What Else Do I Need To Know
- Medicare can help cover your costs for health care, like hospital visits and doctors services.
- Most people dont pay a premium for Part A, but you do pay a monthly premium for Part B.
- If you cant afford the monthly premium, there are programs to help lower your costs. Get details about cost saving programs.
What Is The Medicare Advantage Disenrollment Period
The Medicare Advantage Disenrollment Period, which is now called the Medicare Advantage Open Enrollment Period, is the time of year that someone who is on a Medicare Advantage Plan can make one change to another MAP or to a Supplement with a Part D plan, says Elizabeth Gavino, founder of Lewin & Gavino and an independent broker and general agent for Medicare plans. You can also switch to Original Medicare without a Supplement or prescription drug coverage during this period, but this would leave you with less coverage than your MAP.
The Medicare Advantage Open Enrollment Period runs from January 1 through March 31 of each year. This is important especially if a member used the plan in the first couple of months of the year and found out that their provider no longer participates in the plan or that they chose the wrong carrier and plan for their needs, Gavino says.
Can I Join A Medicare Advantage Plan
Medicare Advantage Plans is both Part A and Part B coverage .1 This can include dental, vision, and prescription drug coverage, as well as no-cost extras.
If you want to enroll, you must:
- Be eligible for Medicare
- Be enrolled in both Medicare Part A and Part B
- Not have end-stage renal disease
- Live within the plans service area
Find your plan service area with our Plan Finder tool
Once you are enrolled, the private company supporting your Medicare plan will set up your benefits. You do not lose your Original Medicare.
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Can I Change Medicare Advantage Plans During My Initial Enrollment Period
The first time you may be eligible to sign up for a Medicare Advantage plan may be during your Initial Enrollment Period. During this period, you can both enroll in a Medicare Advantage plan and switch from one plan to another. Maybe you first sign up for a plan that seems attractive but then decide you want the same coverage your spouse has. You can change Medicare Advantage plans anytime during your Initial Enrollment Period.
If you qualify for Medicare by age, your Initial Enrollment Period starts 3 months before the month you turn 65, includes the month you turn 65, and ends 3 months after the month you turn 65. If you qualify for Medicare through disability, this period starts 3 months before your 25th month of getting Social Security or Railroad Retirement Board benefits, includes the 25th month of getting disability and ends 3 months after your 25th month of getting disability benefits.
Medicare Advantage Open Enrollment Period
Starting in 2019, the Medicare Advantage Open Enrollment Period takes place from .
During the Medicare Advantage Open Enrollment Period, you can change your Medicare plans in the following ways:
- You can switch from your current Medicare Advantage plan to another Medicare Advantage plan, whether or not either plan offers prescription drug coverage.
- You can disenroll from or cancel your current Medicare Advantage plan and return to Original Medicare .
- If you choose to go through Medicare Advantage disenrollment and return to Original Medicare, you also have the option of enrolling in a Prescription Drug Plan during this period.
To disenroll from a Medicare Advantage plan and switch back to Original Medicare, you should contact your Medicare Advantage plan provider, or you can .
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How Do I Know If I Should Change Plans
Health care and budget needs change over time. If your current plan isnt meeting your needs, you can switch to a different plan or even a different type of Medicare coverage.1
Medicare Advantage and Medicare prescription drug plans send information to members every fall. This is called the Annual Notice of Changes . The ANOC explains upcoming updates to the plans benefit coverage, costs, or service area for the next plan year. When looking at your current and future needs, the ANOC can help you decide if you need a different plan.
How To Switch Medicare Advantage Plans
- You have several opportunities to switch your Medicare Advantage plan throughout the year.
- You can switch your plan for Medicare Advantage and Medicare prescription drug coverage during the Medicare open enrollment period or the Medicare Advantage open enrollment period.
- You can also switch your Medicare Advantage plan during a special enrollment period thats triggered by a major change in your life.
Medicare Advantage plans are offered by private insurance companies. If you have a Medicare Advantage plan, you can:
- switch to a different Medicare Advantage plan that offers drug coverage
- switch to a different Medicare Advantage plan that doesnt offer drug coverage
- switch to original Medicare plus a Part D plan
- switch to original Medicare without adding a Part D plan
To switch plans, contact the insurance provider of the plan you like and apply for coverage. If youre not sure how to contact the provider, Medicares plan finder tool may be useful. You will be disenrolled from your previous plan as soon as your new plan takes effect.
If you are switching from a Medicare Advantage plan to original Medicare, you can either call your former plan or enroll through Medicare by calling 800-MEDICARE.
The short answer is no. You may switch Medicare Advantage plans during set enrollment periods each year and within a specified period of time following certain life events.
Well discuss these enrollment periods in the next section.
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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.
How To Apply For Medicare Through Social Security
Apply online: The easiest way to complete the Medicare enrollment application is online at ssa.gov. Its convenient to sign up from home. You can start and stop the application and save your information. After you submit your application, youll get a receipt to print and keep. You can also check the status of your application.
Apply in person: Visit your local Social Security office. You can find the nearest office with the Social Security office locator. They recommend that you make an appointment.
Apply by phone: Call Social Security at 800-772-1213 .
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Can You Change Your Medicare Plan Anytime
You can change your Medicare plan anytime if you encounter certain, specific unforeseen circumstances. But generally, you can join, change or drop your Original Medicare health plan, a Medicare Advantage plan only during Medicares three enrollment periods.
When You Can Change Medicare Coverage
- Initial Enrollment Period
- The initial enrollment period is when you first become eligible for Medicare. This includes the seven-month period that includes the month you turn 65, the three months before your birthday month and the three months following your birthday month.
- Open Enrollment Period
- Original Medicares open enrollment period runs from Oct. 15 through Dec. 7 of each year. If you join, change or cancel your Medicare plan, the change will automatically take effect on Jan. 1 of the new year as long as the new plan gets your request by Dec. 7.
- Medicare Advantage Open Enrollment Period
- The open enrollment period for Medicare Advantage runs from Jan. 1 through March 31 of each year. During this period, you can switch from one Medicare Advantage plan to another. You can also switch from your Medicare Advantage plan to Original Medicare and join a Medicare Part D prescription drug plan at the same time. You can make this change to Original Medicare only once.
How To Switch To Original Medicare From A Medicare Advantage Plan
Original Medicare only provides Part A and Part B . It does not provide some of the benefits you may have with your Medicare Advantage plan, like drug coverage, dental, vision or fitness. Original Medicare also doesnt have an annual out-of-pocket limit, so theres no built-in financial protection.
To switch from a Medicare Advantage plan to Original Medicare, you will need to contact your plan provider or Medicare directly. You can contact Medicare via the Medicare helpline 24 hours a day, seven days a week at 1-800-MEDICARE , TTY 1-877-486-2048.
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How To Join A Medicare Advantage Plan
Not all Medicare Advantage Plans work the same way. Before you join, take the time to find and compare Medicare health plans in your area. Once you understand the plan’s rules and costs, here’s how to join:
- Use Medicare’s Plan Finder.
- Visit the plan’s website to see if you can join online.
- Fill out a paper enrollment form. Contact the plan to get an enrollment form, fill it out, and return it to the plan. All plans must offer this option.
- Call the plan you want to join. Get your plan’s contact information.
When you join a Medicare Advantage Plan, you’ll have to give these:
- Your Medicare number
This information is on your Medicare card.
Reasons To Disenroll Or Change Medicare Advantage Plans
While a lot of effort goes into making an initial decision on Medicare plans, you may need to switch for a variety of reasons. Maybe the plan changed its offerings, or your needs have changed.
If your Medicare Advantage plan isnt meeting your needs, you may want to go back to original Medicare or switch Part C plans. You may need to add or change your prescription plan, switch to a Medicare Advantage plan that covers different providers or services, or find a plan that covers a new location.
Some of the most common reasons for changing plans include:
All of the above situations would qualify you for a special enrollment period.
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Do I Need To Do Anything After I Enroll In A Medicare Advantage Plan
Once you enroll in a Medicare Advantage plan during Annual Enrollment, the plan will work with Medicare to transfer your benefits. You dont have to contact Medicare yourself. Your new plan will begin covering you on January 1.
If you have a stand-alone Part D prescription drug plan or other private Medicare plan, youll need to contact the plan provider directly to dis-enroll. Simply call the number on the back of your insurance member ID card.
When deciding to change to a Medicare Advantage plan, keep the following in mind:
- You may choose a different Medicare Advantage plan or return to Original Medicare during the Medicare Advantage Open Enrollment Period, January 1 March 31.
Enroll By Mail Or Fax
Using our enrollment tool, enter your ZIP code and select the plan youre interested in. On the details page, youll find a link to Enrollment Forms that you can then print from your computer. Mail or fax your completed and signed forms to:
Medicare Advantage Plans – All Locations EXCEPT Arizona
Member Administrative Services
Medicare Advantage – ARIZONA ONLY
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When Can I Enroll In A Medicare Supplement Plan
Making sure you have the right Medicare coverage can be confusing. Enrollment timing, different plans, and personal requirements can make shopping around for Medicare a hassle.
Luckily, thatâs why Medicare Allies is here. We can give you the bite-sized low-down on all things Medicare coverage so you make the most informed decisions possible without having to spend unnecessary time in the weeds.
Through different advertisements, letters, or word-of-mouth, you have probably heard enticing stories of savings and extra benefits through a Medicare Supplement plan.
Here is all you need to know about your options regarding Medicare Supplement plans.
When To Sign Up For Medicare Plans
When you sign up for the various Medicare coverages and when each one comes into effect varies with the different Plans. A general outline follows specific situations or health conditions touch off a number of different enrollment periods. For fuller details see the publications.
Enrolling in Medicare parts A & B:
For qualified individuals, you should sign up during the âInitial Enrollment Periodâ of seven months around the month you turn 65 . Note that this may be before you can or choose to file for Social Security benefits. If you enroll prior to the birthday month, you will start being covered as of your birthday month. If you enroll during the last four months of the period, coverage will start with an additional monthâs delay.
If you didnât sign up for Part A during your Initial Enrollment Period, you can sign up during the âGeneral Enrollment Periodâ between January 1 and March 31 each year. Coverage will begin July 1. If you are a qualified individual, there may be a penalty premium for late sign-up, as mentioned above .
In certain cases, if you did not sign up for Plan A when initially eligible because you were covered under a group health plan based on current employment, you can sign up later during a âSpecial Enrollment Periodâ. See Publication 11219 for details.
Part B :
Part C and Part D :
Some addiitonal information on Medicare sign up can be found at the following non-US government links:
Can You Switch From Original Medicare To Medicare Advantage
If you currently have Medicare, you can switch to Medicare Advantage from Original Medicare , or vice versa, during the Medicare Annual Enrollment Period. If you want to make a switch though, it may also require some additional decisions. The specific choices you need to make depend on which kind of coverage youre switching to and from.
Enrolling In Original Medicare
If youre already receiving Social Security or Railroad Retirement Board benefits and youre a U.S. resident, the federal government automatically enrolls you in both Medicare Part A and Medicare Part B at age 65. Youll receive your Medicare card in the mail about three months before you turn 65, and your coverage will take effect the first of the month you turn 65.
Medicare Part B has a monthly premium, which will be deducted from your Social Security or Railroad Retirement check. The standard Part B premium is $170.10/month for 2022. Thats up from $148.50/month in 2021, and quite a bit higher than initially projected in the Medicare Trustees Report projects. But the Social Security cost-of-living adjustment for 2022 is the largest its been in 30 years, and will cover the increase in Part B premiums . However, the larger-than-expected increase in Part B premiums will eat up a significant portion of the Social Security COLA that many beneficiaries receive.
You can opt out of Part B and avoid the premiums, but its generally only a good idea to do that if youve got health insurance from your current employer or your spouses current employer, and the employer has at least 20 employees.
If youre disabled and receiving Social Security Disability benefits, your Medicare coverage will start automatically in the 25th month that youre receiving disability benefits.
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Can I Enroll In A Medicare Supplement Plan At Any Time
Medicare with Melissa
Yes! This is great news for you. The only requirement to enroll in a Medicare Supplement plan is that you have Medicare Part A and Part B.
These plans allow you to enroll whenever you want. Depending on your circumstances, you will either have a guarantee issue or you will have to be medically underwritten. We have described the special circumstances for a guarantee issue . If you are not entitled to a guarantee issue, you will be underwritten. This means you will answer a series of health questions and the insurance company will review your health history and then either accept you or decline you. Additionally, there are some states that have implemented legislation that gives their Medicare eligible people additional rights.
Some Supplement Plans That Are Great Alternatives To Medicare Advantage Plans
Youre in a Medicare Advantage Plan and your plan is leaving Medicare or stops providing care in your service area, or you move out of the plans service area.
You have the right to buy a Medigap Plan A, B, C, F, K, or L thats sold by any insurance company in your state. You only have this right if you switch to Original Medicare rather than joining another Medicare Advantage Plan. You can/must apply for a Medigap policy:
As early as 60 days before the date your coverage will end
No later than 63 calendar days after your coverage ends Medicare Supplement coverage cant start until your Medicare Advantage Plan coverage ends.
You have Original Medicare and an employer group health plan or union coverage that pays after Medicare pays, and that plan is ending.
You have the right to buy a Medigap Plan A, B, C, F, K, or L thats sold by any insurance company in your state. If you have COBRA coverage, you can either buy a Medigap policy right away or wait until the COBRA coverage ends. You can/must apply for a Medicare Supplement plan no later than 63 calendar days after the latest of these 3 dates:
Date the coverage ends
Date on the notice you receive telling you that coverage is ending
Date on a claim denial, if this is the only way you know that your coverage has ended*Your rights may last for an extra 12 months under certain circumstances.
You have Original Medicare and a Medicare SELECT policy. You move out of the Medicare SELECT policys service area.
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