How to Change Medicare Plans

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Are you satisfied with your current Medicare coverage? Do you find yourself surprised by the price every time you go to the pharmacy? If you are looking for how to change your Medicare plan and what your options look like, you came to the right place. Let’s go over what you need to know about switching Medicare plans.

Basic changes

You want to review your Medicare plans every year and evaluate whether it’s right for you based upon the following factors:

• Coverage
• Convenience
• Cost

Open Enrollment is the time each year (October 15 – December 7) when you can review your coverage and make changes to your plans. Your options for changing plans include:

• Change from Medicare Part A and Medicare Part B (Original Medicare) to a Medicare Part C (Medicare Advantage) plan
• Change from Medicare Advantage back to Original Medicare
• Join, drop or switch a Medicare Part D prescription drug plan
• Switch Medicare Advantage plans

Dropping Medicare Part B to keep only Medicare Part A

If you have coverage through your job or an actively working spouse, you may not want to enroll in Medicare Part B until you need it at a later time. If your Medicare plan hasn’t begun yet, there are two ways to drop out of Medicare Part B:

• If you were automatically enrolled in both Medicare Part A and Medicare Part B, and if you received a Medicare card, then you want to follow the instructions that come with the card and send it back. If you keep the card, you keep Medicare Part B and will have to pay Medicare Part B premiums.
• If you signed up for Medicare through Social Security, contact the Social Security Administration.

Adding Medicare Part C to your coverage

If you want to enroll in a Medicare Part C (Medicare Advantage) plan, you can only do so during specific times of the year. If you are new to Medicare, the Initial Enrollment Period (IEP) is a seven-month window during which when you are first eligible for Medicare. After you enroll in Medicare Part A and Medicare Part B, you can choose to enroll in a Medicare Advantage plan. If you have enrolled in Medicare Part A and Medicare Part B already, consider the Open Enrollment Period (OEP). It takes place each year from October 15 through December 7. During this period, you can switch from an Original Medicare to a Medicare Advantage plan.

Note: If you have Original Medicare with a Medigap policy and you wish to 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. Remember to not drop your existing coverage, if any, until your coverage with your Medicare Advantage plan has started.

Changing Medicare Advantage plans

If you want to switch from one Medicare Advantage plan to another, you can do so each year during the Open Enrollment Period. Once you select a new plan in which to enroll, you’ll be disenrolled automatically from your previous plan when your new plan’s coverage begins. You do not have to contact your old plan to disenroll.

Changing from Medicare Advantage to Original Medicare?

You can leave your Medicare Advantage plan to return to Original Medicare during two times each year:

• Open Enrollment Period (October 15 – December 7)
• Medicare Advantage Disenrollment Period (January 1 – February 14)

In the Medicare Advantage Disenrollment Period, you have until February 14 to pick up a Medicare Part D plan for prescription drug coverage. During this time, you cannot switch between Medicare Advantage plans, nor can you move from Original Medicare to Medicare Advantage. Your coverage will start on the first day of the month after the month in which you switch coverage.

Switching from Medicare Advantage to Medigap

There are generally only a few situations in which you are allowed 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 where 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.

Note: If you had a Medigap policy in the past and dropped it to enroll in a Medicare Advantage plan, you might not be able to get the same Medigap policy back when you return to Original Medicare or, in some cases, any Medigap policy unless you have a “trial right” or “guaranteed issue” right.

Changing Medicare Part D plans

You can switch plans once each year, during the annual Open Enrollment Period.

There are special circumstances when you can switch plans at other times. These include:

• Moving out of the region that your current plan serves
• Entering, leaving or living in a nursing home
• When your plan changes and no longer serves your area
• When you get Extra Help with your Medicare prescription drug costs

Sometimes, Medicare Part D plans change formularies during the year. This happens when:

• New drugs come on the market or are taken off of it
• Generic versions of a brand name drug become available
• There are new clinical guidelines about the use of a medication

Part D plans are required to provide 60 days’ notice to all beneficiaries about a formulary change before it takes place.

Changing Medicare supplement plans

There are many reasons you may want to switch your Medigap plan. Whether you are paying too much for benefits you don’t need, your health has gotten worse and you need more benefits. In most cases, you won’t have a right under federal law to switch Medigap policies unless you’re eligible under a specific circumstance or guaranteed issue rights or you’re within your six-month Medigap Open Enrollment Period.

Switching from Medigap to Medicare Advantage

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 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.