Changing your Medicare Advantage (private health) plan

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Last Update: February 09, 2012

You are limited in when you can change your Medicare health plan during the year.

  1. You can switch Medicare private plans during Fall Open Enrollment (Fall Open Enrollment is sometimes referred to as the Annual Coordinated Election Period – ACEP) which runs from October 15 through December 7 in 2013. Your new coverage starts January 1. During this period you can change your choice of health coverage, and add, drop or change Medicare drug coverage. (You can make as many changes as you need during this period, but only your last coverage choice will take effect January 1. However, to avoid enrollment problems, it is best to make as few changes as possible).

    Note: If you are changing plans to join a Medicare Medical Savings Accounts (MSA), you can usually only do so during the Fall Open Enrollment Period.  

  2. You can switch from your Medicare private health plan (except MSA plan) to Original Medicare during the Medicare Advantage Disenrollment Period (MADP). You can only make this coverage change if you have a Medicare private health plan (also known as a Medicare Advantage plan). The MADP will occur every year starting in 2011, from January 1 to February 14.

    If you have a Medicare private health plan you will be able to switch to Original Medicare with or without a stand-alone prescription drug plan. Changes made during this period will become effective the first of the following month. For example, if you switched from a Medicare Advantage plan to Original Medicare and a stand-alone prescription drug plan in February, your new coverage would begin March 1.

    Note: If you are enrolled in a PFFS plan with a stand-alone drug plan, you must keep your stand-alone prescription drug plan if you switch to Original Medicare during the MADP.

    Note: If you disenroll from your Medicare private health plan (Medicare Advantage plan) federal law does not usually give you the right to buy a Medigap plan. The laws in your state might give you more rights. Medigap plans are supplemental polices that help pay for Original Medicare deductibles and coinsurances. You should check with your SHIP (State Health Insurance Assistance Program) to find out if and when you can enroll in a Medigap plan in your state.

 

    For information on when you can enroll in or change Medicare drug plans, follow the links in the GO TO box.

 

    For information on when you have the right to buy a Medigap, follow the links in the GO TO box.

Medicare Advantage Disenrollment Period 

If you have... You can switch to...
 
a Medicare private health plan with or without drug coverage (Medicare Advantage) Original Medicare and a prescription drug plan* 

or

Original Medicare without
a prescription drug plan
 

A Medicare Private Fee-For-Service (PFFS) plan that does not have prescription drug coverage and a stand-alone prescription drug plan (MA and PDP)

Original Medicare, but you must keep your current prescription drug plan

Original Medicare or Original Medicare and a prescription drug plan You cannot switch your plan during this time 
 

 * If you have a Medicare Advantage plan and a separate stand along drug plan (PDP), then you can switch to Original Medicare but cannot change stand alone drug plans.

3. Under certain circumstances, you may be eligible for a Special Enrollment Period (SEP) to change your health and or drug plan outside of the usual enrollment or disenrollment periods. If you get an SEP, your new coverage will usually start the first of the month after you sign up for or disenroll from a Medicare private health plan. One example of when you qualify for an SEP: when your Medicare private health plan leaves your area or you move out of your plan’s service area, you can switch to another private health plan or to Original Medicare.   

Beginning in 2012, you have an SEP to switch into a five-star plan from your current plan. The five-star SEP encourages Medicare Advantage plans to improve their quality ratings. You can enroll into a new Medicare Advantage Plan or stand-alone Part D plan that was given an overall plan performance rating of five stars for the year 2012.  You may only use this SEP once per calendar year. You must also be eligible to join the plan (i.e. live in the plan’s service area). For more information on this and all Special Enrollment Periods, please see the chart below.   

 Medicare Private Plan Special Enrollment Period (SEP) Chart

Enroll early during an enrollment period to make sure that your new coverage starts when it should.

 

    To learn how to change plans, follow the links in the GO TO box.

 

    To find out what Medicare private health plans are available in your area, click on the link in the LINKS box.

 

 

 


Related Questions
Can my state give me more rights and protections than federal law regarding Medigap plan enrollment?

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State:  
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GO TO
Changing your Medicare private drug plan (Part D)

How do I enroll in the Medicare prescription drug benefit (Part D)?

Will I be penalized for delaying enrollment in the Medicare prescription drug benefit (Part D)?

Joining a Medicare private health plan

How do I switch from a Medicare private health plan to Original Medicare (disenroll)?

Switching from one Medicare private health plan to another

 
LINKS
Medicare.gov Medigap (Medicare Supplement) Policies & Guide

MyMedicare.gov: Access your Medicare information

State Health Insurance Assistance Program (SHIP) Directory

 
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