With a few exceptions, Medicare coverage automatically renews at the end of each year.
There are key dates throughout the year when an insurer must notify you of coverage changes and when you can sign up for new plans.
Once you enroll in Medicare, your plan(s) will usually automatically renew. This is intended to reduce the paperwork you must submit to Medicare. Let’s take a look at what automatic renewal is like for each aspect of Medicare:
Original Medicare
If you have Original Medicare (Parts A and B), your coverage will automatically renew at the end of each year.
Because Original Medicare is a standard policy across the country, you won’t have to worry that your coverage will be dropped.
Medicare Advantage
Your Medicare Advantage (Part C) plans will automatically renew unless Medicare cancels its contract with the plan or your insurance company decides not to offer the plan you’re currently enrolled in.
Prescription drug
Like Medicare Advantage, your prescription drug (Part D) plan should automatically renew. The exceptions are if Medicare does not renew the contract with your insurance company or the company no longer offers the plan.
Medigap
Your Medigap policy should automatically renew. Even if policy changes mean that your insurance company no longer sells a Medigap plan, you can usually keep your plan.
However, others entering the Medicare market may not be able to purchase the Medigap policy you have.
Even though Medicare plans automatically renew, this doesn’t mean you should skip the step of evaluating your coverage each year. Later, we’ll cover some additional tips on ensuring your plan is still right for you.
If your insurance company does not renew its contract with Medicare, you will receive a Medicare plan non-renewal notice in October.
Participating health plans may not renew their contracts with Medicare if they lose a significant amount of revenue during the year.
The non-renewal notice should let you know if you will be consolidated into another plan that is very similar to your previous plan. Insurance companies call this “mapping.”
If you don’t want to be mapped into a new Medicare Advantage plan, you can take one of the following steps:
- Search for and choose a new plan during the annual election period
- Do nothing and let your Medicare coverage revert to Original Medicare by default (you will need to purchase a Part D plan if your previous Medicare Advantage plan had drug coverage)
If a plan sponsor isn’t renewing its contract, you should be notified of alternative Medicare Advantage plans that are available in your region.
You should receive a Medicare plan annual notice of change in September from your plan, either from Medicare Advantage or Part D. This notice will describe any of the following changes:
- Costs: This includes deductibles, copays, and premiums.
- Coverage: Changes may include new services offered and updated drug tiers.
- Service area: This includes covered service areas or in-network status of certain pharmacies.
When your plan notifies you of these changes, they usually go into effect the following January.
If aspects of your plan are changing, review them carefully to determine whether your plan is still affordable and effective for your healthcare needs.
Choosing the best plan is a very individualized process. You probably have unique health needs, prescriptions, and budget concerns. You might find it helpful to:
Review your healthcare spending from last year
Did you quickly meet your deductible? Have more out-of-pocket costs than expected? Start taking any new medications?
If you answered ‘yes’ to any of these questions, you may need to re-evaluate your coverage for the coming year.
Consider your must-haves
Create a list of doctors that you must have in your network, medications you need coverage for, and how much you can afford to spend.
This can help you evaluate your current plan and identify new plans that may better meet your needs.
Carefully review your ANOC
Make sure to read this notice carefully. Think about how the changes may affect you positively or negatively.
Even if your plan hasn’t changed dramatically, it’s still a good idea to shop around. Plans can change significantly from year to year, so it’s worthwhile to spend some time comparing different Medicare plans.
Sometimes, your current plan is still the best. But evaluating plans against your current one can ensure you have the best coverage for you.
If you do choose to switch plans, you can sign up with your new plan during the designated enrollment period. Signing up with the new plan will unenroll you from your previous plan when your new coverage starts.
Just as your insurance company is required to notify you by a certain time of changes, you will have time periods when you can sign up for Medicare Advantage, go back to Original Medicare, or otherwise switch your plan.
Initial enrollment
The initial enrollment period is the 7-month time period where you can sign up for Medicare. This includes the 3 months before your 65th birthday, the month of your birthday, and the 3 months after you turn age 65.
If you’re already receiving benefits from the Social Security Administration or Railroad Retirement Board, you will be automatically enrolled in Medicare. If you aren’t, you can sign up through the Social Security Administration.
Annual election periods
Also known as Medicare open enrollment, this period runs from October 15 through December 7. During this time, you can switch from Original Medicare to Medicare Advantage and vice versa.
You can also change Medicare Advantage plans or add or drop Part D. Once you make changes, your new coverage usually starts on January 1.
General enrollment period
The general enrollment period is from January 1 through March 31.
During this time, you can change your Medicare Advantage coverage, such as switching from one plan to another or from Medicare Advantage to Original Medicare.
You cannot, however, switch from Original Medicare to Medicare Advantage.
Special enrollment period
You can also qualify to make changes outside of a typical Medicare enrollment period during a special enrollment period.
This is usually when you lose coverage due to changes in employment, if you move to a different service area, or move into or out of a nursing home.
When you want to make a change in your Medicare coverage, you can visit the plan search tool on Medicare.gov, call Medicare at 800-MEDICARE, or contact the plan directly.
Your Original Medicare coverage will usually automatically renew. Most Medicare Advantage and prescription drug plans also renew without you having to take action.
If your Medicare Advantage or Part D plan isn’t renewing its contract with Medicare, you should receive a notice before the annual election period to choose a new plan.