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HEALTH INSURANCE INSIGHTS

You can change your Medicare Advantage plan during one of two enrollment periods or, if you qualify, during a special enrollment period.

Medicare has an Annual Enrollment Period (AEP) when you can change your Medicare plan. That’s in the fall.  Medicare Advantage members can make one change during the Medicare Advantage Open Enrollment Period (MAOEP). That’s in the winter. The only other times you can make changes is if you qualify for a special enrollment period.

Those who enroll in Original Medicare during the General Election Period (GEP) may switch to a Medicare Advantage plan or add a Prescription Drug plan in the spring.

Medicare beneficiaries usually have many Medicare Advantage choices. The Centers for Medicare and Medicaid Services estimated that 29.5 million people signed up for a Medicare plan in 2022. That's compared to 26.9 million enrollees in 2021.

Though there are many new Medicare Advantage options, most Medicare recipients don’t change their plans. Instead, they stay with their plan and don’t compare other possibilities. That’s not wise.

There could be another plan that is a better fit. You only need to spend some time digging into the data and comparing your options.

Now, let’s take a look at when you can make changes to Medicare, when it makes sense and how to choose a plan.

KEY TAKEAWAYS
  • Medicare Advantage plan members can swap plans during the annual open enrollment or Medicare Advantage open enrollment.
  • If you qualify for a special enrollment period, you can also change plans during a special enrollment period. You can also decide to swap to Original Medicare.
  • When selecting a Medicare Advantage plan, members should compare premiums, costs, provider networks, prescription drug coverage, supplemental benefits, and the plan’s quality rating.

Medicare Annual Enrollment

Medicare has an open enrollment period from October 15 to December 7 each year known as AEP or Medicare Annual Enrollment Period.

During this period, you can make any of these changes:

  • Swap from Original Medicare to Medicare Advantage
  • Exchange a Medicare Advantage plan for Original Medicare
  • Switch to another Medicare Advantage plan
  • Change Part D prescription drug plans.
  • Do nothing and keep your current Medicare coverage if it’s still available

Any changes made during the period takes effect on January 1.

Medicare Advantage open enrollment

There is also another open enrollment period, but only one change can be made during this period. This period runs from January 1 to March 31 each year. The Medicare Advantage open enrollment period lets you only:

  • Switch to another Medicare Advantage plan
  • Swap back to Original Medicare

During this time, you’re not able to move from Original Medicare to Medicare Advantage. You also can’t make any changes to your Part D plan if you have Original Medicare paired with Plan D.

Special enrollment for Medicare Advantage

Unless you enroll in Original Medicare during the General Election Period, the only other time you can change your Medicare Advantage plan is during a special enrollment period. You can qualify for a special enrollment if a life event affects your coverage.

Some qualifying events that trigger a special enrollment include:

  • Losing health insurance coverage
  • A spouse’s death
  • Moving to another state
  • Losing hours at work

If any of these life events happen, you can make changes during a special enrollment period. Changes made during a special enrollment period usually kick in the first day of the next month.

When to change Medicare Advantage plans

Most eligible enrollees keep the same Medicare Advantage plan each year. It’s a good idea to compare plans each year, but studies have found most don't make any changes.

When should you change Medicare Advantage plans? Here are some times when it can make sense:

  • Your Medicare Advantage plan is no longer offered.
  • You want to switch from a restrictive plan to one with more flexibility, such as going from a health maintenance organization to a preferred provider organization plan.
  • You start a new medication and your Medicare Advantage plan doesn't cover it.
  • Your physician is no longer considered in-network for your plan.
  • You expect an expensive upcoming surgery and want to limit out-of-pocket costs.
  • You want to reduce your premiums.

How to choose a Medicare Advantage plan

If you’re looking to make a change, you should compare plans in your area to find the right one for you.

Medicare allows you to compare plans with its Medicare Star Ratings. Medicare Plan Finder let’s you see each plan’s overall rating, premiums, out-of-pocket costs and estimated health and drug costs.

When figuring out what plan to choose, here are topics to explore:

  • Provider and hospital network
  • Type of plan
  • Premiums and out-of-pocket costs
  • The plan’s quality rating
  • Prescription drug coverage and whether your medication is covered

Find out more about Medicare costs.

Discovering the right Medicare Advantage plan for you takes some effort. However, finding the perfect plan for your situation can save you money and give you peace of mind that your health insurance is right for you.

Disclaimer:
Insurance.com is not affiliated with or endorsed by the government or Federal Medicare program. Plans are insured or covered by a Medicare Advantage organization with a Medicare contract and/or a Medicare approved Part D sponsor. Enrollment in the plan depends on the plan’s contract renewal with Medicare. We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE (TTY 1-877-486-2048), 24 hours a day/7 days a week, to get information on all of your options. Not all plans offer all of these benefits. Benefits and availability may vary by carrier and location. Limitations and exclusions may apply. Every year, Medicare evaluates plans based on a 5-star rating system. Part B Premium give-back is not available with all plans. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.

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