Can I still make changes to my Medicare coverage for 2019?

  • By
  • medicareresources.org Contributor
  • December 8, 2018

Q: Can I still make changes to my Medicare coverage for 2019?

How well are you prepared to enroll in Medicare? Take the Medicare Smarts quiz.

How well are you prepared to enroll in Medicare? Click the graphic to take our brief quiz.

A: For 2019 coverage, open enrollment (also known as the annual election period) for Medicare Advantage and Medicare Part D continues ended on December 7, 2018.

But for people who are on Medicare Advantage, there’s a new Medicare Advantage open enrollment period during the first quarter of the new year. It runs from January 1 to March 31, and replaces the Medicare Advantage Disenrollment Period that was available in prior years. The disenrollment period used to end in mid-February, so the new Medicare Advantage open enrollment period gives enrollees twice as much time to make changes to their coverage, and it allows Medicare Advantage enrollees the option to switch to a a different Medicare Advantage plan.

In the past, the disenrollment period only allowed people to drop their Medicare Advantage plan and enroll in Original Medicare instead. You can still do that, but picking a different Medicare Advantage plan is now an option during the first quarter of the year.

In addition to those two enrollment windows, some people have other opportunities to enroll or make changes to their coverage:

5-Star Plans

If there’s a Medicare Advantage or Medicare Part D plan in your area that has earned the government’s five-star (excellent) rating, you’re allowed to switch onto that plan anytime between December 8 and November 30. This is called the 5-star special enrollment period, and you’re allowed to utilize it one time during that period.

For 2019, there are a total of 19 plans that have a five-star rating. Fifteen are Medicare Advantage plans, and four are stand-alone Part D plans.

General Medicare enrollment for those who didn’t sign up when first eligible

From January 1 to March 31 each year, people who are eligible for Medicare Parts A and B but not yet enrolled can sign up for coverage. It will take effect on July 1 of that year. If you didn’t sign up for Part B when you were first eligible and you haven’t had creditable coverage from an employer plan in the meantime, you’ll have to pay an additional premium for your Part B plan, as a late enrollment penalty.

Special Needs Plans

If you develop a condition that makes you eligible for a Medicare Special Needs Plan (SNP) and an applicable SNP is available in your area, you can join it at any time, but once you join, your special enrollment period ends.

Dual-eligible enrollees

If you’re covered by both Medicare and Medicaid, you can switch plans at any time during the year. This applies to Medicare Advantage as well as Medicare Part D.

Note that there are SNPs designed for people who are dual-eligible for Medicaid and Medicare, and there are also SNPs for people who are institutionalized.

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. (Be aware that not all of the special enrollment periods for Medicare Advantage or Medicare Part D apply to Medigap plans).

But you can still apply for a Medigap plan outside of open/special enrollment periods — just be aware that in most states, the carrier will use medical underwriting to determine whether to accept your application, and how much to charge you. Some states have created annual windows during which enrollees can switch to a different Medigap plan without medical underwriting, but this is the exception rather than the rule; federal law does not grant any sort of annual open enrollment period for Medigap plans.


Louise Norris is an individual health insurance broker who has been writing about health insurance and health reform since 2006. She has written dozens of opinions and educational pieces about the Affordable Care Act for healthinsurance.org. Her state health exchange updates are regularly cited by media who cover health reform and by other health insurance experts.