Can You Switch Medicare Advantage Plans Anytime?

Medicare Advantage plans, often called Part C, offer an alternative way to receive Medicare benefits. These plans are provided by private insurance companies approved by Medicare and bundle together Medicare Part A (hospital insurance) and Medicare Part B (medical insurance). Many Medicare Advantage plans also include prescription drug coverage (Part D) and may offer additional benefits not covered by Original Medicare, such as dental, vision, and hearing services. Switching Medicare Advantage plans is generally restricted to specific enrollment periods, although certain life events can create exceptions.

Standard Enrollment Periods

Most individuals make changes to their Medicare Advantage plans during predictable, regularly scheduled times each year. These periods provide a structured opportunity to review current coverage and explore new options.

The Annual Enrollment Period (AEP) runs from October 15 to December 7 each year. During this period, individuals can switch from Original Medicare to a Medicare Advantage plan, change from one Medicare Advantage plan to another, or switch from a Medicare Advantage plan back to Original Medicare. This window also allows for joining, switching, or dropping a Medicare Part D prescription drug plan. Any changes made during the AEP become effective on January 1 of the following year.

The Medicare Advantage Open Enrollment Period (MA OEP) occurs from January 1 to March 31 annually. This period is exclusively for individuals already enrolled in a Medicare Advantage plan. During the MA OEP, a person can switch from their current Medicare Advantage plan to another, or disenroll and return to Original Medicare. If returning to Original Medicare, they can also join a standalone Medicare Part D prescription drug plan. Only one change can be made during this period, and new coverage typically begins on the first day of the month after the plan receives the request.

Special Enrollment Periods

Specific circumstances, often related to significant life events, trigger Special Enrollment Periods (SEPs). These periods allow individuals to make changes to their Medicare Advantage coverage outside of typical annual windows.

One common reason for an SEP is moving to a new address. If a new residence is outside the current plan’s service area, or if new plan options become available, an SEP is granted. This allows for enrollment in a new Medicare Advantage plan or a return to Original Medicare. The SEP for moving generally lasts for two full months after the month of the move, or up to two months after notifying the plan.

Losing other creditable coverage, such as an employer-sponsored health plan, can also trigger an SEP. When employer coverage ends, an individual generally has an eight-month SEP to enroll in Medicare Part B and, subsequently, a Medicare Advantage plan. This period helps prevent gaps in coverage. Eligibility for “Extra Help,” a Low-Income Subsidy for prescription drug costs, also provides a continuous SEP, allowing monthly changes to prescription drug plans or Medicare Advantage plans that include drug coverage.

Other qualifying events for an SEP include moving into or out of a qualified institutional facility, such as a nursing home. For those residing in such facilities, a monthly SEP allows for changes to Medicare Advantage or Part D plans. If a current plan leaves the Medicare program or significantly reduces its service area, an SEP is provided to choose a new plan. Federal emergency or disaster declarations can also create an SEP for affected individuals who missed enrollment deadlines. A change in eligibility for a Special Needs Plan (SNP), such as no longer having a chronic condition that qualified for the SNP, also triggers an SEP.

How to Change Plans

Once eligibility for a change has been determined during a standard or special enrollment period, the process of switching Medicare Advantage plans involves several direct steps.

One straightforward method is to use the official Medicare website, Medicare.gov. The “Plan Compare” tool allows individuals to search for plans in their area, compare features and costs, and enroll directly online. This digital approach provides comprehensive information and a convenient enrollment pathway.

Another option is to contact Medicare directly by calling 1-800-MEDICARE. This toll-free number connects individuals with Medicare representatives who can provide guidance, help compare plans, and assist with the enrollment process over the phone. TTY users can access assistance by calling 1-877-486-2048.

Individuals can also contact the specific Medicare Advantage plan they wish to join directly. Insurance companies offering Medicare Advantage plans have enrollment departments that can provide application forms and assist with the sign-up process. Working with a licensed insurance agent can also be beneficial, as agents are knowledgeable about various plans and can help navigate options and complete enrollment paperwork. When applying for a new plan, essential information such as the Medicare number and the effective dates for Medicare Part A and Part B will typically be required.

After Changing Plans

Once a new Medicare Advantage plan has been selected and the enrollment request submitted, understanding the subsequent steps and practical implications is important.

The new plan’s coverage will begin on a specific effective date, which depends on the enrollment period used for the change. For instance, changes made during the Annual Enrollment Period take effect on January 1 of the following year. For changes made during the Medicare Advantage Open Enrollment Period or most Special Enrollment Periods, coverage generally begins on the first day of the month after the new plan receives the enrollment request.

A significant aspect of switching plans is the automatic disenrollment from the previous plan. When an individual successfully enrolls in a new Medicare Advantage plan, their old plan is automatically canceled. There is no need to contact the prior plan to disenroll, as enrollment in the new plan triggers the termination of the old one, preventing any gaps in coverage.

Following enrollment, the new plan will send a welcome packet, which usually includes a new member identification card and detailed plan documents. Upon receiving these materials, it is advisable to confirm that all current prescriptions are covered by the new plan’s formulary and to understand any changes in prescription costs or pharmacies. Checking if current doctors, specialists, and other healthcare providers are within the new plan’s network is also important to avoid unexpected out-of-network costs.