May 9th 2022
By Ari Parker
Important periods for Medicare.
By Ari Parker
Many of our members often reach out because they want to understand the ideal times of the year to change or improve their current Medicare coverage. This question is a common one because as we continue to age, our health journeys often change, alongside our prescriptions and doctors. These changes in turn can impact our current healthcare coverage. And even if our health doesn’t change, all plans change their premiums each year, and some even change their benefits and networks of healthcare providers.
For all these reasons, it is important to re-evaluate your plan with a licensed Medicare advisor every year to ensure you are on the optimal plan for your specific needs.
If you’d like to change your Medicare Advantage or Medicare Part D Prescription Drug plan, the best time to do so is during the Annual Enrollment Period. This window runs from October 15 to December 7 every year. Any changes you make will become effective on January 1 of the following year.
During the period, you can:
- Choose to switch from Original Medicare (Part A and Part B) to a Medicare Advantage plan
- Switch from one Medicare Advantage plan to another Medicare Advantage Plan
- Change from a Medicare Advantage plan back to Original Medicare (Part A and Part B)
- Switch from a Medicare Advantage plan that doesn’t offer drug coverage to a Medicare Advantage plan that does
- Switch from a Medicare Advantage plan that offers drug coverage to a Medicare Advantage plan that doesn’t
- Enroll in a Medicare Part D Prescription Drug plan for the first time, for example, if you missed an earlier enrollment window
- Change your Medicare Part D Prescription Drug plan
The Open Enrollment Period is designed for people who are already on a Medicare Advantage plan. During this period from January 1 to March 31, if you are already enrolled in a Medicare Advantage plan, you can choose to change to a different Medicare Advantage plan or switch back to Original Medicare. If you make a plan change, the change will become effective on the first day of the following month. Note that during this period, you cannot enroll in a Medicare Advantage plan for the first time or switch a standalone Part D prescription drug plan. However, if you switch back to Original Medicare from a Medicare Advantage plan, you can also choose a Medicare Part D Prescription Drug plan.
There are certain life events that will qualify you to change your Medicare Advantage plan or standalone Medicare Part D Prescription Drug plan. Under certain circumstances, you may qualify for one of the Special Election Periods. Examples of these events include the following but are not limited to:
- If you and your family are planning or have moved to a new address outside the service area of your prior plan
- If you qualify for Extra Help paying for Medicare Prescription Drugs
- If your Medicaid status changes
Finally, none of these periods explicitly allow you to change a Medicare Supplement plan. If you have a Medicare Supplement plan already, you can change it year-round. In most states, however, you will need to undergo medical underwriting.
If you are looking to switch from a Medicare Advantage plan to a Medicare Supplement plan, you may use either the Annual Enrollment Period or Open Enrollment Period to move from your Medicare Advantage plan back to Original Medicare. Because using Original Medicare is a prerequisite to enrolling in a Medicare Supplement plan, you can then apply for a Medicare Supplement. Again, however, most states will require that you undergo medical underwriting if you have had Part B coverage for more than 6 months.
If you have any questions on how and whether to consider improving or changing your coverage, our advisors are available to help. You can reach us at (833) 501-3101.
If you are new to Medicare or have a loved one who plans to enroll in Medicare for the first time, we have a separate guide you can share here on the relevant enrollment windows.
