How Do You Change Medicare Advantage Plans?

How Do You Change Medicare Advantage Plans?  There is the Annual Election Period allows Medicare Member to make changes to their coverage every year.  This allows them to make the changes that fit their needs in the year to come or to improve their coverage completely.  It pays to review your coverage every year and evaluate whether it’s right for you based upon:

  • Coverage
  • Convenience
  • Cost

How Do You Change Medicare Advantage Plans

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

  • Change from Medicare Parts A & B (Original Medicare) to a Part C (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

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 Period (AEP): 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 (Medicare Supplement) 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.

checkmark Healthy Tip: 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 from one Medicare Advantage plan to another, you can do so each year during the Annual Election Period (AEP), which runs October 15 to December 7.

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:

 checkmark Healthy Tip: In the Medicare Advantage Disenrollment Period, you will have until Feb. 14 to pick up a Part D plan for prescription drug coverage.  During this time, you cannot switch between Medicare Advantage plans or move from Original Medicare to Medicare Advantage. 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.

checkmark Healthy Tip: 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 Annual Election Period (AEP) which runs from October 15 – December 7 each year.  But if you receive Extra Help with your Medicare prescription drug costs, you can switch plans as often as once a month.

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 a 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 Medigap plan.  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 for 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.

checkmark Healthy Tip: 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, later on, 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.

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