How To Change Your Medicare Plan

Updated: Jul 17, 2022

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As a Medicare beneficiary, you have many different options when changing Medicare plans. However, making the switch isn’t always straightforward.

How To Change Your Medicare Plan

For example, how do you change your Medicare plan, when are changes possible, and how do you switch from a Medicare Advantage to a Medicare Supplement plan?

How to Enroll in or Change Your Medicare Plan

If you’re 65 or older and sign up for Medicare for the first time, you can either register through Social Security or online. However, if you’re already enrolled in a Medicare Advantage plan, you can take one of two simple steps to change coverage plans.

  1. Join the new plan during one of the Medicare Open Enrollment Periods. Your old policy will be canceled when coverage for the new one begins.
  2. Contact your plan provider or speak to a licensed Medicare professional to switch back to Original Medicare.

Before you enroll in a Medicare Advantage plan, you should find out which coverage your employer or other benefits administrator is currently providing. Under some circumstances, joining an Advantage plan can result in losing employer-sponsored coverage.

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Five Factors to Consider When Changing Medicare Plans

Each year, you should reevaluate your Medicare needs based on the following five criteria.

  • Coverage – Is your current coverage sufficient to cover all of your needs? Are you eligible for other types of health care, such as employer-sponsored health or prescription drug plan? Your benefits administrator or insurer can help you answer these questions.
  • Expenses – What are the out-of-pocket costs? For example, how much are deductibles, copayments, premiums and other service costs? Make sure the annual limits stay within your budget.
  • Provider Choice – Do your current physicians accept the desired coverage plan? Some policies may limit your choice of doctors or make you choose from a limited network.
  • Convenience – Are you concerned about the quality and accessibility of care? Some networks may not offer convenient services such as electronic health records and mail-order prescriptions. You should also consider the opening hours of the network physician and which pharmacies are working with your doctor.
  • Travel

Depending on your circumstances, you can choose between six different Medicare health plans. These include the following:

  • Medicare Advantage
  • Cost plans
  • Pilot programs
  • Medication therapy management
  • PACE (all-inclusive care for the elderly)
  • Medicare savings accounts

When Can You Change Your Medicare Plan?

There are two Medicare Open Enrollment Periods when you can switch Medicare and Medicare Advantage coverage options. If you want to cancel all of your Medicare Advantage plans, you’ll need to provide written notification. In some instances, you could qualify for a Special Election Period (SEP). Medicare Supplement plans can be changed at any time.

If you have Medicare Advantage coverage and later decide you’d rather have a Medicare Supplement plan, it may be possible to switch.

Medicare Open Enrollment Period

The Medicare Open Enrollment Period (OED) is October 15 through December 7. During the Annual Election Period (AEP), you can review your needs and change Medicare plans. As a Medicare beneficiary, you have the following four options.

  • Switch from Medicare Advantage (Part C) to Part A and Part B
  • Change from Medicare Parts A and B to Medicare Advantage
  • Choose a different Medicare Advantage plan
  • Obtain Medicare Part D prescription drug coverage

However, if you’re already enrolled in Medicare Advantage, you’ll have another option.

Medicare Advantage Open Enrollment Period (MA OEP)

You can switch Medicare Advantage policies from January 1 through March 31. During this period, you can do the following.

  • Change Medicare Advantage plans
  • Switch to Medicare Plans A, B and D from Medicare Advantage

However, you cannot make changes to Part D coverage during the MA OEP.

Special Election Period

A Special Enrollment Period (SEP) allows you to make changes to your coverage outside of the OEP and MA OEP. A SEP may be available for the following reasons.

  • You move to a location outside of your previous coverage network.
  • You relocate to an area with different plan options.
  • You enter a long-term care facility or nursing home.
  • Your Medicare coverage is canceled.
  • You become eligible for assistance paying Medicare Part D.

The dates for Special Enrollment Periods may vary according to your circumstances.

When Can You Change Medicare Supplement Plan?

You can change your Medicare Supplement, or Medigap, plan anytime you choose. When you first enroll, you’ll have a six-month timeframe to select any supplement plans with Guaranteed Issue rights.

After this open window, you’ll have to apply through the carrier’s application process. However, some states, such as California, Oregon, Missouri and Washington, enable you to change supplement plans without fulfilling these requirements.

Why Should You Change Your Medicare Supplement Plan?

Here are some reasons you may want to consider a different Medigap plan:

  • You require additional benefits.
  • You’re paying for benefits you don’t use.
  • You’re looking for more affordable coverage.
  • You want to change insurers.

You’ll have a 30-day window to change your mind once you switch Medicare Supplement plans. However, if you don’t cancel your previous policy at the same time, you’ll have to pay both premiums for the 30 days.

When Can You Change from a Medicare Advantage Plan to a Medicare Supplement Plan?

If you have Medicare Advantage coverage and later decide you’d rather have a Medigap plan, it may be possible to switch. You need to understand that these two policies are entirely different coverages.

Medicare Supplement plans cover out-of-pocket expenses that Medicare Part A and B don’t cover.

Medicare Advantage Plan

This plan offers an alternative to pay for Original Medicare benefits through a private insurer. Coverage will pay for everything Original Medicare covers. Additionally, Advantage plans may offer other benefits such as dental, vision and hearing coverage.

Medicare Supplement Plan

Medicare Supplement plans cover out-of-pocket expenses that Medicare Part A and B don’t cover. Some examples include copaymentsdeductibles and coinsurance. These programs don’t cover costs under Part D drug coverage.

How to Switch Between Medicare Advantage and Medigap Plans

You cannot have both coverages at the same time, so you have to choose between an Advantage or a Medicare Supplement plan. Follow the steps below to switch from Medicare Advantage to Medigap.

  • Cancel your Medicare Advantage coverage and change back to Original Medicare. You can only cancel coverage during one of the Open Enrollment Periods. Usually, you will lose your Guaranteed Issue rights when you switch.
  • Apply for a Medicare Supplement insurance plan. If you first signed up for Medicare within the past year, you’ll receive guaranteed eligibility. In other circumstances, you’ll have to go through the insurer’s medical underwriting procedure.
  • Check for exceptions. For example, if you move to a different state and Medicare Advantage is not available, you may be entitled to switch back to Original Medicare and a Medigap plan.

If you’ve already changed between the two plans in the past, you may not be able to reinstate your Medigap policy without medical underwriting.

How to Change a Medicare Part D Plan

You can change to Part D coverage, or Medicare prescription drug policy, during the OEP from October 15 to December 7. You’ll need to cancel your Advantage plan and enroll in a different one with prescription drug coverage. You can take these steps during the MA OEP from January 1 to March 31. However, if you want to keep your Advantage plan, you should change plans during the OEP instead of the MA OEP.

If you’ve already changed between the two plans in the past, you may not be able to reinstate your Medigap policy without medical underwriting.

Special Enrollment Periods are available for individuals in the following circumstances.

  • Your employer-based drug coverage changes
  • You lose coverage and are not at fault
  • You move to a location outside of the Part D coverage area
  • Changes in Extra Help
  • You’re admitted to a care facility
  • You want to join a 5-star plan
  • You’re eligible for Special Needs Plans (SNPs)

However, you won’t qualify for a SEP if your policy stops offering a prescription drug you need.

You have many different options when changing Medicare plans, but you may not know what’s best for your health care. To learn more about how to change your Medicare plan, contact a licensed Medicare professional for more information.