Changing Your Medicare Plan

Many people find that as they age their Medicare requirements evolve and they need to change plans to better accommodate their healthcare needs.  Changing your Medicare plan doesn’t need to be difficult and can be a relatively easy process once you understand when and how often you can switch from one plan to another.

Make sure that if you want to disenroll from a Medicare Advantage plan and don’t want to enroll in another Medicare Advantage plan, you notify your plan in writing.  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.

Generally, you can only change Medicare plans during the Medicare Annual Election Period (AEP), the Medicare Advantage Open Enrollment Period (MAOEP), or a Special Election Period (SEP).

Annual Election Period
The best time to change your Medicare Advantage or Medicare Part D Prescription Drug plans is during the Annual Election Period (AEP) that runs from October 15th to December 7th each year.  During this time period you are allowed to:

  • Change from Original Medicare, Part A & B, to a Medicare Advantage Plan.
  • Change from a Medicare Advantage plan back to Original Medicare, Part A & B.
  • Change from a Medicare Advantage back to original Medicare and enroll in a Part D plan
  • Switch from one Medicare Advantage plan to another Medicare Advantage
  • Switch from a Medicare Advantage plan that doesn’t offer drug coverage to a Medicare Advantage plan that does.
  • Switch from a Medicare Advantage plan that offers drug coverage to a Medicare Advantage plan that doesn’t offer drug coverage.
  • Switch from one Medicare Prescription Drug Plan (Part D) to another.

When you change plans during the AEP your new coverage begins on January 1 of the following year.

Open Enrollment Period (MAOEP)

You must be enrolled in a Medicare Advantage plan on January 1st to make any changes during the Open Enrollment Period.

  • Change from a Medicare Advantage plan back to Original Medicare, Part A & B.
  • Change from a Medicare Advantage back to original Medicare and enroll in a Part D plan
  • Switch from one Medicare Advantage plan to another Medicare Advantage

Your coverage will go into effect the first day of the month after your new plan receives your enrollment form.  Note:  MSA Medicare Advantage plans are not eligible for this election period.

Special Election Period
Medicare allows for special circumstances that may allow you to change your Medicare Advantage or Part D drug plans during the Special Election Period (SEP).  This includes a permanent move out of the service area, losing your current coverage, loss of employer group coverage, or qualifying for other coverage such as Medicaid, and other assistance programs like qualifying for Extra Help to pay for Medicare Part D coverage through the Social Security administration.

The dates and types of changes you can make vary according to the Special Election Period.

If there is a Medicare Advantage or plan in your area that has earned the government’s 5-star (excellent) rating, you can switch onto that plan anytime between December 8 and November 30. This is called the 5-star special enrollment period, and you’re allowed to utilize it one time during that period. If you made a Medicare Advantage change during AEP, this SEP is only available the following year.

Special Needs Plans
If you develop condition that makes you eligible for a Medicare Special Needs Plan (SNP) and an applicable SNP is available in your area, you can join it at any time, but once you join, your special enrollment period ends.  The most common C-SNP plan conditions are diabetes, COPD/Emphysema, CHF or heart related issues.

Dual Eligible
If you’re covered by both Medicare and Medicaid, you can switch plans 1 time per quarter for the first 3 quarters of the year This applies to Medicare Advantage as well as Medicare Part D.  There are DSNPs designed for people who are dual-eligible for Medicaid and Medicare and there are also SNPs for people who are institutionalized.

Medigap
You can apply for a Medicare Supplemental Insurance (Medigap) plan at any time during the year. If you’re within the six-month open enrollment window that begins as soon as you’re at least 65 and enrolled in Medicare Part B, there are no underwriting questions or health qualifications.

You can still apply for a Medigap plan outside of open enrollment period; just be aware that in most states, the carrier will use medical underwriting to determine whether to accept your application, and how much to charge you for your premium.

If you delay your Part B enrollment due to other creditable coverage, such as an employer plan. You will have 8 months to enroll in Part B without penalty and 6 months open enrollment to join a Medicare Supplement without underwriting.  Most individuals will opt to coordinate the Part B to take effect when the employer plan ends for a seamless transition.

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2 thoughts on “Changing Your Medicare Plan”

  1. Is there a plan to cover us so we do not fall into the prescription coverage gap? My husband is on Humana Gold Plus HMO.

  2. Is there a plan to cover us so we do not fall into the prescription coverage gap? My husband is on Humana Gold Plus HMO. What is the SNP coverage for people with Heart failure and COPD? thank you

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