Savvy Senior: When Can I Change My Medicare Coverage?

Listen to my One Thing or Another Podcast interview with Jim Miller.

By Jim Miller

Dear Savvy Senior,

Is it possible to make changes to my Medicare coverage now? I know we’ve passed the fall open enrollment period, but I’ve heard that there are other times of the year beneficiaries can make changes. What can you tell me?

Changed My Mind 

Dear Changed,

Yes! The annual Medicare open enrollment period isn’t your only opportunity to swap out Medicare coverage. There are other opportunities, but the timing of when you can make those changes depends on your specific circumstances and the kind of Medicare coverage you have. Here’s what you should know.

Medicare Advantage Change

If you’re enrolled in a Medicare Advantage Plan, you may be able to use the Medicare Advantage Open Enrollment Period, which occurs each year from Jan. 1 through March 31.

During this period, you can switch from your current Medicare Advantage Plan to another Medicare Advantage Plan or to original Medicare with or without a prescription drug plan. You can only make one change during this period, and it will be effective the first of the next month after you make the change.

Special Enrollment

Depending on your circumstances, you may also qualify for a Special Enrollment Period to change your Medicare health and drug coverage.

There are a number of circumstances in which you may have a Special Enrollment Period, such as if you moved outside of your plan’s service area, your Medicare Advantage Plan terminated a significant amount of its network providers, or you are enrolled in a State Pharmaceutical Assistance Program.

Those with Extra Help – the federal program that helps pay for drug costs – also have a Special Enrollment Period to enroll in a Part D plan, or switch between plans once per quarter in the first three quarters of the year.

If you need to make changes to your coverage but aren’t sure whether you qualify for a Special Enrollment Period, contact your State Health Insurance Assistance Program (SHIP), which provides free Medicare counseling. To find a SHIP counselor in your area visit ShipHelp.org or call 877-839-2675.

Also, be aware that if you’re enrolled in a Medicare plan by mistake or because of misleading information, you may be able to disenroll and change plans.

Typically, you have the right to change plans if you joined unintentionally, joined based on incorrect or misleading information, or, through no fault of your own, were kept in a plan you did not want.

To get help, call Medicare at 800-633-4227 and explain to a customer service representative how you joined the plan by mistake and to request retroactive disenrollment or a Special Enrollment Period.

Fall Open Enrollment

As you noted in your question, there’s also the Fall Open Enrollment Period that allows all Medicare beneficiaries – those with original Medicare and Medicare Advantage plans – to make changes.

The Fall Open Enrollment Period occurs each year from Oct. 15 through Dec. 7. During this period, you can join a new Medicare Advantage Plan or stand-alone prescription drug plan (Part D) plan. You can also switch between Original Medicare with or without a Part D plan and Medicare Advantage.

You can make as many changes as you need during this period, and your last coverage choice will take effect Jan. 1.

Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit SavvySenior.org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book.

Enjoy the content at LGBTSr? Subscribe here for weekly delivery!