Ready To Change Coverage Youre Not Alone
Youve done your homework, carefully compared Medicare coverage options, and youve become one of more than 63 million Americans enrolled in some kind of Medicare plan.
And now whats this? Youre ready to change your Medicare plan or your coverage?
Youre not alone. Hundreds of thousands of Medicare enrollees take a hard look at their Medicare coverage and decide to switch each year . Many beneficiaries are looking for improvement in their access to providers or specific medications, while others complain that they chose coverage based on inaccurate information theyd received. Others cite claims denials for medical services they expected would be covered.
But while there are a variety of reasons a consumer might want to make a leap to new coverage, the options for coverage switches are limited. With that in mind, weve put together a summary of your options for changing your coverage.
How Do I Sign Up For Medicare Part B If I Already Have Part A
If you are already enrolled in Medicare Part A and you would like to enroll in Part B under the Special Enrollment Period , you can apply online at Apply for Medicare Part B Online during a Special Enrollment Period. You can upload your application and documents that verify your group health plan coverage through your employer.
You can also fax or mail your completed CMS-40B, Application for Enrollment in Medicare Part B and the CMS-L564, Request for Employment Information enrollment forms and evidence of employment to your local Social Security office. If you have questions, please contact Social Security at 1-800-772-1213 .
Note: When completing the forms CMS-40B and CMS-L564:
- State I want Part B coverage to begin in the remarks section of the CMS-40B form or online application.
- If your employer is unable to complete Section B, please complete that portion as best as you can on behalf of your employer without your employers signature.
- Also submit one of the following forms of secondary evidence:
- Income tax returns that show health insurance premiums paid.
- W-2s reflecting pre-tax medical contributions.
- Pay stubs that reflect health insurance premium deductions.
- Health insurance cards with a policy effective date.
- Explanations of benefits paid by the GHP or LGHP.
- Statements or receipts that reflect payment of health insurance premiums.
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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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Changes During Annual Open Enrollment
There are many plan changes that Medicare beneficiaries might want to make from one year to the next.
For most of them, the applicable open enrollment period is October 15 to December 7, with changes effective on January 1. During that timeframe, you can:
- Switch from Original Medicare to Medicare Advantage, or vice versa.
- Switch from one Medicare Advantage plan to another.
- Enroll in a Part D Prescription Drug Plan for the first time
- Switch from one Part D plan to another.
- Drop your Part D coverage altogether .
Read more about the four ways you can upgrade your Medicare coverage during open enrollment. And take a minute to read about Medicare enrollment mistakes that could cost you money.
Do You Have A Medicare Supplement Plan Heres How To Handle Your Move To Another State
If youre enrolled in a Medicare Supplement plan and move to another state, you may be able to keep the same policy. There are 10 standardized Medigap plans available in 47 states . Because the plans are standardized in most states, you may be able to remain with the same plan. But be aware that you might have to pay more for the Medigap plan in your new state, and you might have to answer some questions about your health history..
Most Medicare Supplement plans let you see any doctor who accepts Medicare assignment, but one type of Medigap plan called Medicare SELECT may require you to use providers within its network. If you have a Medicare SELECT policy and you move out of the plans service area:
- You can sign up for a standardized Medigap policy from your current Medigap policy insurance company that includes the same, or fewer, benefits as your current Medicare SELECT policy.
- Generally, you can sign up to buy any Medigap Plan A, B, C, F, K, or L thats available in the area where you live.
- You wont have to undergo medical underwriting if youve had your Medicare SELECT policy for more than six months. Otherwise, the insurance company may review your health history and may charge you more if you have a health condition.
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Can I Change Medicare Supplement Providers
You can change your Medicare Supplement company at any time to get a lower premium. Many carriers offer a rate lock for the first year of coverage, making this another advantage of switching Medicare Supplement companies. During this rate lock period, you don’t need to worry about increases to your premium.
If I Have Coverage Through My Employer Is There Anything I Need To Do To Ensure Im Covered In My New State
When you move due to your job, whether youll have to change health plans depends on the type of coverage your employer provides. If you have an HMO plan, you will most likely need to select a new plan through your employer.
If you dont have an HMO, chances are the only thing youll have to do is change your address with your human resources department. But schedule a meeting with your HR rep anyway, and let them know you want to talk about health insurance as it relates to your relocation. There may be aspects to your plan that will change, such as your choice of healthcare providers in your new location.
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What To Do About Medicare When You Move
Relocating can be a chaotic time. Its easy for small details to get lost in the shuffle or forgotten. Dont let your Medicare coverage be one of those details.
Depending on the type of Medicare coverage youve chosen and whether youre moving across town or far away, the steps you need to take could be as simple as notifying the Social Security Administration of your change of address. However, they could be as complicated as invoking a special enrollment period, choosing a new health plan, finding a new healthcare provider, and transferring your medical records.
If Youre Transitioning Into Or Out Of Inpatient Care
If youve been hospitalized as an inpatient and move out of state after discharge, your Medicare benefits wont be disrupted.
Hospitalization and inpatient care are covered under Medicare Part A, which is part of original Medicare and required to be a part of every Medicare Advantage plan.
While you may still need to switch your Medicare Advantage plan once you move, your Medicare Part A benefits will be covered either way.
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Can I Change My Medicare Coverage Outside Of The Medicare Open Enrollment Period
You can, but generally only under special circumstances that qualify you for a Special Enrollment Period . These circumstances include moving to a new location that is outside of your current plans service area or where additional plan options are available, moving back into the U.S. after living abroad, moving into or out of a facility, or if Medicare terminates your current Medicare Advantage plan.
Some beneficiaries can change coverage on a quarterly basis. This includes enrollees who receive assistance from Medicaid and enrollees who receive Extra Help paying their Medicare drug plan premiums and cost sharing, who can switch Part D plans or Medicare Advantage plans once per calendar quarter in the first three quarters of the year, and during the Medicare Open Enrollment period that runs from October 15 through December 7 each year. Some beneficiaries can change coverage from month to month. This includes beneficiaries in certain institutions, such as nursing homes, who can switch Medicare Advantage or Part D plans once a month for as long as they are living there.
What Happens If At The End Of The Process My Income Is Verified To Be Higher Than The Income Limits
Your copay status will be changed from copay exempt to copay required, which may result in disenrollment due to enrollment restrictions for Veterans whose income exceeds the income limits. VA facilities involved in your care will be notified of your change in status and to initiate billing for services provided during that income year. Your enrollment priority status may be changed if your financial status is adjusted by the income verification process. If your enrollment status is changed, you will be notified by mail.
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Health Insurance When Moving To A New State
Hannah is a freelance relocation writer from NYC that has become an expert on packing and unpacking.
Are you planning to relocate to a new address? If youre about to switch states, there are crucial things you must learn. We will cover your options for health insurance when moving to another state. This is an essential topic for anyone who is relocating. You will need to gather all the necessary information in order to commence the next phase of your life properly at your chosen location.
Change Medicare Plans During Medicare Advantage Open Enrollment Period
If youre enrolled in Medicare Advantage and want to switch back to Original Medicare, Part A and Part B, you can do so during the Medicare Advantage Open Enrollment Period , which runs from January 1-March 31 each year. You will also have until March 31 to join a stand-alone Medicare Prescription Drug Plan , and your coverage will go into effect the first day of the month after your new plan gets your enrollment form.
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What If I Do Not Receive This Form
VA annually sent IRS Form 1095-B to Veterans who were enrolled in the VA health care system at any time the previous calendar year. If you did not receive a Form 1095-B from VA explaining your health care coverage for each year you are or have been enrolled, call 1-877-222-VETS Monday through Friday from 8 a.m. until 8 p.m. ET. This form is for your records only and should not be sent to the IRS or returned to VA.
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Can I Still Make Changes To My Medicare Coverage For 2022
Q: Can I still make changes to my Medicare coverage for 2022?
A: For 2022 coverage, open enrollment for Medicare Advantage and Medicare Part D ended on December 7, 2021. The enrollment window for 2023 coverage will follow the same schedule, starting October 15, 2022 and continuing through December 7, 2022.
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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.
Work And Healthcare Policy
If you are relocating without a job, your prime concern will be to get a job in a new city. On the other hand, if you are moving to another state for a job, you can also count on your employers help with getting insured. Workplace healthcare insurance is typically less expensive than getting an individual health plan. According to Federal law, large companies must pay at least half of health plan premiums. Statistics suggest that employers paid 67% of medical premiums for family coverage in 2020.
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Moving With A Medigap Plan
Moving To Another State With Medicare Advantage Or Part D
Your new home address isnt in your plans service region
If you end up moving to a different state that happens to fall outside the service region, you can change to a new plan. Those with a Medicare Advantage Plan can switch back to Medicare. Tell the plan before the move then, the SEP begins the month you move and extends two months. However, tell the company after the move, and the SEP begins the month you notify them plus two months.
Your new home is still within your plans service area, but new plan options are available
If your new zip code is within the service area but with new plan options, you can select a new plan. Your SEP starts the month the company knows of the move and lasts for two months after.
Youve recently moved back to the United States
If you were living in another country and move back to the U.S., you can enroll in a new plan for up to two months.
Youve moved into or out of a health facility
If you recently moved into, currently reside in, or recently moved out of a nursing facility, you have several options. You can choose to join a plan if you dont have one, or switch your current policy. Also, you may choose to drop your Advantage plan and return to Medicare, or you can drop Part D. If you are continuing to live within the nursing facility, you can join, switch plans, or even drop your coverage. You can do this for up to two months after you move out of the health facility.
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Your Plan Changes Its Contract With Medicare
- Medicare takes an official action because of a problem with the plan that affects me.
What can I do?
Switch from your Medicare Advantage Plan or Medicare Prescription Drug Plan to another plan.
Your chance to switch is determined by Medicare on a case-by-case basis.
- Medicare ends my plan’s contract.
What can I do?
Switch from your Medicare Advantage Plan or Medicare Prescription Drug Plan to another plan.
Your chance to switch starts 2 months before and ends 1 full month after the contract ends.
- My Medicare Advantage Plan, Medicare Prescription Drug Plan, or Medicare Cost Plan’s contract with Medicare isn’t renewed.
What can I do?
Join another Medicare Advantage Plan or Medicare Prescription Drug Plan.