What to Know About Changing Your Medicare Plan
Key Takeaways
- Several enrollment periods each year allow you to change your Medicare coverage.
- The Medicare Open Enrollment Period (October 15 to December 7) allows you to switch from Original Medicare (Parts A and B) Original Medicare is a fee-for-service health insurance program available to Americans aged 65 and older and some individuals with disabilities. Original Medicare is provided by the federal government and is made up of two parts: Part A (hospital insurance) and Part B (medical insurance). to a Medicare Advantage (Part C) Medicare Advantage (Medicare Part C) is health insurance for Americans aged 65 and older that blends Medicare benefits with private health insurance. This typically includes a bundle of Original Medicare (Parts A and B) and Medicare Prescription Drug Plan (Part D). plan, or vice versa.
- Medicare Advantage beneficiaries can also change their plan during the Medicare Advantage Open Enrollment Period each year from January 1 to March 31.
- A Special Enrollment Period allows you to change your Medicare plan outside of the normal enrollment periods. To qualify, you must go through certain life events such as a move or losing other coverage.
While many Medicare beneficiaries remain in the same plan for years, getting the most out of your healthcare may mean changing your Medicare at some point. While it’s not an overly complex process, there is no magic button marked “Change Medicare Plan.” Instead, you’ll need to know some basic facts about how to change Medicare plans, and when.
On this page, we’ll break down how to make a change and answer some important questions — like, if you can change Medicare plans after open enrollment. Your health and life circumstances can change at any time; we’ll show you how to make sure your Medicare coverage keeps up.
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How Do I Change My Medicare Plan?
The specific steps needed to change your Medicare plan depend on the type of plan you want to join.
Changing to Original Medicare (Parts A and B)
If you’re on Medicare Advantage and want to change to Original Medicare, you’ll need to enroll in Parts A and B through the Social Security Administration. Original Medicare is public health insurance, and enrollment is handled by the SSA. There are several ways to enroll in Original Medicare, including:
- Over the phone at 1-800-772-1213 (TTY: 1-800-325-0887).
- Online at the Social Security Administration website.
- At a local Social Security office.
Unlike government-run Original Medicare (Parts A and B), Medigap and Medicare prescription drug plans are sold by private insurance companies. To enroll in these policies, you can:
- Research the options in your area and verify that your doctors and drugs are covered. Then, contact each of the individual companies to purchase, and enroll in, the plan you want.
- Contact an independent broker. At GoHealth, we have a team of experienced, licensed insurance agents that will discuss your needs and find options in your area that work for you.
Like Medigap and Medicare prescription drug plans, Medicare Advantage plans are offered by private insurance companies. Unlike the previous two, however, Part C plans can’t be purchased alongside Original Medicare. Instead, Medicare Advantage plans are an alternative to Original Medicare that provide at least the same Part A and B coverages. Part C plans also tend to include additional benefits, including prescription drug, vision, dental and hearing coverages, under the same plan.
To make the switch to a Medicare Advantage plan — whether you’re changing from Original Medicare or switching from a different Medicare Advantage plan — you generally have two options:
- Research the Medicare Advantage plans in your area and choose one that includes the doctors and medications you need. Next, contact the insurance company directly to enroll in your plan.
- Use an independent broker or other third-party help. Not all forms of guidance are equal — while a friend or family member may have a great plan for them, the same plan may not work for you. Instead, consult with a professional that can take your needs and match them with a plan in your area that will prioritize your health.
When Can I Change My Medicare Plan?
The most popular time to change your Medicare plan for the upcoming year is during Medicare’s Annual Enrollment Period (AEP) from October 15 to December 7. During this time, you can:
- Change from Original Medicare to Medicare Advantage.
- Swap Medicare Advantage for Original Medicare.
- Switch from one Medicare Advantage plan to another (with or without drug coverage).
- Join, switch, or drop a Medicare prescription drug plan.
How Often Can I Change Medicare Plans?
You can change your upcoming plan as many times as you’d like during Medicare’s Annual Enrollment Period, but your final plan choice must be received by December 7. Plans chosen during this time go into effect January 1.
As we all know, life circumstances can cause our health needs to change, and that rarely happens when it’s convenient — like, say, during an enrollment period. Fortunately, Medicare allows you to make changes at other times of the year.
Can You Change Medicare Plans After Enrollment?
Depending on your circumstance, you may have an opportunity to change your Medicare plan after the Medicare Annual Enrollment Period. Whether you’re allowed to make a change (and when) depends on what type of Medicare plan you’re enrolled in.
If you enrolled in a Medicare Advantage plan — also known as a Part C plan — during the Annual Enrollment Period, you have a three-month window each year to change plans once your coverage kicks in. This applies whether you actively enrolled in a new Medicare Advantage plan or re-enrolled in the same plan for the upcoming year. This window is open annually from January 1 to March 31, and it’s known as the Medicare Advantage Open Enrollment Period. It’s designed for Part C beneficiaries who aren’t happy with the plan they chose and want to make a switch. For example, if you signed up for a Part C plan but forgot to include drug coverage — or your doctors aren’t covered — you’ll have a chance to make the change you need.
What can you do during the Medicare Advantage Open Enrollment Period?
- Switch from a Medicare Advantage plan with drug coverage to one without drug benefits.
- Switch from a Medicare Advantage plan that doesn’t cover prescription drugs to one that does.
- Drop your Medicare Advantage plan and enroll in Original Medicare.
- Add a Medicare Part D prescription drug plan if you dropped Medicare Advantage for Original Medicare.
When Can I Switch to Part C if I Missed My Initial Enrollment Period?
Your first chance to change your Medicare is by signing up for Medicare Advantage; this can only be done after you’ve enrolled in Medicare Parts A and B. The year you turn 65, you’ll have an Initial Enrollment Period (IEP) — a seven-month timeframe during which you can first enroll in Original Medicare (Parts A and B). It includes your birth month, plus three months before and after. Once you’ve enrolled in Original Medicare, you can change to Medicare Advantage up until your IEP closes or your new policy starts — whichever happens last.
Aside from the enrollment penalties you may face if you miss your IEP, you’ll also have to wait to enroll in Parts A and B until the next General Enrollment Period (January 1 to March 31). If you enroll during this window and want to switch to Medicare Advantage, your first chance to do so is from April 1 to June 30.
Medicare Special Enrollment Period
Medicare will allow you to enroll in or change your Medicare coverage if you experience certain life events. These can include moving or losing other coverage. Not only can this be helpful if you miss your Initial Enrollment Period when you turn 65, it may also help you change your existing coverage.
Special Enrollment Periods and Original Medicare
Unlike Medicare Advantage, Original Medicare does not have a three-month period at the beginning of each plan year when you can change your mind. Once Medicare’s Open Enrollment Period closes on December 7, Original Medicare beneficiaries will need to qualify for a Special Enrollment Period if they hope to change their current plan.
Here are a few examples:
If you move to an area with new plan options: If you have Original Medicare, moving won’t technically affect your coverage since you can use your Parts A and B at any provider across the nation that accepts Medicare. But moving may give you options you didn’t have before. If you move, a Special Enrollment Period will open when you can switch Medicare prescription drug plans, or change to a Medicare Advantage plan.
If you lose other coverage (group coverage from an employer, for example): You can enroll in Original Medicare during a Special Enrollment Period. Once you’re enrolled, you can switch to Medicare Advantage.
Special Enrollment Periods and Medicare Advantage
When it comes to Special Enrollment Periods, Original Medicare and Medicare Advantage (Part C) are similar — if you undergo certain life events, you’ll have the chance to change your existing plan to better suit your needs. This can be even more necessary with Medicare Advantage since plans rely on locally based provider networks. If you move, you may have a new set of doctors and providers available to you, or you may find a plan that’s more affordable than what was offered near your former home. That said, you may not need to move in order to find another plan.
What Is the 5-Star Special Enrollment Period?
Medicare provides a rating system to measure Medicare Advantage, prescription drug plans, and other Medicare-related services. These ratings use a five-star scale and measure a plan in areas like customer service and patient satisfaction. If a Medicare Advantage plan or a Medicare prescription drug plan that’s rated five stars becomes available in your area, you can switch to it during a Special Enrollment Period. The 5-star special enrollment period can only be used once per year between December 8 and the following November 30.
Changing Medicare Plans During AEP
If you’re thinking about changing your Medicare plan during AEP, there are a few questions to consider before making your decision.
- Has your health changed in the past year?
- Do you expect to travel often?
- Has your budget or income changed?
- Are you taking any new medications?
- Are your preferred doctors still covered by your plan?
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Sources
- Social Security Office Locator. SSA.gov.
- Joining a health or drug plan. Medicare.gov.
- Special circumstances (Special Enrollment Periods). Medicare.gov.
- 5-star special enrollment period. Medicare.gov.
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