When Can I Change My Medicare Plan?
One of the biggest questions Medicare participants have is: “Can I change my plan any other time besides Open Enrollment?”
Your current Medicare plan won’t always fit your needs. Whether you’re facing prescription drug changes, new health concerns, or are moving to a new area, you want a Medicare plan that meets your current healthcare needs. When your needs change, when can you change your Medicare plan?
Every year from October 15 to December 7, there is an open enrollment period. During this time, members on Medicare Advantage Plans and Medicare Prescription Drug Plans may change their plan for an effective date of January 1.
- For the first twelve months after your initial enrollment to a Medicare Advantage plan, you can change to a Medigap (Medicare Supplement) plan at any time.
- If, at any time, you decided to drop your Medigap plan for a Medicare Advantage plan, you have a one-time opportunity to return to original Medicare and a guaranteed eligibility period to rejoin a Medigap plan within one year.
Moving to a New Area
Not every state and every county have identical Medicare plans. If you are moving to a new area which is outside your current plan’s service area or provides you with new Medicare Advantage and Part D options you didn’t have before, you can change your plan. Typically, you have 30 days before and 60 days after you move to make this change.
California’s Birthday Rule
Medigap plans participants may change their plan the month of their birthday.
Note: The “birthday rule” does not apply to Medicare Advantage or Part D plans.
Losing Current Coverage
If you chose not to sign up for Medicare part B when you turned 65 because you were still receiving healthcare benefits through a company plan, you have an eight-month period to enroll in a Medicare plan once you leave the company plan.
Special Needs Plan
There are Special Needs Plans (SNP) that allow Medicare members to enroll at any time during the year.
- Those who develop chronic conditions such as End-stage renal disease (ESRD), Amyotrophic Lateral Sclerosis (ALS or Lou Gehrig’s disease), COPD, diabetes, or chronic health disease may be eligible to change their Medicare plan to an SNP.
- You may be able to switch to an SNP if you qualify for both Medicare and Medicaid.
- Those who qualify for low-income subsidy (LIS) may receive help for their Medicare Part D and can change their prescription drug plan any time during the year.
Note: There are several other conditions that allow for a SNP. Please consult an agent to find out more.
You can find out more information about Medicare plans and enrollment periods by contacting Caress Insurance Agency, who works with Scripps Mercy Hospital to help answer your Medicare questions.