There are several good reasons to change Medicare plans – maybe your doctor is now out of network, or your prescription drug needs have changed. About 10% of Medicare beneficiaries change plans each year, but it’s important to know what the enrollment windows are. If you miss the specified enrollment periods, it might be too late.
This article provides a guide to Medicare enrollment periods, including the windows that allow you to change Medicare Advantage plans. Get out your calendar, and mark these dates.
Changing Medicare Plans
The National Council on Aging recommends reviewing Medicare coverage annually to determine whether you are on the right plan and if it’s time to expand your coverage, reduce your costs, or adjust coverage based on your health, lifestyle, or even a new address.
This advice is particularly relevant if you are looking to change Medicare Advantage plans or amend Part D prescription drug coverage, which is only allowable during specific times of the year, barring special circumstances.
We’ve outlined different enrollment periods below.
Medicare Open Enrollment
Every year, Medicare beneficiaries are eligible for an open enrollment period (also called an annual enrollment period or annual election period). The Medicare open enrollment period starts October 15th and lasts until December 7th.
During open enrollment (aka the annual election period), Medicare beneficiaries can do the following:
- Switch from Original Medicare (Medicare Parts A and B) to a Medicare Advantage Plan
- Switch a Medicare Advantage plan back to Original Medicare
- Enroll in Medicare prescription drug plan coverage (Medicare Part D)
- Switch or drop prescription drug coverage options
- Change your Medicare Advantage plan to a different Medicare Advantage plan
Medicare Advantage Open Enrollment Period
If you are already enrolled in a Medicare Advantage plan, you have access to another open enrollment window referred to as Medicare Advantage open enrollment. This enrollment period starts on January 1st and ends on March 31st, allowing you to acquire a different Medicare Advantage plan.
The options during the Medicare Advantage open enrollment periods are to switch Medicare Advantage plans or switch to Original Medicare with a Part D plan for prescription drug coverage.
Switching to Medicare Advantage (Medicare Part C)
Many seniors are unsure whether they should sign up for Original Medicare or Medicare Advantage during the Initial Enrollment Period.
As a reminder, the Initial Enrollment Period is based on your birthday. It starts three months before your 65th birthday, includes your birthday month, and extends three months beyond your birthday month. The total IEP window is seven months.
After enrolling in Original Medicare, it is possible to select a Medicare Advantage plan. For existing Medicare beneficiaries with Original Medicare, getting a new Medicare Advantage plan or switching to another Medicare Advantage plan can be done during the annual / open enrollment period, spanning from October 15th through December 7th.
Keep in mind that Medicare Advantage plans can change every year, so it’s also a good idea to review your Medicare coverage annually.
If you delayed signing up for Medicare health coverage during the Initial Enrollment Period, you can enroll in a Medicare Part B plan from January 1st through March 31st each year.
This timeframe also applies to those who don’t qualify for the Special Enrollment Period, SEP for short. The SEP is for those who had employer-based insurance as a private or federal employee when they gained eligibility for Medicare and extends for up to eight months after losing that insurance.
You may also be able to decline or delay Medicare Part B if your enrollment occurred through Social Security. In this situation, contact the Social Security office or a Medicare Advantage plan advisor for more information.
Other SEP triggers include moving out of your plan’s service area, which could allow you to change Medicare Advantage plans or Part D drug coverage options.
Coverage used to be delayed until July for those who enrolled in Medicare during the general enrollment period, but starting in 2023, those who enroll in a Medicare plan during the general enrollment period are now eligible for coverage one month after the date of enrollment.
5-Star Special Enrollment Period
Some Medicare Advantage plans and Part D plan coverage options have received distinguished five-star ratings from the government. As of 2023, 62 Medicare Advantage plans qualify. After reviewing these Medicare options, you can switch to one of these plans from a special enrollment period lasting from December 8th until November 30th.
Enrollment for a Medigap Policy
After enrolling in Medicare Part B, you have an additional six months to get a Medigap policy. It’s also possible to get a new plan with Medigap coverage after the six-month period through a process called medical underwriting. This process is performed by insurance companies as they evaluate coverage eligibility and determine insurance premiums.
Keep in mind that eligibility for Medigap happens once after you turn 65 and enroll in Medicare Part B. If you fail to get Medigap during this time, it will likely cost more.
Switching to a Medicare Advantage Plan
Because one of the most common reasons to switch plans is to either get a new Medicare Advantage plan, switch from their current Medicare Advantage plan, or evaluate different Medicare Part D plans, it can be helpful to review the relevant deadlines outlined here for your reference.
To ensure you have accurate information, take note of these dates from Medicare’s website about when you can join, change, or discontinue Medicare Advantage plans:
- During the Initial Enrollment Period, which varies based on your 65th birthday
- During the Open Enrollment Period, which happens each year from October 15th – December 7th
- During the Medicare Advantage Open Enrollment Period during the first quarter of each year (January 1st – March 31st), in which you can switch Medicare Advantage plans or revert to Original Medicare with additional Part D drug coverage.
Changing Medicare Advantage plans or getting a Medicare supplement plan can help you keep your same coverage at a lower price or expand your coverage while maintaining your budget.
For more details about special enrollment periods or to discuss your ideal Medicare plan, contact a Medicare Advantage advisor today.