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When You Can Change Medicare Plans

You’re not stuck with the same Medicare plan forever.

Life events and different health care needs can sometimes lead to considering a change in your Medicare coverage or plans.

Moving is one example. Your plan may or may not be offered in your new location. And plans sometimes decide to change their service area. What happens if your plan leaves you?

Well, there’s an enrollment period for that! Here’s a summary of when you can change your Medicare coverage.

Medicare Open Enrollment

Medicare Open Enrollment is the main time period for changing your Medicare coverage or plan. It is similar to the annual enrollment you probably experienced with your employer health coverage. It’s a good reminder each year to consider whether you need to make a change.

Medicare Open Enrollment happens every year from October 15 through December 7. Any changes you make during this time go into effect on January 1 of the following year.

Here’s what you can do during this enrollment period:

  • Change from Original Medicare to a Medicare Advantage plan, or vice versa.
  • Switch from one Medicare Advantage plan to a different Medicare Advantage plan.
  • Enroll in a Medicare prescription drug plan or switch to a different Medicare prescription drug plan.
  • Drop your Medicare prescription drug coverage completely.

If you miss Medicare Open Enrollment, you may have to wait until the following year to change your coverage, unless you qualify for a Special Enrollment Period.

Special Enrollment Periods

Things happen in life that may affect your Medicare coverage needs. Special Enrollment Periods allow you to make changes to your coverage outside of Medicare Open Enrollment under certain circumstances.

Some situations that may qualify for a Special Enrollment Period are:

  • You are transitioning from employer, union or other coverage to Medicare.
  • You move to a location outside your current plan’s service area.
  • You move into or out of an institution (nursing home, long-term care hospital, jail) or back to the U.S. after living in another country.
  • Your current plan is no longer available where you live.
  • You have a chance to get other coverage, such as through an employer, union or federal assistance program.

Many people work past age 65, so transitioning to Medicare from employer coverage is common. You have eight months to enroll in Original Medicare (Part A, Part B or both) from the time your employment or insurance ends, whichever comes first. You have just two months from this date to join a Medicare Advantage plan (Part C) or a Medicare prescription drug plan (Part D).

Special Enrollment Periods for other situations have different rules about when you can make changes and what changes you can make. It’s important to understand the rules. There may be enrollment penalties in some cases.

Medicare Advantage Disenrollment Period

The Medicare Advantage Disenrollment Period gives you a chance to leave a Medicare Advantage plan and go back to Original Medicare. This time period happens every year from January 1 through February 14.

You are automatically switched to Original Medicare when you leave a Medicare Advantage plan. If your Medicare Advantage plan included drug coverage, then you have until February 14 to enroll in a Medicare prescription drug plan (Part D). Your drug coverage will begin the first day of the month after the Part D plan gets your enrollment form. You may incur a premium penalty if you don’t enroll in a Part D plan at this time and decide to get it later.

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