How and when you can change your Medicare coverage

How you can change Medicare coverage during open enrollment

Open enrollment for Medicare Advantage and Medicare Part D coverage started October 15 and continues through December 7. Changes during this enrollment period will be effective for 2020 coverage.

During this open enrollment period, you can:

• switch from one Medicare Advantage plan to another, or from one Medicare Part D plan to another and
• if you didn’t enroll in a Part D plan when you were first eligible, you can do so during the general open enrollment, although a late enrollment penalty may apply.
• If you want to enroll in a a Medicare Advantage plan, you must meet some basic criteria.

Medicare changes outside of open enrollment

Enrolling in Medicare Part A and B

• 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, but there is a late enrollment penalty that applies if you’re subject to premiums for Part A.)

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 is 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), allows a person who is already enrolled in Medicare Advantage to switch to a different Medicare Advantage plan. They 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). They can apply for a Medigap plan at that point as well, but unless they have a guaranteed-issue right, Medigap insurers in most states can use medical underwriting to determine whether to accept the application.
• The new enrollment period means that if you signed 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. For 2019, there are a total of 19 plans that received a five-star rating (fifteen Medicare Advantage plans and four stand-alone Part D plans).

For a thorough overview of the changes you can make to your coverage, read How do I change my Medicare coverage?

Enrolling in or 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 – although in most states, carriers will use medical underwriting to determine whether to accept your application, and how much to charge you. There are several states, however, where Medigap coverage is guaranteed issue for at least some point during each year.

Knowing your Medicare coverage options is critical

How well do you understand Medicare’s coverage options? Take our new Medicare Smarts Quiz to see if you are ready to shop for new coverage.

Ready or not, you can always learn more right here. The articles on this site are authored by a team of veteran healthcare writers who know the health insurance industry, understand the political battles over healthcare – and, most importantly, who know the needs of consumers.

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.

We hope you’ll find the answers to all your burning questions. If you can’t, please don’t hesitate to send us your questions.