Medicare Advantage to Medigap during either your first year of enrollment into Medicare Advantage or the special enrollment period, then you are guaranteed approved.
2.) Special enrollment periods cover a few circumstances. If you have lost your insurance that was provided by an employer, or if you moved away from your coverage area , then you are in a special enrollment period.
Medical Approval Options:
3.) The annual election period.
4.) The Medicare Advantage disenrollment period.
During these two periods, you will need to answer medical questions that could lead to approval or disapproval.
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.
A person who wants to add Medicare Part D to their original Medicare coverage should contact a plan provider.
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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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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If You Have Other Coverage
Talk to your employer, union, or other benefits administrator about their rules before you join a Medicare Advantage Plan. In some cases, joining a Medicare Advantage Plan might cause you to lose employer or union coverage. If you lose coverage for yourself, you may also lose coverage for your spouse and dependents.
In other cases, you may still be able to use your employer or union coverage along with the Medicare Advantage plan you join. Remember, if you drop your employer or union coverage, you may not be able to get it back.
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Medicare Advantage Open Enrollment Period
This special opportunity to leave Medicare Advantage lasts from January 1 through March 31 each year.
If you disenroll during January, your changes will be effective on February 1.
If you disenroll during February, your changes will be effective on March 1.
If you disenroll during March, your changes will be effective on April 1.
Consider Premiumsand Your Other Costs
To see how a Medicare Advantage Plan cherry-picks its patients, carefully review the copays in the summary of benefits for every plan you are considering. To give you an example of the types of copays you may find, here are some details of in-network services from a popular Humana Medicare Advantage Plan in Florida:
- Hospital stay$175 per day for the first 10 days
- Diabetes suppliesup to 20% copay
- Diagnostic radiologyup to $125 copay
- Lab servicesup to $100 copay
- Outpatient x-raysup to $100 copay
- Renal dialysisup to 20% copay
As this non-exhaustive list of copays demonstrates, out-of-pocket costs will quickly build up over the year if you get sick. The Medicare Advantage Plan may offer a $0 premium, but the out-of-pocket surprises may not be worth those initial savings if you get sick. The best candidate for Medicare Advantage is someone who’s healthy,” says Mary Ashkar, senior attorney for the Center for Medicare Advocacy. “We see trouble when someone gets sick.”
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How Can I Get The Medicare Advantage Coverage I Need In My New Area Of Residence
The first step in making changes to your Medicare Advantage plan as a result of a move is to determine what plan options will be available to you in your new area of residence. You can start researching and comparing plan benefits, pricing, and networks today when you contact the licensed insurance agents at MedicareInsurance.com by phone at 950-0608.
If you need more information concerning your eligibility for Medicare coverage in your new area, our friendly insurance experts are more than willing to help. We look forward to hearing from you!