Most people can change their Medicare health coverage and Medicare drug coverage during three different enrollment periodsEnrollment periods are designated time periods to enroll or disenroll from the various parts of Medicare. There are six Medicare enrollment periods.. Each period has different rules. If you are new to Medicare, you have an additional option.
Most of us know about the Medicare open enrollment periodDuring the Medicare Open Enrollment Period, Medicare Advantage and Part D plan members can change, switch, or drop a plan they chose during the Annual Election Period. OEP starts on January 1 and ends on March 31. in the fall. With all of the TV commercials advertising Medicare coverage options, it’s hard to miss.
In this article, we’ll cover your Medicare open enrollmentIn health insurance, open enrollment is a period during which a person may enroll in or change their selection of health plan benefits. Health plan enrollment is ordinarily subject to restrictions. options and how you can use them for your benefits. We’ll also cover three special rights you have and why you should use them.
Key Takeaways
- After your Initial Enrollment PeriodThe Initial Enrollment Period is a seven-month period when new beneficiaries can enroll in Medicare without a penalty. Most people enroll in Medicare at age 65., there are three enrollment periods you can use to add, change, and drop plans. Each period has different rules.
- The Annual Election Period – October 15 through December 7 each year – is when you can add, change, and drop Medicare Advantage plansMedicare Advantage (MA), also known as Medicare Part C, are health plans from private insurance companies that are available to people eligible for Original Medicare (Medicare Part A and Medicare Part B). and Medicare Part DMedicare Part D plans are an option Medicare beneficiaries can use to get prescription drug coverage. Part D plans provide cost-sharing on covered medications in four different phases: deductible, initial coverage, coverage gap, and catastrophic. Each... plans.
- The Medicare Advantage Open Enrollment Period – January 1 through March 31 – allows you to change or drop a Medicare Advantage plan or prescription drug plan, but only if you already have one.
- A Special Enrollment PeriodSpecial Enrollment Periods (SEPs) allow beneficiaries to change their Medicare Advantage and Part D plans due to a special circumstance. Common reasons for a SEP include moving, losing employer coverage, and Medicaid eligibility, to name... allows you to change plans under special circumstances, such as when you move. There is also a 5-Star enrollment period.
Can Medicare Plans Be Switched Anytime?
No.
Generally speaking, you cannot switch Medicare plans anytime you want. Medicare Supplement plans are the exceptionIn a Medicare Part D plan, an exception is a type of prescription drug coverage determination. You must request an exception, and your doctor must send a supporting statement explaining the medical reason for the... to this rule. And, there are exceptions for special circumstances.
When you first qualify for Medicare, you are entitled to enroll in Medicare Parts A and B. At the same time, you can join a Medicare Advantage plan, Medicare Part D plan, or buy a Medicare Supplement policy. This is your Initial Enrollment Period (IEP).
After your IEP, you must wait for a valid enrollment period or request a Special Enrollment Period.
Can You Switch Medicare Plans After Open Enrollment?
Yes.
There are two Medicare open enrollment periods each year. And, you may qualify for a Medicare Special Enrollment Period (SEP).
The annual Open Enrollment Period (OEP), previously called the Annual Enrollment PeriodThe Annual Enrollment Period is when Medicare beneficiaries can join, drop or change Medicare Advantage and Medicare Part D prescription drug plans. AEP begins on 15 October and ends on 7 December. (AEP), is when you can add, drop, or change Medicare Advantage plans and Medicare Part D plans. The new plan information typically comes out around October 1.
Starting October 15 you can make new plan elections. December 7 is the last day of the fall enrollment period. The plan changes you make by the 7th will go into effect on January 1.
If you made a mistake, or you didn’t make changes in the fall, you have a second opportunity. The Medicare Advantage Open Enrollment Period (MA-OEP) allows you to make changes to your current Medicare Advantage plan.
MA-OEP runs from January 1 through March 31. If you are enrolled in a Medicare Advantage plan, you can switch back to Original MedicareOriginal Medicare is private fee-for-service health insurance for people on Medicare. It has two parts. Part A is hospital coverage. Part B is medical coverage. or join a different Medicare Advantage plan. If you go back to Original Medicare, you can also get prescription drug coverage with a Part D drug plan.
Note: You are not allowed to join, switch, or drop a Medicare Advantage plan during MA-OEP unless you are already enrolled in Medicare Advantage. And, you can only switch plans once.
When Can I Change My Medicare Plan for 2023?
Most people add, change, and drop plans during the fall Open Enrollment Period between October 15 and December 7. This is the best time because it gives you a second chance to switch plans if you don’t like your new plan election.
If you joined a plan during OEP, then change your mind, you can use the enrollment period from January 1 through March 31 to get a new Medicare Advantage plan. However, the Medicare Advantage Open Enrollment Period only applies to Medicare Advantage. You can’t use this enrollment period to go from Original Medicare to Medicare Advantage.
There is also what’s known as the 5-Star Special Enrollment Period. During this period, which runs from December 8 to November 30 the following year, you can switch Medicare Advantage plans or Medicare Part D plan and join a 5-star plan.
You can use this Special Enrollment Period only once. And, you can only switch to a 5-star plan if one is available in your area.
When Can You Change Your Medicare Supplement Plan?
Unlike Medicare Advantage plans and Medicare Part D plans, Medicare Supplement InsuranceMedicare Supplements are additional insurance policies that Medicare beneficiaries can purchase to cover the gaps in their Original Medicare (Medicare Part A and Medicare Part B) health insurance coverage. (Medigap) does not have specific enrollment periods. However, there is a period of time when you have certain Medigap protections.
When you initially qualify for Medicare and enroll in Medicare Part BMedicare Part B is medical coverage for people with Original Medicare benefits. It covers doctor visits, preventative care, tests, durable medical equipment, and supplies. Medicare Part B pays 80 percent of most medically necessary healthcare services., your Medicare Supplement Open Enrollment Period begins. It is a six-month period of time.
During this six-month period, you have a guaranteed issue rightGuaranteed-issue is a right granted to Medicare beneficiaries and applies to Medicare Supplement insurance (aka, Medigap plans). All states and the federal government enforce this essential right, which protects Medicare beneficiaries from medical underwriting. to buy the Medigap policy of your choice. You cannot be turned down, even if you have a pre-existing conditionA pre-existing condition is any health problem that occurred before enrolling in a health plan. The Affordable Care Act law made it illegal for health plans to or charge more due to a pre-existing condition..... And, so long as you continue paying the monthly premiumA premium is an amount that an insurance policyholder must pay for coverage. Premiums are typically paid on a monthly basis. In the federal Medicare program, there are four different types of premiums. , the policy cannot be canceled.
Once your six-month Medicare Supplement Open Enrollment Period ends, so do your Medigap protections. This does not mean you cannot apply for a new policy. You can.
You can cancel your policy at any time and apply for a new policy at any time. However, without Medigap protections, an insurance company can turn you down.
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Are There Other Times When Can You Change Your Medicare Advantage Plan?
Above you learned about three open enrollment periods for Medicare Advantage plans. There are two more times that need to be discussed.
The first time is when you initially sign up for Medicare at age 65. At that time, if you decide to join a Medicare Advantage plan you have a one-year trial right.
While you have your trial right, under federal law you can buy a Medigap policy and a Medicare drug plan if you return to Original Medicare within 12 months. Some special circumstances apply:
- If you had a Medigap policy before you joined a Medicare Advantage plan, you may be able to get the same policy back. If the policy is not available, you can buy another Medigap policy.
- If you joined a Medicare Advantage plan when you were first eligible for Medicare, you can choose from any Medigap plan from the insurance company of your choice.
- Some states may have additional special rights to buy a Medigap policy.
The second time is when you move out of your plan’s service area when your plan notifies you that it is leaving your area, or you have another qualifying life event. When this happens, you will have a Special Enrollment Period to switch Medicare Advantage plans or go back to Original Medicare and join a stand-alone prescription drug plan.
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When Can You Change Your Medicare Part D Plan?
The rules for Medicare drug coverage are the same as the rules for Medicare Advantage. And, the same special enrollment periods (SEP) apply to your drug coverage. If you move out of your plan’s service area, you can get a SEP. Here are some other life events that may apply:
- You move into a nursing home.
- You no longer qualify for MedicaidMedicaid is a public health insurance program that provides health care coverage to low-income families and individuals in the United States..
Also, if you change Medicare Advantage plans to a plan without drug coverage, you can join a Medicare Part d plan to get