You Can Change Plans only During Specific Enrollment Periods

As you grow older, your healthcare needs may change, and it's not uncommon to find that your current Medicare plan no longer provides the coverage you require. It can be frustrating to realize that the plan that worked for you in the past no longer meets your needs.

Fortunately, Medicare understands this and allows you to change your plan if you're unsatisfied with it.

But can you change plans anytime?

While it's not always possible to change plans whenever you want, there are specific periods when you can make changes.

Let's explore the various enrollment periods to understand when you can join Medicare and make changes to your plan.

When Can I Enroll in Medicare?

Your Initial Enrollment Period (IEP), commonly known as your first opportunity to enroll in Medicare, typically occurs when you are approaching the age of 65. Nevertheless, if you have a disability, end-stage renal disease (

ESRD

) or

ALS

(also called Lou Gehrig’s disease), you may be eligible for Medicare even before you turn 65.

The Initial Enrollment period lasts for seven months, starting three months before your 65th birthday and ending three months after your birthday. But, if your birthday falls on the first of the month, it begins four months before your birth month and extends until two months after.

For example, if your birthday is in February, your IEP will start in November and end in May. But if your birthday is on the 1st of February, your IEP will begin in October and end in April.

Initial Enrollment Period

During your IEP, you can:

When Will My Medicare Coverage Start If I Enroll During My IEP?

Your Medicare coverage start date depends on when you sign-up for Medicare, as follows:

Medicare Coverage Start Date

‎

When Will My Medicare Coverage Start If I Have a Disability, ESRD or ALS?

If you have a disability, end-stage renal disease (ESRD) or

ALS

(also called Lou Gehrig’s disease), your Medicare coverage start date will depend on your particular situation as follows.

1. For individuals with a disability

If you have a disability and have been collecting

Social Security

benefits, you'll be automatically enrolled in Medicare at the beginning of the 25th month. Your coverage will start the same month.

2. For individuals with ESRD

If you have been diagnosed with ESRD and have enough work credits to qualify for retirement benefits, your Medicare coverage start date will depend on your specific circumstances.

3. For individuals with ALS

If you have been diagnosed with ALS, your Medicare coverage will start as soon as you receive your disability benefits. 

Can I Switch Medicare Plans Anytime?

No. You cannot switch Medicare Plans at any time.

If you're not satisfied with your current plan, you can make changes to your current plan during specific periods each year. Depending on your need, you can drop, switch, or join a new plan during these periods.

When Can I Switch Medicare Plans?

Finding the right Medicare plan can be daunting, and even after careful consideration, you may still find that it doesn't meet your healthcare needs or has high out-of-pocket costs. The good news is that Medicare understands that life circumstances can change, and they offer three enrollment periods for you to change your plan. These are:

Let's learn more about these enrollment periods.

1. Annual Enrollment Period

The Medicare Annual Enrollment Period, also known as Fall Open Enrollment Period, extends from October 15th to December 7th every year.

During this period, you can:

When Does My Coverage Begin?

Any changes you make during the AEP will take effect from January 1st of the following year.

However, if you're happy with your current plan, it will automatically renew on January 1st.

2. Medicare Advantage Open Enrollment Period

The Medicare Advantage Open Enrollment Period is a one-time opportunity during which Medicare beneficiaries already enrolled in a Medicare Advantage Plan can switch to another Medicare Advantage Plan or return to Original Medicare.

Medicare Advantage Open Enrollment Period runs from:

During this period, you can:

When Does My Coverage Begin?

Any changes made during the Medicare Advantage Open Enrollment Period will take effect on the first day of the following month.

3. Special Enrollment Period

The Medicare Special Enrollment Period (SEP) is when you can change your Medicare coverage due to certain life events.

During this period, you can:

When Does My Coverage Begin?

It may vary depending on specific situations, but generally, the first of the month after the plan gets your request.

You may be eligible for the Special Enrollment Period if:

Let's examine some specific scenarios in more detail and explore the steps you can take.

Your Move to a New Place

If you move to a new address that falls outside of your current plan's service area, or if your original service provider introduces new plan options in your new location, you can:

Note: If you do not enroll in a new Medicare Advantage plan, you will automatically be enrolled in Original Medicare when you disenroll from your old Medicare Advantage plan.

Your SEP depends on when you inform your service provider:

You Moved Into, Currently Live In or Moved Out of an Institution

If you recently moved into, currently live in or moved out of a skilled nursing facility or long-term care hospital, you have the following options:

Your SEP lasts as long as you live in the institution and ends two months after you move out.

You're No Longer Eligible for Medicaid

If you are no longer eligible for Medicaid, you can:

Your SEP lasts for three months from whichever date is later:

You Lose Coverage With Your Employer

If your employer or union COBRA coverage ends after 18 months, you can join a Medicare Advantage or Medicare drug plan.

Your SEP lasts two months after your coverage ends or two months after you are notified, whichever is later.

Your Plan Terminates Its Contract with Medicare

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 two months before the contract ends and extends until one month after.

Other Situations

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).

Medicare Enrollment Periods to Switch Plans

Is It Time to Switch Your Medicare Plan?

As your healthcare needs change, it's possible that your current plan may not provide the coverage you need. Review your plan periodically and make necessary changes to ensure you get the best possible care.

If you're enrolled in Original Medicare, review the following year's "Medicare & You" handbook to understand your Medicare benefits and costs clearly. For those with a Medicare Advantage Plan or a Part D plan, review the Annual Notice of Change (ANOC) and/or Evidence of Coverage (EOC) from your plan. These documents will detail any changes to your plan's costs, benefits, and regulations for the upcoming year.

Additionally, it's also recommended to research other Medicare options in your area, even if you are satisfied with your current coverage. There might be another plan that better meets your healthcare needs and is more affordable. 

At

Fair Square Medicare

, we prioritize our client's satisfaction, so we review their coverage and costs yearly during the AEP. This ensures they are not overpaying and their plan meets their healthcare needs. If you have any questions about your plan coverage and costs or are unsure if your current plan is the best fit, please do not hesitate to contact us at 1-888-376-2028.