Let’s say you went through all the trouble of enrolling in a Medicare plan to find out your doctor isn’t in your network after all. So what now? Oftentimes, the easiest way to change your Medicare plan is to do so during the Medicare Advantage and Prescription Drug Plan Annual Enrollment Period (AEP). However, the next Annual Enrollment Period might not be for a few months, so it’s helpful to know if you have other options. Here’s a guide to changing your Medicare plan if you’re unhappy with your current coverage.
The Primary Times to Switch to a Different Plan
If you miss the Medicare Annual Enrollment Period, there are a few circumstances in which you are allowed to change your coverage. Each year, there are five set times you can enroll in Medicare or change existing Medicare plans:
Medicare Annual Enrollment Period (AEP)
During the Medicare Annual Enrollment Period (AEP), Medicare beneficiaries can switch from Original Medicare to a Medicare Advantage plan (Part C), switch between different Medicare Advantage plans, or drop their Medicare Advantage plan and return to Original Medicare. They also enroll in, drop, or switch Medicare Part D prescription drug plans. AEP runs from October 15 to December 7 each year, and any changes made during this time take effect on January 1 of the following year.
Medicare Advantage Open Enrollment Period (OEP)
The Medicare Advantage Open Enrollment Period (OEP) runs from January 1 to March 31 and allows beneficiaries enrolled in a Medicare Advantage plan to make a one-time plan change: either switching to a new Medicare Advantage plan or dropping their Medicare Advantage plan and returning to Original Medicare.. This enrollment period is specifically for beneficiaries who are already enrolled in a Medicare Advantage plan.
What if I missed the enrollment periods?
If you miss AEP, here's what happens:
You'll Keep Your Current Plan: If you were already enrolled in a Medicare plan, you will likely be automatically re-enrolled in the same plan for the next year, assuming the plan is still offered in your area.
You Won't be Able to Make Coverage Changes: You won't be able to make changes to your Medicare Advantage or Part D coverage until the next AEP, unless you qualify for a Special Enrollment Period (SEP).
The Medicare Advantage Open Enrollment Period May Be an Option: The Medicare Advantage Open Enrollment Period (MA OEP) runs from January 1 to March 31. It allows people with Medicare Advantage plans to switch to a different Medicare Advantage plan or disenroll from their Medicare Advantage plan and return to Original Medicare. If you go back to Original Medicare, you can also enroll in a Part D plan. However, you cannot use the MA OEP to enroll in a Medicare Advantage plan if you are currently on Original Medicare.
If you miss the MA OEP, you will have to wait until the next Annual Enrollment Period (October 15 to December 7) to make any changes to your Medicare Advantage plan, unless you qualify for a Special Enrollment Period.
When a Life Event Allows You to Change Plans
Certain life events can make an individual eligible for a Special Enrollment Period, during which they may enroll in Original Medicare or enroll in/change Medicare Advantage coverage. Qualifying events for an SEP include:
Becoming newly eligible for Original Medicare
Moving
Losing your health insurance
Your Options for Other Types of Medicare Coverage
Changing Your Medicare Supplement (Medigap) Plan
There are limited circumstances in which you can change your Medicare Supplement plan, also known as Medigap. If you’re still within your Initial Enrollment Period (three months before and three months after your 65th birthday), you have the option to switch your coverage. The only other opportunity, beyond enrollment periods, is if you’re eligible under a specific circumstance or guaranteed issue rights.
Finding a Different Medicare Part D Plan
In most cases, you can only make changes to your Medicare Part D coverage during the Annual Enrollment Period. If you have a Medicare Advantage plan, however, you can make changes to your Part D coverage during the Medicare Advantage Open Enrollment Period, which runs from January 1 to March 31 each year. You can also sign up for Part D coverage during this period if you’re switching from a Medicare Advantage plan back to Original Medicare (Parts A and B).
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