- medicareresources.org Editor
- October 15, 2018
Changes during Medicare open enrollment
- Switch from Original Medicare to Medicare Advantage, or vice versa.
- Switch from one Medicare Advantage plan to another.
- Enroll in a Part D Prescription Drug Plan for the first time (a late enrollment penalty may apply)
- Switch from one Part D plan to another.
- Drop your Part D coverage altogether. (You won’t be able to re-enroll until the following year’s open enrollment period, and a late enrollment penalty may apply when you eventually re-enroll).
For millions of Americans, the annual Medicare’s open enrollment period (October 15 through December 7) is a golden opportunity for beneficiaries to reevaluate Medicare coverage – whether it’s Original Medicare with supplemental drug coverage, or Medicare Advantage — and make changes if they want to do so.
During open enrollment, beneficiaries can change Medicare Advantage plans, switch from Medicare Advantage back to Original Medicare or vice versa, join a Medicare Part D prescription drug plan, switch from one Part D plan to another, or drop Medicare Part D coverage entirely. Changes made during open enrollment are effective on January 1.
But the annual open enrollment does not apply to Medigap plans, which are only guaranteed-issue in most states during a beneficiary’s initial enrollment period, and during limited special enrollment periods.
Making changes to Medigap
- You can apply for a Medicare Supplemental Insurance (Medigap) plan at any time during the year. If you’re within the six-month open enrollment window that begins when you turn 65, the coverage is guaranteed issue. That is also the case if you’re in a special enrollment period triggered by a qualifying event.
- You can still apply for a Medigap plan outside of open/special enrollment periods – though in most states, carriers will use medical underwriting to determine whether to accept your application, and how much to charge you.
If you didn’t enroll when first eligible
- If you didn’t sign up for Medicare A and B when you were first eligible, you can enroll between January 1 and March 31, with coverage effective July 1, but you may be subject to a late enrollment penalty. (For Medicare Part B, the penalty is an additional 10 percent of the premium for each 12-month period that you were eligible but not enrolled, and did not have other creditable coverage in place. Medicare Part A is premium-free for most enrollees, based on work history.)
Changing or leaving Medicare Advantage plans
- In addition to the regular annual open enrollment period, beneficiaries who have Medicare Advantage also have a chance to change their coverage during the first three months of the year. Starting in 2019, there will be a new Medicare Advantage open enrollment period, from January 1 to March 31. (It’s not really new, since this is the system that was used prior to 2011, but the ACA switched to a Medicare Advantage disenrollment period, during which Advantage enrollees could drop their Medicare Advantage plan and return to Original Medicare; that system is being replaced by the new open enrollment period.)The new Medicare Advantage open enrollment period, which was authorized by the 21st Century Cures Act (see Section 17005), will allow a person enrolled in Medicare Advantage to switch to a different Medicare Advantage plan. They’ll also have the option to switch back to Original Medicare and pick a Part D prescription plan at the same time (as was the case under the previously used disenrollment period).The new enrollment period means that if you sign up for a Medicare Advantage plan during the annual election period (October 15 to December 7) and then decide you’re not happy with it once it takes effect, you have the option to switch to a different Medicare Advantage plan (or back to Original Medicare) at any time during the first three months of the new year. But you can only exercise this right one time per year (as opposed to the annual election period, when there’s no limit on how many times you can change your mind).
- From December 8 through November 30 each year – you can actually switch to a new Medicare Advantage or Medicare Part D plan – if you enroll in a plan in your area that has earned the government’s five-star (excellent) rating. (A list of plans that received the five-star rating for 2018 is available here; more data from CSM is available here).
For a thorough overview of the changes you can make to your coverage, read How do I change my Medicare coverage?
Knowing your coverage options is critical
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In these pages, you can tap into an extensive collection of resources, including:
- overview of Medicare’s plan options and benefits, from physical therapy to hospital beds and hospice care;
- explanations of when you can – and can’t – change your Medicare coverage
- an explanation of the gaps in Medicare’s coverage
- eligibility and enrollment guidelines;
- a glossary of Medicare terms;
- answers to the most frequently asked questions;
- links to dozens of resources, including providers and plans that are right for your needs.
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