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How to change your Medicare Advantage plan

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You can only change your Medicare Advantage plan or switch to Medicare Advantage during specific times of year.

Medicare has an annual open enrollment when you can make any changes to any Medicare plan. That’s in the fall. There’s also another open enrollment that’s restricted to two specific changes. That’s in the winter.

The only other time you can make changes is if you qualify for a special enrollment period. 

Initially, people can sign up for Medicare three months before their birth month to three months after their birth month when they turn 65. After that, Medicare limits changes to specific periods.

Medicare beneficiaries usually have many Medicare Advantage choices. There are about 4,800 Medicare Advantage plans available across the country for 2021. That's 1,600 more plans than in 2020. The average county has 47 Medicare Advantage plan options in 2021 -- an increase from an average of 39 in 2020.

Rural areas usually have fewer Medicare Advantage options. However, for 2021, the Centers for Medicare and Medicaid Services (CMS) estimates that there are 2,900 Medicare Advantage plans available -- an increase from 2,450 in 2020.

There are also more Medicare Advantage beneficiaries expected in 2020. CMS predicted nearly 27 million Medicare Advantage members in 2020, which is about 42% of people eligible for Medicare.

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.

Medicare open enrollment

Medicare has an open enrollment period from Oct. 15 to Dec. 7 each year.

During that 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 Jan. 1.

Medicare Advantage open enrollment

There is also another open enrollment period, but Medicare limits the changes. This period runs from Jan. 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

The only other time you can make changes to your Medicare Advantage plan is during a special enrollment period. You can qualify for a special enrollment if a life event affects your coverage.

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 seniors 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.