Reaching the age when you’re eligible for Medicare health care insurance is a big deal. For millions of Americans, enrollment in this federal program comes at a time when they are experiencing both economic and health care changes.
At age 65, you may no longer be eligible for group health insurance through an employer, your retirement benefits may provide less money than your salary or wages did, and you may be more concerned about medical issues as your approach your senior years. This means that you should look for health care insurance that best fits your situation.
Even though many people remain healthy in their 60s, things can change as we age. What might be sufficient health care coverage for you when you first sign up for Medicare may not be enough later, when you’re older.
Medicare gives beneficiaries the opportunity to switch their plans, add plans, or drop plans at certain times during the year. This way, Medicare enrollees can adjust their health care coverage if they need to. Here’s a look at when you can make changes to your Medicare coverage.
When can you switch your Medicare plan?
Medicare allows people to make coverage changes during certain times of the year, called enrollment periods. The enrollment period during which you can make your change depends on the type of coverage involved in the switch: Original Medicare, Medicare Advantage, Medicare Part D prescription drug, and/or Medicare Supplement insurance (like Medigap).
Here’s a look at some of the Medicare enrollment periods, and what you can do with your Medicare coverage during that period.
Initial Enrollment Period (IEP)
When you first become eligible for Medicare at age 65, if you’re receiving Social Security or Railroad Retirement benefits at the time, you are automatically enrolled in Original Medicare Part A (hospital insurance) and Part B (medical insurance). You can also enroll yourself during this period if you aren’t getting these benefits already.
Of course, if you enroll yourself in Medicare during your IEP, you can choose the type of coverage plan you want from the outset. However, if you are automatically enrolled and you don’t want to remain enrolled in Part A or Part B, you can contact the SSA and decline these benefits.
During your IEP, you can enroll in a Medicare Advantage (Part C) plan as an alternative to Original Medicare Parts A and B. If you choose to get your benefits through Original Medicare, you can also add Medicare Part D (prescription drug) coverage by enrolling in a stand-alone plan that you purchase from a private insurance company.
Open Enrollment Period
The Medicare Open Enrollment Period (OEP) takes place every year from October 15th to December 7th. OEP, Medicare beneficiaries can make the following coverage changes:
- Switch from Original Medicare to Medicare Part C. To do this, you must be enrolled in both Part A and Part B and live within the service area of your new Medicare Advantage plan.
- Switch from your current Medicare Advantage plan back to Original Medicare Parts A and/or B. You can also purchase a Medicare Part D plan if you leave Medicare Advantage.
- Switch from your current Medicare Advantage plan to a different Medicare Advantage plan, with or without prescription drug coverage.
- Switch from one Medicare Part D plan to another.
Your new coverage kicks in on January 1st of the new year.
Medicare Advantage Open Enrollment Period (MA-OEP)
The MA-OEP runs from January 1st to March 31st. During this enrollment period, you can make the following switch:
- If you are already enrolled in a Medicare Advantage (Part C) plan, you can switch to a different Part C plan
- You can switch back to Original Medicare Parts A and/or B; You can purchase a stand-alone Medicare Part D plan if you go back to Original Medicare
During the Medicare Advantage Open Enrollment Period, you can make only one plan change.
5-Star Special Enrollment Period
From December 8 through November 30, you can make a change to a Medicare Advantage plan with a 5-star rating than your current plan. Medicare plans are rated based on information from member satisfaction surveys, plans, and healthcare providers. If a 5-star plan is available in your area, you may make a switch one time.
Special Enrollment Period
You may be able to switch your Medicare coverage if you experience certain life events during the year outside of the traditional enrollment periods. If you move out of your current plan’s service area, lose your group insurance from an employer or union, or move into or out of assisted living, among other circumstances, may qualify you for a Special Enrollment Period.