Wednesday, May 22, 2024

How To Switch Medicare Advantage Plans

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Why Switch To Medicare Advantage

Switching From Medicare Advantage to Medigap

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

Dont Stick With Coverage That Isnt Working For You

The wrong Medicare Advantage plan could put a huge strain on your retirement budget and cause you to neglect your health and thats not what you want. If youre unhappy with your current plan, take advantage of the option to switch.

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Shop Options & Switch If Necessary

Our software will look at all the Advantage plans in your zip code based on your medications and pharmacy. It will then display anywhere from 20 to 40 different plans available in your market. The plans will be organized from top to bottom based on coverage and costs. Youll be able to see if your meds are covered, what the cost of your co-pays will be, and how much youll pay in premiums.

Once you found a plan you like, the next step is to ensure all your health providers are in the plans network. This includes doctors, specialists, and hospitals. If your providers are not in the network, we would advise you to scroll down and find another plan that includes them in its network.

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Choosing Traditional Medicare Plus A Medigap Plan

As noted above, Original Medicare comprises Part A and Part B . You can supplement this coverage with a stand-alone Medicare Part D prescription drug plan and a Medigap supplemental insurance plan. While signing up for Medicare gets you into Parts A and B, you have to take action on your own to buy these supplemental policies.

If Youre Admitted To Institutional Care

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If youre admitted to any type of long-term care setting, you can switch your plan up to once per month during your stay, if you wanted to leave Medicare Advantage for Original Medicare. Facilities that qualify as institutional care include: 1.) long-term hospitals, 2.) skilled nursing facilities , 3.) rehabilitation hospitals and units, 4.) psychiatric hospitals and units, 5.) care facilities for the intellectually disabled, and 6.) and swing bed hospitals.

  • You can move from Medicare Advantage to Original Medicare for up to two months after youre discharged.

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What Is Medicare Advantage

Medicare Advantage plans are a way for adults 65 and older to get Medicare benefits from private insurance companies rather than the U.S. government. Theyâve been available since January 1999, but thereâs still a lot of confusion about them.

Because Medicare Advantage plans are offered by insurance companies, thereâs a lot of variation from plan to plan. And there can be several plans available in the state where you live. Having to look at and compare multiple âsummary of benefitsâ pages can feel pretty overwhelming. So hereâs what you need to know to choose the right Medicare Advantage plan.

When Can You Disenroll From A Medicare Advantage Plan

Like switching Medicare Advantage Plans, you can only disenroll from a Medicare Advantage Plan during certain times of the year.

You can disenroll from your plan during the annual election period, special election periods or during the annual Medicare Advantage Open Enrollment Period, Dworetsky says. Medicare will automatically disenroll you from your old plan if you switch to a different Medicare Advantage plan during any of these periods.

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Why Should I Switch My Medicare Advantage Plan

Many people switch Medicare Advantage plans when their current plan becomes too costlyand thats certainly a good reason to switch. But its not the only reason:

You might find better benefits on another plan. Lately, plans are offering more supplemental benefits like meals, over the counter medication allowances, and telemedicine.

You might get better coverage on another plan. You could find a plan with better coverage for the essentials, like hospital copays. Or you could switch to a plan that your doctor is contracted with. Or, your current plan could stop covering a drug you depend on. Or another plan could offer the same coverage you have now, but for cheaper premiums or copays.

You might need to switch if you move. Some switches are necessary because your current plans service area doesnt operate where you moved to.

Regardless of any reasons for switching, you should read your current plans Annual Notice of Change when it arrives each year. The packet outlines how your coverage, premiums, and copays will change the following year.

Moving When You Have Original Medicare

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Original Medicare includes Medicare Part A hospital insurance and Medicare Part B medical insurance. Because it is administered by the federal government, you can take your coverage with you if you move anywhere within the United States and its territories.

Where You Can Move and Take Your Original Medicare Coverage

  • Any of the 50 states
  • The District of Columbia
  • Puerto Rico

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If You Can Enroll In Coverage From Your Union Employer Or A Program Of All

Youre free to leave Medicare Advantage and enroll in certain types of private plans. If your employer or union offers a plan that you find more appealing than Medicare Advantage, you can disenroll without penalty.

  • You can switch from Medicare Advantage to other coverage whenever the rules of your union, employer, or PACE plan allow for it.

General Medicare Enrollment For Those Who Didnt Sign Up When First Eligible

From January 1 to March 31 each year, people who are eligible for Medicare Parts A and B but not yet enrolled can sign up for coverage. Coverage will take effect on July 1 of that year. If you didnt sign up for Part B when you were first eligible and you havent had creditable coverage from an employer plan in the meantime, youll have to pay an additional premium for your Part B plan, as a late enrollment penalty.

If you sign up for Medicare during the general enrollment period, you have three additional months during which you can select a Part D plan or a Medicare Advantage plan. And once youre enrolled in Medicare Part B , youll have a one-time enrollment window during which Medigap plans in your area are guaranteed-issue. In most states, Medigap plans will then be medically underwritten if you apply after that six-month window ends.

Although the fall enrollment window for 2022 coverage is approaching, people who arent enrolled in Part B cannot sign up for it during the fall window. Instead, theyll need to wait until January 1, and enroll in Part B during the general enrollment period.

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Occurs: Jan 1 Through March 31 Each Year

If you’re enrolled in a Medicare Advantage plan on Jan. 1, you can:

  • Change to a different Medicare Advantage plan.
  • Leave your Medicare Advantage plan to join Original Medicare.
  • Add or drop Medicare Part D when switching plans.

However, you cannot switch from one stand-alone prescription drug plan to another stand-alone prescription drug plan.

Any changes you make, take effect the first day of the month after your request.

What Happens To Your Medicare Part D Drug Plan When You Move

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If you have a Medicare Part D prescription drug plan, youll need to enroll in a new plan in your new state. Medicare Part D drug plans are sold by private insurers and are specific to the state where theyre sold.

Youll only have two months to sign up for a new plan once you move. If you dont sign up within that window, youll lose coverage. And youll have to wait until the open enrollment period in October to sign up.

But if you notify your Medicare Plan D plan administrator that you are moving, you can purchase a new plan in the state where youre moving beginning the month before the move. Youll still have the two month period after you make the move as a buffer.

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What You Should Know:

  • You can only change Medicare Advantage Plans during certain times of the year, unless you qualify for a Special Enrollment Period .
  • Anyone can change their Medicare Advantage Plan during their Initial Enrollment Period, Open Enrollment or Medicare Advantage Open Enrollment.
  • Open Enrollment occurs every year from October 15 to December 7. Medicare Advantage Open Enrollment lasts from January 1 through March 31 each year.
  • If you qualify for a SEP, you generally have 2 months to make a change to your Medicare Advantage Plan.
  • There are 3,550 Medicare Advantage Plans available nationwide in 2021, according to the Kaiser Family Foundation. The average Medicare beneficiary has access to 33 different plans she can choose from. This can make choosing the right plan for you a challenge. The good news is that changing Medicare Advantage Plans is easy: Simply join a new plan and youll be automatically disenrolled from your old plan. The bad news is there are only certain times of the year when you can change your Medicare Advantage Plan. You must be enrolled in Medicare Part A and B to join a Medicare Advantage Plan.

    Can I Switch Medicare Supplement Providers

    Because not all insurance companies sell the same exact Medigap plans, switching policies may require switching Medicare supplement providers to get the plan you want. The rules for switching between Medicare supplement providers is no different than switching plans within the same provider. There is no penalty to switching to a Medigap plan from a different insurance company.

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    When Can You Change Medicare Supplement Plan

    You can change your Medicare Supplement, or Medigap, plan anytime you choose. When you first enroll, youll have a six-month timeframe to select any supplement plans with Guaranteed Issue rights.

    After this open window, youll have to apply through the carriers application process. However, some states, such as California, Oregon, Missouri and Washington, enable you to change supplement plans without fulfilling these requirements.

    How To Change Medicare Plans

    How To Change Medicare Supplement (Medigap) and Medicare Advantage Plans

    Be aware that if you want to disenroll from a Medicare Advantage plan and dont want to enroll in another Medicare Advantage plan, you have to notify your plan in writing. However, if you want to change from one Medicare Advantage plan to another or from one Medicare prescription drug plan to another, all you have to do is join the new plan, and you will automatically be disenrolled from the old one.

    Also understand that you can generally only change Medicare plans during the Medicare Advantage Open Enrollment Period, Annual Election Period, or a Special Election Period .

    Medicare information is everywhere. What is hard is knowing which information to trust. Because eHealths Medicare related content is compliant with CMS regulations, you can rest assured youre getting accurate information so you can make the right decisions for your coverage. Read more to learn about our Compliance Program.

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    Fall Medicare Open Enrollment Part D Prescription Drug Plans

    If youre enrolled in Original Medicare , you can enroll in a stand-alone Medicare Part D Prescription Drug Plan during the Fall Medicare Open Enrollment period, which is the same time period described above . You need to live within the service area of the plan. You can make other coverage changes during the Fall Medicare Open Enrollment Period, such as:

    • Switch from one Medicare Part D Prescription Drug plan to another.
    • Drop your Medicare prescription drug coverage completely.

    If you decide to drop your Medicare prescription drug coverage, be aware that if you go without this coverage for 63 days in a row or longer, you could face a Medicare Part D late-enrollment penalty if you decide to enroll again at a later date.

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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.

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    How To Switch Between Medicare Advantage And Medigap Plans

    You cannot have both coverages at the same time, so you have to choose between an Advantage or a Medicare Supplement plan. Follow the steps below to switch from Medicare Advantage to Medigap.

    • Cancel your Medicare Advantage coverage and change back to Original Medicare. You can only cancel coverage during one of the Open Enrollment Periods. Usually, you will lose your Guaranteed Issue rights when you switch.
    • Apply for a Medicare Supplement insurance plan. If you first signed up for Medicare within the past year, youll receive guaranteed eligibility. In other circumstances, youll have to go through the insurers medical underwriting procedure.
    • Check for exceptions. For example, if you move to a different state and Medicare Advantage is not available, you may be entitled to switch back to Original Medicare and a Medigap plan.

    If youve already changed between the two plans in the past, you may not be able to reinstate your Medigap policy without medical underwriting.

    If youve already changed between the two plans in the past, you may not be able to reinstate your Medigap policy without medical underwriting.

    How Can I Get The Medicare Advantage Coverage I Need In My New Area Of Residence

    How to Switch Medicare Advantage Plans

    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 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!

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    Heres What You Need To Know About Switching Your Medicare Advantage Plan

    The Medicare Annual Election Period takes place each year from Oct. 15 through Dec. 7. During this time you can:

    • Switch from Original Medicare to a Medicare Advantage plan
    • Change from a Medicare Advantage plan back to Original Medicare
    • Switch from one Medicare Advantage plan to another Medicare Advantage plan

    Coverage begins on Jan. 1.

    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.

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