Kelly Blackwell is a Certified Senior Advisor (CSA)®. She has been a healthcare professional for over 30 years, with experience working as a bedside nurse and as a Clinical Manager. She has a passion for educating, assisting and advising seniors throughout the healthcare process.
What you should know:
- You can only change Medicare Advantage Plans during certain times of the year, unless you qualify for a Special Enrollment Period (SEP).
- Anyone can change their Medicare Advantage Plan during their Initial Enrollment Period, Open Enrollment or Medicare Advantage Open Enrollment.
- Open Enrollment occurs every year from October 15 to December 7. Medicare Advantage Open Enrollment lasts from January 1 through March 31 each year.
- If you qualify for a SEP, you generally have 2 months to make a change to your Medicare Advantage Plan.
There are 3,550 Medicare Advantage Plans available nationwide in 2021, according to the Kaiser Family Foundation. The average Medicare beneficiary has access to 33 different plans she can choose from. This can make choosing the right plan for you a challenge. The good news is that changing Medicare Advantage Plans is easy: Simply join a new plan and you’ll be automatically disenrolled from your old plan. The bad news is there are only certain times of the year when you can change your Medicare Advantage Plan. You must be enrolled in Medicare Part A and B to join a Medicare Advantage Plan.
Can you switch Medicare Advantage plans anytime?
You cannot switch Medicare Advantage plans at any time. There are only three enrollment periods when you can switch a Medicare Advantage Plan. Your first opportunity is after you first enroll in a MA Plan during your Initial Enrollment Period.
Your Initial Enrollment Period generally lasts for 7 months from 3 months before the month you turn 65 to 3 months after the month you turn 65, unless you qualify for Medicare based on disability. In this case, your Initial Enrollment Period starts 3 months before your 25th month of receiving disability benefits and ends 3 months after your 25th month of disability benefits.
During these 7 months, you can make any changes you need to your plan elections, says Matt Dworetsky, founder of Dworetsky Financial in Manalapan, New Jersey. If you enroll during your Initial Enrollment Period, you can also make changes anytime in the first 3 months of your Medicare coverage.
“After that, you can switch plans during open enrollment in the Fall or during Medicare Advantage open enrollment, which is at the beginning of each year,” Dworetsky says.
Medicare Open Enrollment occurs from October 15 to December 7 each year. If you have Medicare Part A already and get Part B for the first time during Open Enrollment, you can join a Medicare Advantage Plan, says Cynthia Pruemm, investment advisor, founder and CEO of SIS Financial Group in Hoffman Estates, Illinois. “This is referred to as the General Enrollment Period.”
Medicare Advantage Open Enrollment lasts from January 1 through March 31 each year and is specifically for Medicare Advantage Plans. If you’re already enrolled in a MA Plan, you can switch to a different MA Plan or to Original Medicare during this time.
Can you change my Medicare Advantage plan after open enrollment?
“Once the open enrollment ends, in general you will not be able to make changes until the next enrollment period,” says Joe Boden, vice president and partner at EP Wealth Advisors in Seattle. “However, there are a few exceptions when you can make a change or disenroll from your plan outside of the enrollment periods.”
Certain events may make you eligible for a Special Enrollment Period (SEP). For instance, if this is the first time you’ve ever enrolled in a Medicare Advantage Plan and you dropped a Medigap policy to enroll, you have a 12 month trial period after enrolling in the MA Plan in which you can drop your MA Plan and go back to Original Medicare.
“Another exception is if your Advantage plan drops your healthcare provider,” Boden says. “Also, if you move and your plan does not have coverage in your new location, you can change plans.” Even if your new address is within your current plan’s coverage area, you can switch to a different plan if your move made you eligible for new options that weren’t available at your old address. You have from one month before your move until 2 months after your move to switch plans.
When can you disenroll from a Medicare Advantage Plan?
Like switching Medicare Advantage Plans, you can only disenroll from a Medicare Advantage Plan during certain times of the year.
“You can disenroll from your plan during the annual election period, special election periods or during the annual Medicare Advantage Open Enrollment Period,” Dworetsky says. “Medicare will automatically disenroll you from your old plan if you switch to a different Medicare Advantage plan during any of these periods.”
What happens if you need to change plans during a period you cannot change plans?
The only way to change Medicare Advantage Plans outside of the standard annual enrollment periods is by qualifying for a Special Enrollment Period. SEPs when you can change Medicare Advantage Plans include, but are not limited to:
- Moving outside of your current plan’s service area.
- Moving to a new address within your current plan’s service area but which has new plan options.
- Moving into or out of a skilled nursing facility or long-term hospital care.
- You are eligible for both Medicare and Medicaid.
- Becoming ineligible for Medicaid.
- If Medicare takes an official action because of a problem with your current plan that affects you.
- If Medicare terminates or does not renew your current plan’s contract.
- You joined a plan or chose not to join a plan due to an error by a federal employee.
You generally have 2 months to make a change to your Medicare Advantage Plan during a SEP.
For a complete list of special circumstances that qualify you for a SEP, click here: Special circumstances (Special Enrollment Periods).
These experts were consulted for insight into changing Medicare Advantage Plans.
- Joe Boden, vice president and partner at EP Wealth Advisors in the firm’s Seattle office
- Matt Dworetsky, founder of Dworetsky Financial in Manalapan, New Jersey
- Cynthia Pruemm, Investment Advisor, Founder and CEO of SIS Financial Group in Hoffman Estates, Illinois
- Medicare: Medicare Advantage Plans | Last accessed June 2021
- KFF: Medicare Advantage 2021 Spotlight: First Look | Last accessed June 2021
- Medicare: Join, switch, or drop a Medicare Advantage Plan | Last accessed June 2021
- Medicare: Joining a health or drug plan | Last accessed June 2021
- Medicare Rights Center: Special Enrollment Periods for Medicare Advantage Plans and Medicare Part D Drug Plans | Last accessed June 2021
- Medicare: Special circumstances (Special Enrollment Periods) | Last accessed June 2021