Medicare Advantage (also known as Medicare Part C) is a health insurance plan that private insurance companies offer. It’s an alternative way to receive Medicare benefits catered to your specific needs and circumstances.  

However, your needs might change over time and you might find your current Medicare Advantage plan inadequate. In this case, you would want to switch or change your plan. 

Is it possible to Switch Medicare Advantage plans?

Yes, you can switch between different Medicare Advantage plans. It doesn’t matter what type of coverage you currently have. If you find it unsuitable for your healthcare needs, you can choose any other Medicare Advantage plan. However, you must shift from one plan to another during a specific time period that allows such changes.

Can I change Medicare Advantage plans anytime?

The simple answer is no. You can only change it during two enrollment periods and within specific time frames each year. Also, there is a Special Enrollment Period that gives certain individuals another chance to make the change. 

When can I change my Medicare Advantage plan?

With the Medicare Advantage plan, you can have two opportunities to change the coverage each year. 

Also, the decisions you make will take effect on the first day of the following month.

1. Medicare Annual Election Period 

The annual election period usually runs from October 15 to December 7. It is also called Open Enrollment. During this period, all Medicare beneficiaries can make changes to their plans.

This is the right time to review your current coverage and make decisions for the following year.

You can join another MA plan with or without prescription drug coverage. You can also join a separate Part D plan if your MA plan doesn’t currently cover drugs. Or, you can shift from Medicare Advantage back to Original Medicare.

The changes in the coverage during this period will take effect on January 1 of the following year.

2. Medicare Advantage Open Enrollment Period (MA OEP)

During this open enrollment period, you can change your mind about your decision from the fall and change Medicare Advantage plans once at any time from January 1 to March 31 for the current year coverage.

In this period, you can only make changes to your Medicare Advantage plans. For example, you can switch from a Medicare Advantage plan without drug coverage to the one that offers drug coverage.

You can also switch to a Medicare Advantage plan that has overall better benefits than your current coverage. If you want to leave Medicare Part C and go back to Original Medicare, this change is also possible.

Can you change Medicare plans outside of  Open Enrollment?

Yes, there are special circumstances where it is possible to change your Medicare plan after open enrollment periods. 

Below, we have discussed these possibilities in detail. However, if you don’t fit in any of them, then you will have to wait for the next open enrollment period to make any changes in your Medicare coverage. 

1. Initial Enrollment Period

New Medicare beneficiaries – who have opted for the Medicare Advantage plan but don’t find it suitable for their needs anymore – can change the plan during the Initial Enrollment Period. 

This is a 7-month timeframe that depends on how you qualify for Medicare.

• If you qualify for Medicare based on age, your initial enrollment will begin three months before your 65th birthday, including your birth month, and the next three months after your birthday. So, in total, the initial enrollment lasts for seven months.
• If you’re eligible for Medicare based on a disability, your initial enrollment will start three months before the 25th month of receiving your disability benefits. It will include the 25th month and continue for the next three months. It’ll last a total of seven months.

However, you can’t make changes to your Medicare Advantage plan at any time during these 7 months. You can only do this within the first 3 months of having Medicare Part A and B.

So, if you want to join another MA plan or switch back to Original Medicare, you must make the decision within the first 3 months. Missing this opportunity means you will have to wait for the Open Enrollment Period. 

2. Special Enrollment Period

You’re eligible for Special Enrollment Periods if certain significant events happen in your life, such as changing your location or losing other coverage. So, in special cases, you can change Medicare Advantage plans. 

However, the type of changes you can make and the time limit you’ll have to make those changes will depend on your life event. Here’s the summary of different cases and scenarios:  

• You change your location

Special enrollment applies if you:

• Move to a new address that’s not covered by your current Medicare Advantage plan; 
• Move back to the U.S. after living abroad; 
• The area you’ve moved to has new coverage plans;
• Released from prison;
• Move into, currently live in, or moved out of any nursing facility.

In these scenarios, you have two months to make changes in your Medicare Advantage plans.

• You lose your current coverage.

If you lose your current coverage plan from your employer, you’ll have two months to switch Medicare Advantage plans.

• You have a chance to get other coverage

If you have a chance to switch to another coverage plan offered by your employer, the situation will be considered as Special Enrollment. You can drop your Medicare Advantage plan and accept the plan offered by your employer whenever your employer allows.

• Your coverage plan changes its contract with Medicare

You can change a Medicare Advantage plan to another plan in the Special Enrollment period if:

• Your Medicare Advantage plan’s contract with Medicare is not renewed. You’ll have time from December 8 to the end of February to join any other Medicare Advantage or Medicare Drug plan.
• Medicare terminates the contract with your coverage plan. You’ll have two months before and one month after the contract ends to switch the coverage.
• Medicare takes sanctions against your coverage plan. Depending on the case, you’ll be given time to switch to another plan.

There are some other situations that come into consideration during the special enrollment period. Read here if you want to know more.

3. 5-Star Special Enrollment Period

If a Medicare Advantage or Medicare Prescription Drug plan with a 5-star rating is available in your area, you can switch from your current Medicare plan. You can use this Special Enrollment Period only once between Dec 8 and Nov 30.

How to change Medicare Advantage plans?

If you want to change your Medicare Advantage plans, here’s how you can do it.

1. Check the plans that are available in your area

The first step is to find out the coverage plans available in your area and compare them. Don’t forget to enter the healthcare providers you visit and prescription drugs you take to get the most suitable plan and its estimated monthly and yearly costs. Use a plan finder or Hella Health’s Personal Shopper.

2. Make sure the plan meets your needs

Make sure the plan is meeting your needs. It’s very important to do complete research. Thoroughly go through each plan’s description and ensure what you want is present in the coverage. Use a comparison plan tool to make the process easier.

3. Join the plan

Once you choose the plan, select “Enroll” and contact them to join. You can visit their website or directly call them. 

Also, if you’re switching from Medicare Advantage to Original Medicare, you’ll have to disenroll yourself first from the Advantage plan. You can do so by contacting Medicare at 1-800-MEDICARE (1-800-633-4227). TTY users can call 1-877-486-2048. 

Important: if you forget to sign up for Part D while you are eligible, you’ll have to pay a penalty for a late sign-up. 

Questions about Medicare?

Shoot us an email at medicare@hihella.com.