By Daniel Petkevich
Sep 19, 2022
If there is one constant in life, it's change. And if your medical needs or living circumstances change, so should your healthcare coverage.
Medicare helps you adapt. It lets you switch health insurance plans at specific times each year.
Keep reading to find out when you can change your Medicare Advantage plan and how to qualify for Special Enrollment Periods.
Yes!
If you're unhappy with your current plan or want to change your coverage, you can switch from one Medicare Advantage Plan to another, or return to Original Medicare. However, there are exceptions to when you can switch plans.
Note: Before switching plans, compare the costs and ratings of all Medicare Advantage plans in your area. We can help you do this.
You can join, change, or drop your Medicare Advantage plan during these specific periods:
Initial Enrollment period
Annual Election Period
Medicare Advantage Open Enrollment Period
Let's look at each period in detail.
You first sign up for Medicare during the Initial Enrollment period.
You start by enrolling in Parts A and B. Then, you can switch to any Medicare Advantage plan of your choice.
Your Initial enrollment period (IEP) depends on when you first get Medicare.
Below are some examples:
Your IEP is a 7-month window:
It begins 3 months before you turn 65.
It ends 3 months after your birth month.
If you enroll in a Medicare Advantage Plan during this time and aren't satisfied, you can drop it anytime within the next 12 months and return to Original Medicare.
Your IEP is a 7-month window:
It begins 3 months before your Medicare coverage begins (24 months after you get Social Security or RRB benefits)
It extends to 3 months after you start getting Medicare benefits
Your IEP is a 7-month window:
It begins 3 months before you turn 65.
It ends 3 months after your birth month.
During this period, you can either join, drop, or switch your Medicare Advantage Plan.
If you add Medicare Part B during the GEP (January 1st – March 31st), your IEP lasts from April 1st – June 30th.
The Annual Election Period (AEP) also known as the Fall Open Enrollment occurs from October 15th – December 7th each year.
During this period, you can:
Switch from Original Medicare to Medicare Advantage Plan.
Return to Original Medicare from a Medicare Advantage Plan.
Switch from one Medicare Advantage Plan to another (with or without drug plans).
Join a Medicare drug plan (Part D).
Switch from one Medicare drug plan to another.
Disenroll from a Medicare drug coverage.
Changes made during the AEP come into effect on January 1st.
The Medicare Advantage Open Enrollment Period (MA OEP) occurs from January 1st – March 31st each year.
During this period, you can:
Switch from a Medicare Advantage Plan to another plan
Return to Original Medicare from a Medicare Advantage Plan
However, you can’t:
Switch from Original Medicare to the Medicare Advantage Plan
Join a Medicare drug plan (Part D)
Switch from one Medicare drug plan to another
The change made during the MA OEP comes into effect the first of the month following enrollment.
Note: you can only switch your plan once during this period.
Yes. You can switch plans outside the three enrollment periods.
To do this, you must qualify for the Special Enrollment Period (SEP).
You're eligible for the Special Enrollment Period if:
You move to a different location
You lose your current coverage
You have a chance to get other coverage
Your plan changes its contract with Medicare
The state you live in grants an SEP
Let's look at some specific situations in more detail and discuss some steps you can take.
If you move to a new address outside your plan's service area or your original service provider introduces plan options in your new location, you can:
Switch to a new Medicare Advantage plan or Medicare drug plan
Return to Original Medicare (if you’re outside your plan’s service area)
Note: If you don’t enroll in a new Medicare Advantage plan, you’ll automatically get Original Medicare when you disenroll from your old MA plan.
If you inform your service provider before you move — your SEP begins the month before you move and extends to 2 months after you move.
If you inform your service provider after you move — your SEP starts the month you tell your provider and ends after 2 months.
If you leave the U.S. and move back, you can join a Medicare Advantage Plan or a Medicare drug plan.
Your SEP lasts from 1 month before you move until 2 months after you move back to the U.S.
If you recently moved out of a nursing home or rehabilitation hospital, you can:
Join a Medicare Advantage Plan or Medicare drug plan.
Switch from your current plan to another Medicare Advantage Plan or Medicare drug plan.
Return to Original Medicare.
Drop your Medicare drug coverage.
Your SEP lasts as long as you live in the institution. It ends 2 months after you move out.
If you no longer qualify for Medicaid, you can:
Join a Medicare Advantage Plan or Medicare drug plan
Switch from your current plan to another Medicare Advantage Plan or Medicare drug plan
Return to Original Medicare
Drop your Medicare drug coverage
Your SEP lasts for 3 months from whichever date is later:
The date you’re no longer eligible
The date you find out you’re no longer eligible
If your employer or union no longer provides coverage (including COBRA coverage), you can join a Medicare Advantage Plan or Medicare drug plan.
Your SEP lasts for 2 months after your coverage ends or 2 months after you are notified, whichever is later.
If Medicare takes an official action (a “sanction”) because of a problem with the plan, you can switch from your Medicare Advantage Plan or Medicare drug plan to another plan.
Medicare determines your SEP on a case-by-case basis.
If your plan is no longer part of Medicare, you can switch from your Medicare Advantage Plan or Medicare drug plan to another plan.
Your SEP begins 2 months before the contract ends and extends till one month after.
If your Medicare Advantage plan, Medicare drug plan, or Medicare Cost Plan isn’t renewed for the next contract year, you can switch from your Medicare Advantage Plan or Medicare drug plan to another plan.
Your SEP acts as an extension of the AEP and starts on October 15th and ends on the last day of February.
If you qualify for both Medicare and Medicaid, you can:
Join a Medicare Advantage Plan or Medicare drug plan
Switch from your current plan to another Medicare Advantage Plan or Medicare drug plan
Return to Original Medicare
Drop your Medicare drug coverage
You can join, switch, or drop once during each of these periods:
January – March
April – June
July – September
If you switch from Medigap to Medicare Advantage, you can:
Drop your Medicare Advantage Plan and enroll in Original Medicare
Buy a Medigap policy (with special rights)
Your SEP lasts 12 months after you first join a Medicare Advantage Plan.
Some other special circumstances also qualify you for a Special Enrollment Period. If you're in a situation not mentioned in this list, contact Medicare at 1-800-633-4227 (TTY users call 1-877-486-2048).
You may want to change or drop your Medicare Advantage Plan if:
You're unhappy with your current plan
Your doctor moves out of network
You move to a new place
Your medical situation changes
Whatever the case, Medicare lets you switch plans during specific enrollment periods.
You may also qualify for a Special Enrollment Period. Call Medicare or talk to our licensed advisers at 1-888-376-2028 to check your eligibility.
If switching plans feels confusing, Fair Square Medicare is here to help. We'll provide unbiased info about each plan, so you can choose the one that best meets your needs.
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