How to Change or Switch Medicare Plans?

How to Change or Switch Medicare Plans

Annual Election Period (AEP), October 15 and December 7, is the time each year when you can review your coverage and make changes to your plans. You can:

  • Change from Medicare Part A and Part B (Original Medicare) to a Part C (private Medicare Advantage) plan
  • Change from Medicare Advantage back to Original Medicare
  • Join, drop or switch a Part D prescription drug plan
  • Switch Medicare Advantage plans

If you are enrolled in Medicare Advantage plan you have additional opportunities to re-evaluate your coverage during the Medicare Advantage Open Enrollment Periods (MA OEP). The first is the annual period from January 1 – March 31, anyone with a Medicare Advantage plan can change plans during this time. The other is an individualized Medicare Advantage Open Enrollment Period that’s limited to new Medicare beneficiaries who enroll in an MA plan during the first three months they have Medicare. They have a three-month MA OEP to switch plans. During these times you can:

  • Switch to a different Medicare Advantage plan
  • Switch from a Medicare Advantage plan to Original Medicare and a standalone Part D plan

Since signing up for Original Medicare, I have decided I don’t want to take Part B. Can I switch to only Part A?

If you have coverage through your job or an actively working spouse, you may not want to enroll in Part B until later. If your Medicare hasn’t started yet, there are two ways to drop Part B:

  • If you were automatically enrolled in both Part A & Part B and sent a Medicare card, follow the instructions that come with the card and send the card back. If you keep the card, you keep Part B and will pay Part B premiums.
  • If you signed up for Medicare through Social Security, contact Social Security.

I’m signed up for Medicare Parts A & B. Can I sign up for Part C?

If you want to enroll in a Medicare Part C (Medicare Advantage) plan, you can only do so during specific times:

  • You are new to Medicare – Initial Enrollment Period (IEP): This is the 7-month period when you are first eligible for Medicare. After you enroll in Parts A & B, you can choose to enroll in a Medicare Advantage plan.
  • You have enrolled in Medicare Parts A & B already – The Annual Election/Open Enrollment Period (OEP): Each year between October 15 and December 7, you can switch from Original Medicare to a Medicare Advantage plan or vice versa.

Be aware that if you have Original Medicare with a Medigap/supple-
mental policy and you switch to Medicare Advantage, you most likely will not be able to get a Medigap policy again if you switch back.

The date your coverage starts depends on the period in which you enroll. Remember not to drop your existing coverage, if any, until your coverage with your Medicare Advantage plan has started.

Is Changing Medicare Advantage Plans Allowed?

If you want to switch between one Medicare Advantage plan to another, you can do so each year during the Annual Election/Open Enrollment Period, which runs October 15 to December 7 and the annual Medicare Advantage Open Enrollment Period, which runs January 1 – March 31 every year. If you are new to Medicare, you can switch MA plans during an individualized Medicare Advantage Open Enrollment Period that runs during the first 3 months you enroll in Medicare. You may also be able to switch plans during a Special Enrollment Period based on your plans star rating.

Once you select a new plan to enroll in, you’ll be disenrolled automatically from your old plan when your new plan’s coverage begins. You do not have to contact your old plan to disenroll.

What About Changing from Medicare Advantage to Original Medicare?

You can leave your Medicare Advantage plan to return to Original Medicare during two times each year:

  • During Annual Election/Open Enrollment Period (Oct. 15 – Dec. 7)
  • During the annual Medicare Advantage Open Enrollment Period (January 1 – March 31)
  • During an individual Medicare Advantage Open Enrollment Period (during the first 3 months of enrollment in Medicare Part A and B)

During the Open Enrollment Period, you can switch between Original Medicare and Medicare Advantage plans. Beginning in 2019, the Medicare Advantage Open Enrollment Period replaces the Medicare Advantage Disenrollment Period, which ran from January 1 to February 14. During this time, you can switch from a Medicare Advantage plan to Original Medicare. Your coverage will start on the 1st day of the month after the month in which you switch coverage.

Can I Switch from Medicare Advantage to Medigap?

There are generally only a few situations that allow you to leave Medicare Advantage and pick up a Medigap plan without being subject to medical underwriting.

If you joined a Medicare Advantage plan when you were first eligible for Medicare and you aren’t happy with the plan, you’ll have special rights to buy a Medigap policy if you return to Original Medicare within 12 months of joining.

If you are moving to a different state or part of the state and your Medicare Advantage plan does not serve that area, you also have special rights to return to Original Medicare and pick up a Medigap plan.

Remember, If you had a Medigap policy in the past then left it to get an MA plan, when you return to Original Medicare, you might not be able to get the same Medigap policy back or in some cases, any Medigap policy unless you have a “trial right” or “guaranteed issue” right.

Can I switch my Part D plan?

Most people are allowed to switch plans once a year, during the Annual Election/Open Enrollment Period (October 15 – December 7). If you are switching from a Medicare Advantage plan to Original Medicare during the Medicare Advantage Open Enrollment Period (MA OEP) which runs from January 1 – March 31, you can add a Part D plan. The MA OEP does not allow for Part D changes for individuals enrolled in Original Medicare, including those enrolled in stand-alone Part D plans.

If you receive Extra Help with your Medicare prescription drug costs, you can switch plans as often as once per quarter during the first nine months of the year (January -September).

There are special circumstances when you can switch plans at other times:

  • You move out of the area your current plan serves OR
  • You enter, leave or live in a nursing home OR
  • Your plan changes and no longer serves your area OR
  • You get Extra Help with your Medicare prescription drug costs.

My drug plan’s formulary changed in the middle of the year. Is that allowed?

Part D plans sometimes change their formularies during the course of the year. This happens because new drugs come on or are taken off the market, generic versions of a brand name drug become available or there are new clinical guidelines about the use of medication. Part D plans are required to provide 60 days’ notice to all plan members about a formulary change before it happens.

What About Changing Medicare Supplement Plans?

There are many reasons you may want to switch your Medicare supplement plan (also known as Medigap). Maybe you are paying too much for benefits you don’t need. Or maybe your health has gotten worse, and now you need more benefits.

In most cases, you won’t have a right under Federal law to switch Medigap policies unless you’re eligible under a specific circumstance or guaranteed issue rights or you’re within your 6-month Medigap Open Enrollment Period.

Can I suspend my Medigap coverage if I get a job?

If you get other health insurance, you may be able to put your Medigap policy on hold or suspend it. You can suspend your Medigap policy if:

  • You have Medicare and a Medigap policy when you are under age 65 and you go back to a job that offers health insurance, or
  • You are the dependent, spouse, or adult child of someone who gets a job that offers health insurance.

This right to suspend your Medigap policy if you get employer health insurance is only for people with Medicare and Medigap who are not yet 65.

You will need to contact your Medigap insurance company and let them know. You can suspend your Medigap:

  • At any time while you have employer group health insurance, and
  • As long as you are eligible to get Medicare because of a disability.

If you lose your job’s health insurance coverage, you can get your Medigap back. You will need to contact your Medigap company and let them know within 90 days of losing your job’s coverage. Your Medigap coverage will begin the day you lost your job’s coverage.

Can I suspend my Medigap if I get Medicaid?

You can put your Medigap policy on hold, or suspend it, within 90 days of getting Medicaid. You send the company a letter to suspend your policy. Your insurance company can tell you exactly what to say in your letter and where to send it.

You can suspend your Medigap policy for up to 2 years. Some people choose to keep their Medigap policy active so they can see doctors that do not accept Medicaid. This can be expensive, so carefully consider if you need both.

If you already have Medicaid, an insurance company cannot by law sell you a Medigap policy except if:

  • Medicaid pays your Medigap premium, or
  • Medicaid only pays all or part of your Medicare Part B premium.

Can I switch from Medigap to a Medicare Advantage plan?

Medigap policies can’t work with Medicare Advantage Plans. Your Medigap policy can’t be used to pay your Medicare Advantage Plan copayments, deductibles, and premiums. If you have a Medigap policy and join a Medicare Advantage Plan (Part C), you may want to drop your Medigap policy.

If you decide to leave your Medicare Advantage plan, you might not be able to get the same Medigap policy back or any Medigap policy, unless you have a “trial right” or “guaranteed issue” right. Generally, you will only have this right during the first 12 months that you’re enrolled in a Medicare Advantage plan.

Lastly, Medicare is full of rules. Don’t make mistakes that cost you later. Contact the Medicare store, or schedule a call with one of our representatives. We will do everything we can to help you do what you are trying to accomplish.