Knowing when you can make changes to your Medicare Advantage Plan is essential for managing your health care.
These enrollment periods, or windows of time when you can add, drop or change your Medicare plans, happen throughout the year. Some periods occur annually and are available to all Medicare enrollees. In contrast, others are only available to new enrollees or for those that meet special requirements.
Not being aware of which enrollment period applies to you can be the difference between obtaining a Medicare Advantage Plan that best fits your needs or being stuck with a plan you don’t want for an extended period of time – from a financial or coverage standpoint.
To keep you better informed, we’re breaking down some of the annual and common life-event enrollment periods, so you’re not stuck asking, “When can I change Medicare Advantage Plans?”
Initial Enrollment Period
If you’re approaching age 65, then kudos to you for getting an early start on researching your health care options and for nearing your Initial Enrollment Period.
Your IEP lasts a total of seven months and is your first opportunity to join a Medicare plan. This period begins three months before the month of your 65th birthday includes the month you turn 65 and ends three months after the month you turned 65.i
For example, if your birthday is on July 14, your IEP begins on April 1 and ends Oct. 31.
During this time, you can enroll in Medicare Plans Part A (hospital insurance) and Part B (medical insurance), a stand-alone Prescription Drug Plan (PDP), or a Medicare Advantage Plan, which may include Medicare Part A, Part B and a PDP.
Annual Open Enrollment Period
Every year from Oct. 15 to Dec. 7, current Medicare enrollees or those who missed out on their IEP can take part in the Annual Open Enrollment Period. This is the time when any eligible Medicare enrollee can make changes to their health care plan.ii
For example, a Medicare enrollee can:
- Change to a Medicare Advantage Plan from Original Medicare Parts A & B coverage, or vice versa.
- Switch from one Medicare Advantage Plan to another M.A. Plan.
- Switch to a Medicare Advantage Plan offering prescription drug coverage from an M.A. Plan that doesn’t have Prescription Drug Coverage or vice versa.
- Join, switch or drop a Medicare Prescription Drug Plan.
- Drop coverage completely.
Once you make changes to your plan, your new coverage will start on the first of the month following your health insurance provider receiving word of your update.
Medicare Advantage Open Enrollment Period
If you missed out on the annual enrollment period or realizing your new Medicare plan isn’t working out for you, then you’ll want to take advantage of this enrollment period.
Also known as the General Enrollment Period, the Medicare Advantage Open Enrollment Period happens annually starting Jan. 1 to March 31. This period allows you to make one plan change, and that change goes into effect the first month after the plan gets your request.iii
Here is what you can do during this period:
- You can switch from a Medicare Advantage Plan to another M.A. plan, with or without drug coverage.
- Drop your Medicare Advantage Plan and return to Original Medicare (Parts A & B).
Here is what you can’t do during this period:
- Switch from Original Medicare to a Medicare Advantage plan.
- Join a Medicare prescription drug plan if you’re in Original Medicare.
- Switch prescription drug plans if you’re in Original Medicare.
Special Enrollment Periods
Life happens, and sometimes you need to make a change to your health care plan. Depending on a variety of qualifying life events, you can change your Medicare Advantage Plan. These are called Special Enrollment Periods.
Special Enrollment Periods have their own set of rules on what life event triggers the period, what you can do during the period, and how long it lasts. Here is a breakdown of some of the common life events that trigger a Special Enrollment Periods for Medicare Advantage Plans.iv
When You Change Where You Live
Moving or changing your current living situation usually triggers a Special Enrollment Period for many Medicare enrollees. If your new address isn’t in your plan’s service area or your new address is within your plan’s service area but offers different options, then you’ll have the opportunity to change plans.
If you tell your health care plan provider that you’re moving, your enrollment period begins the month before the month of your move, plus two months. However, if you tell your health care plan provider after you’ve moved, then your period begins that month and runs for two additional months.
You Have Dual Eligibility
If you’re eligible for both Medicare and Medicaid, then you’ll have the ability to join, switch or drop your Medicare Advantage Plan or Medicare Prescription Drug coverage. You’ll be able to make a change anytime between January through September. Once you make the plan change, it’ll go into effect on the first day of the following month. You can also change your coverage during your Open Enrollment Period, between Oct. 15 through Dec. 7. However, the changes will not go into effect until Jan. 1.
You’re Losing Coverage from Your Employer or Union
Once you retire or no longer eligible for employer or union health insurance, then you’ll have the opportunity to join a Medicare Advantage Plan or Prescription Drug Plan. This enrollment period lasts for two full months after the month your current coverage ends.
You Lost Your Medicaid Coverage
Suppose you get notified that you no longer qualify for Medicaid. In that case, you’ll have three full months following the date your eligibility ends or notified, whichever is later. During that time, you can join, switch or drop your Medicare Advantage Plan or Drug Plan, or switch back to Original Medicare.
What About Special Enrollment Periods for Non-Medicare Advantage Enrollees?
Although we talked a lot about Medicare Advantage, it’s also worth mentioning that there are other enrollment periods for people with other Medicare health plans. There is a total of 16 qualifying life events that trigger a special enrollment period. You can go to Medicare.gov to learn more about these periods.
Ready to Learn About Your Medicare Advantage Options?
Now that you know when and how these enrollment periods occur, you’ll be ready to make any changes to your Medicare Advantage Plan. If you’re approaching one of the yearly enrollment periods or you qualify for a special enrolment period and wish to learn about your options, then please call Ensurem.
Ensurem partners with some of the most well-known insurance companies in the U.S. to offer Medicare plans with the lowest cost and the most benefits. Our licensed insurance agents have only one goal, to find you the best Medicare health care plan that fits your needs. They will serve as your advocate throughout the Medicare plan enrollment process. Give Ensurem a call and find the Medicare Advantage plan that’s right for you.0122BGMAGN2020M_V1
i “Joining a Health or Drug Plan,” Medicare.gov., www.medicare.gov/sign-up-change-plans/joining-a-health-or-drug-plan
ii “Understanding Medicare Advantage & Medicare Drug Plan Enrollment Periods,” Medicare.gov., Rev. Sept. 2020, https://www.medicare.gov/Pubs/pdf/11219-Understanding-Medicare-Part-C-D.pdf
iii “Medicare and You Handbook 2021, Page 67, Department of Health and Human Services, https://www.medicare.gov/Pubs/pdf/10050-Medicare-and-You.pdf
iv “Special Circumstances (Special Enrollment Periods), Medicare.gov, https://www.medicare.gov/sign-up-change-plans/when-can-i-join-a-health-or-drug-plan/special-circumstances-special-enrollment-periods