If you’ve missed Medicare’s Open Enrollment Period but you’re still not satisfied with your current Medicare Advantage plan, you may still have an opportunity to make a change. If you qualify to participate in the Medicare Advantage Open Enrollment Period (MA-OEP), you may have questions.
Why choose Medicare Advantage?
When you become eligible for Medicare, you can either enroll in Original Medicare Part A and/or Part B, or you can enroll in a Medicare Advantage (MA) plan as an alternative. Medicare Advantage plans are sold by private insurance providers who are affiliated with the federal Medicare program. MA plans are required by law to cover the same benefits that Original Medicare does, but most Medicare Advantage plans also cover prescription drugs and some extra benefits. However, depending on the type of MA plan you have, you may have restrictions regarding which health care providers, physicians, and medical facilities you can use.
If you enroll in Medicare Part B and Part D when you first become eligible, you avoid paying late enrollment penalties. But that doesn’t mean you need to stay in one Medicare plan forever. Fortunately, Medicare provides enrollment periods each year, so you can change coverage if you want.
If you have Medicare Advantage, you might want to switch to a different plan if:
- Your finances change, and you want a more economical plan.
- You need to adjust your coverage – you may have too much or too little.
- You want to choose your own health care providers and your current plan is too restrictive.
- You need prescription drug (Part D) coverage.
- You’re planning to move to a different service area, or your living arrangements are changing. In this instance, you may also qualify for a special enrollment allowance.
- You don’t like your current provider or coverage, or your provider is ending your current plan.
Beneficiaries who have Medicare Part C coverage can make changes to their coverage during the Open Enrollment Period, the Medicare Advantage Open Enrollment Period, or a Special Enrollment Period if you qualify.
What is the Medicare Advantage Open Enrollment Period?
This special period runs from January 1 to March 31 every year. It is an enrollment period provided for people who are currently enrolled in a Medicare Advantage (Part C) plan.
If you have this type of insurance coverage, you can do the following during this period:
- Switch to another Part C policy that either includes, or doesn’t include prescription drug (Part D) coverage.
- Drop the Medicare Advantage plan you currently have and return to both Parts A and B of Original Medicare. If you do, you can also purchase a stand-alone Medicare prescription drug (Part D) plan.
Your new plan’s coverage begins on the first of the month following your request to change your plan.
It’s important to note that you can only make one change during the Medicare Advantage Open Enrollment Period, so you should be certain about your options before deciding.
During this enrollment period you can’t make the following changes:
- Drop Original Medicare coverage and enroll in a Medicare Advantage plan
- Enroll in Part D coverage if you have Original Medicare
- Switch from one Part D plan to another if you have Original Medicare
Are there other enrollment periods for Medicare Advantage?
Besides your Initial Enrollment Period (IEP) when you first become eligible for Medicare, you can also make the following coverage changes during the annual Open Enrollment Period (OEP) which takes place between October 15th and December 7th:
- Switch from Original Medicare to Medicare Advantage
- Drop your Medicare Advantage plan and return to Original Medicare
- Switch from one MA plan to another MA plan that either covers or doesn’t cover prescription drugs.
- Enroll in a stand-alone Part D coverage
- Switch from one Part D plan to another
- Drop Part D coverage
Any changes you make during this enrollment period take effect on January 1st.
If you experience a qualifying life event, you may also be eligible for a Special Enrollment Period.