- 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 (October 15 through December 7) or the Medicare Advantage open enrollment period (January 1 through March 31).
- You can also switch your Medicare Advantage plan during a special enrollment period that’s triggered by a major change in your life.
If your circumstances have changed since you first enrolled in a Medicare Advantage plan, you might now be looking for a different plan that better meets your needs. But can you drop one plan and switch to another?
The short answer is yes. The long answer: You can switch your Medicare Advantage plan, but only during specific enrollment periods during the year. It’s not difficult, but it’s important to do it at the right time. Otherwise, you could lose coverage or create gaps in your coverage.
Here’s what you need to know about when and how to switch your Medicare Advantage plan.
Medicare Advantage (Part C) 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 doesn’t offer drug coverage
- switch to original Medicare (parts A and B) plus a Part D plan (prescription drug)
- switch to original Medicare without adding a Part D plan
You can usually make only one change to your plan during the Medicare Advantage open enrollment period.
To switch plans, contact the insurance provider of the plan you like and apply for coverage. If you’re not sure how to contact the provider, Medicare’s 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.
You may switch Medicare Advantage plans during predetermined periods each year and within a specified period of time following certain life events. Here are the specific dates and rules for when you may switch Medicare Advantage plans.
Initial enrollment period
You can switch your Medicare Advantage plan at any time during your initial enrollment period.
If you qualify for Medicare based on your age, then your initial enrollment begins 3 months before the month of your 65th birthday, includes your birth month, and continues for 3 months afterward. In total, the initial enrollment period lasts for 7 months.
If you qualify for Medicare based on a disability, your initial enrollment period begins 3 months before your 25th month of getting Social Security Disability Insurance or Railroad Board Benefits, includes your 25th month, and continues for 3 months after that.
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.
Open enrollment period
You can make changes to your Medicare Advantage plan at any time during the annual election period, known as open enrollment. This lasts from October 15 through December 7 each year. The changes you make will take effect on January 1 of the following year.
Special enrollment periods
Certain life events can trigger the opportunity to switch your Medicare Advantage plan. If you move to a new location, your coverage options change, or you encounter certain other life circumstances, Medicare may offer you a special enrollment period.
Here’s a summary of those events and the options you’ll have:
|If this happens…||I can…||I have this long to make changes…|
|I move out of my plan’s service area||switch to a new Advantage or Part D plan||2 months*|
|I move and new plans are available where I live||switch to a new Advantage or Part D plan||2 months*|
|I move back to the United States||join an Advantage or Part D plan||2 months*|
|I move out of or into a skilled nursing facility or long-term care facility||join an Advantage or Part D plan, |
switch Advantage plans, or
drop Advantage and switch to original Medicare
|for as long as you live in the facility and 2 months after you leave|
|I’ve been released from jail||join an Advantage or Part D plan||2 months*|
|I’m not eligible for Medicaid anymore||join an Advantage or Part D plan, |
switch Advantage plans, or
drop Advantage and switch to original Medicare
|I don’t have health insurance from my employer or union anymore||join an Advantage or Part D plan||2 months*|
|I enroll in a PACE plan||drop Advantage or Part D plan||anytime|
|Medicare sanctions my plan||switch Advantage plans||determined case by case|
|Medicare ends my plan||switch Advantage plans||from 2 months before the plan ends until 1 month after it ends|
|Medicare doesn’t renew my plan||switch Advantage plans||from Dec 8 through the last day in Feb|
|I’m eligible for Medicare and Medicaid||join, switch, or drop Advantage plans||once during Jan–Mar, Apr–Jun, and Jul–Sep|
|I enroll in a State Pharmaceutical Assistance plan (or lose the plan)||join an Advantage plan with Part D||once per calendar year|
|I drop my Medigap policy when I join an Advantage plan||drop Advantage and join original Medicare||12 months after you first join the Advantage plan|
|I have a Special Needs Plan but no longer have the special need||switch to an Advantage or Part D plan||3 months after grace period ends|
|I join the wrong plan because of a federal employee error||join an Advantage or Part D plan, |
switch Advantage plans, or drop Advantage and switch to original Medicare
|Medicare gives a 5-star rating to a plan in my area||switch to a 5-star Advantage plan||once between Dec 8 and Nov 30|
*Consult Medicare.gov for details on when the clock starts ticking.
Medicare Advantage (Part C) plans are health insurance plans sold by private insurance companies. They offer the same coverage as original Medicare (parts A and B), plus additional benefits.
Depending on the plan, some of those extra benefits could include dental, hearing, vision, and prescription drug coverage. You can compare plans by using Medicare’s plan finder tool. This will let you see the coverage and rates available near you.
Your cost for a Medicare Advantage plan in 2020 depends on which plans are available where you live. Here’s a brief sampling of locations and costs across the United States:
Medicare Advantage costs in several cities
|Plan||Location||Monthly premium||Part B premium||In-network deductible||Drug deductible||Copays & coinsurance||Out-of-pocket max|
|Humana Gold Plus H0028-028 (HMO)||Sun City, Arizona||$0||$144.60||$0||$225||$0 primary; $40 specialist||$5,500|
|Blue Medicare Saver||St. Petersburg, Florida||$0||$144.60||$0||$50||$0 primary; $45 specialist||$6,700|
|HealthPartners Journey Pace||St. Paul, Minnesota||$0||$144.60||$0||$300||$25 primary; $50 specialist||$10,000 in or out of network; $5,700 in network|
|MVP WellSelect with Part D (PPO)||Albany, New York||$0||$144.60||$0||$0||$0 primary; $50 specialist||$10,000 in or out of network; $6,700 in network|
To be eligible for a Medicare Advantage plan, you must be enrolled in original Medicare (Part A and Part B). You will also need to live in an area covered by an insurance provider that offers Medicare Advantage plans to new beneficiaries.
To be eligible for original Medicare, you must be a U.S. citizen or legal permanent resident for at least 5 years and fit one or more of these categories:
You can make changes to your Medicare Advantage plan by:
- either adding or dropping prescription drug coverage
- switching to a different Medicare Advantage plan
- going back to original Medicare, with or without a drug plan
The important thing to note is that you can change your plan only at specific times during the year. You can switch at any time during your 7-month initial enrollment period. You can also switch during the open enrollment period each fall (October 15 through December 7).
Another time you can make changes is during the Medicare Advantage open enrollment period from January 1 through March 31 every year. Plus, certain life changes allow you to change your plan during special enrollment periods.
When you’re ready to switch, know that you can get help finding and enrolling in the right plan for you.
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