How to switch Medicare Advantage Plans or switch from Medicare Advantage to Original Medicare

Typically, you can only enroll in a different Medicare Advantage Medicare Advantage Medicare Advantage, also known as Part C, Medicare Private Health Plan, or Medicare Managed Care Plan, allows you to get Medicare coverage from a private health plan that contracts with the federal government. All Medicare Advantage Plans must offer at least the same benefits as Original Medicare (Part A and Part B), but can do so with different rules, costs, and coverage restrictions. Plans typically offer Part D drug coverage as part of Medicare Advantage benefits. Medicare Advantage Plans include Health Maintenance Organizations (HMOs), Preferred Provider Organizations (PPOs), Private Fee-for-Service (PFFS) plans, Special Needs Plans (SNPs), and Medicare Medical Savings Accounts (MSAs). Plan or switch between Original Medicare Original Medicare Original Medicare, also known as Traditional Medicare, is the fee-for-service health insurance program offered through the federal government, which pays providers directly for the services you receive. Almost all doctors and hospitals in the U.S. accept Original Medicare. and Medicare Advantage during specific times each year. Make sure to enroll in a timely manner to avoid gaps in coverage gaps in coverage Gaps in coverage are services or costs that are not covered by Original Medicare, such as vision, dental, and hearing care, as well as deductibles and coinsurance. when using these enrollment periods enrollment periods Enrollment periods are certain periods of time when you can join the Original Medicare program, or enroll in a Medicare Advantage Plan, Part D plan, or supplemental insurance plan (Medigap). See also: Fall Open Enrollment, Medicare Advantage Open Enrollment Period, General Enrollment Period, Initial Coverage Election Period, Initial Enrollment Period, Medigap Open Enrollment Period, and Special Enrollment Period. .

1. Fall Open Enrollment Period: You can make a number of changes to your Medicare coverage during Fall Open Enrollment (also known as the Annual Election Period, or AEP). The Fall Open enrollment Period occurs each year from October 15 through December 7, with your new coverage starting January 1.

• During this period you can:
  • Change your choice of health coverage
  • Add, drop, or change Medicare drug coverage
• You can make as many changes as you need during this period, and your last coverage choice will take effect January 1. To avoid enrollment problems, it is usually best to make as few changes as possible.

2. Medicare Advantage Open Enrollment Period: You can switch from your Medicare Advantage Plan (excluding Medical Savings Accounts, cost plans, and PACE) to another Medicare Advantage Plan, or to Original Medicare with or without a stand-alone prescription drug plan (Part D), during the Medicare Advantage Open Enrollment Period (MA OEP). The MA OEP occurs each year from January 1 through March 31. Remember, you can only use this enrollment period if you have a Medicare Advantage Plan. Changes made during this period take effect the first of the month following the month you enroll. For example, if you switch to a new Medicare Advantage Plan in February, your new coverage begins March 1. Unlike Fall Open Enrollment, you can only make a single change during the MA OEP.

* If you have a Medicare Advantage Plan and a separate Part D plan, you can switch to a Medicare Advantage Plan that does not include drug coverage or Original Medicare, but you cannot change Part D plans.

Note: To make a change during the MA OEP, call 1-800-MEDICARE (633-4227). If you choose to contact a Medicare Advantage Plan directly to make changes, make sure you submit disenrollment disenrollment Disenrollment is leaving a Medicare Advantage Plan or Part D plan. and enrollment requests at the same time to avoid errors.

3. Special Enrollment Period: Under certain circumstances, you may be eligible for a Special Enrollment Period (SEP). SEPs allow you to change your health and/or drug coverage outside normal enrollment periods. For example, if your Medicare Advantage Plan would leave your area or you would move out of your plan’s service area service area The service area is the geographic area where a Medicare Advantage Plan or Part D plan provides medical services to its members. In many plans, the service area is where your network of providers is located. , you would receive an SEP to switch to another MA Plan or to Original Medicare. There are several circumstances that may trigger an SEP.

Note: In most cases, you can only switch to a Medicare Medical Savings Account plan during the Fall Open Enrollment Period.