I currently have Original Medicare and am considering switching to a Medicare Advantage (MA) Plan. I am worried I will regret it and want to switch back, though… Is it easy to switch between the two? How would I switch between Original Medicare and Medicare Advantage again in the future?
-Mathilda (Wasilla, AK)
Typically, you can only switch between Original Medicare and Medicare Advantage during specific times each year.
First, is the Fall Open Enrollment Period (also known as Medicare’s Open Enrollment Period), which occurs each year from October 15 through December 7. 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, 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.
If you are planning to use Fall Open Enrollment to switch to a Medicare Advantage Plan, it is helpful to know that you will have an additional enrollment period early in the new year, called the Medicare Advantage Open Enrollment Period (MA OEP). During this time, you can switch from your Medicare Advantage Plan to another Medicare Advantage Plan, or to Original Medicare with or without a stand-alone prescription drug plan (Part D). The MA OEP occurs each year from January 1 through March 31 and changes take effect the first of the month following the month you make the change. For example, if you switch from a Medicare Advantage Plan to Original Medicare in February, your new coverage begins March 1. Unlike Fall Open Enrollment, you can only make a single change during the MA OEP. Remember, you can only use this enrollment period if you have a Medicare Advantage Plan.
Additionally, 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, you would receive an SEP to switch to another MA Plan or to Original Medicare. There are several circumstances that may trigger an SEP.
To make changes during any of the above enrollment periods, you can call 1-800-MEDICARE (633-4227).
Finally, note that the enrollment rules for Medigaps are different, and changing to a Medicare Advantage Plan may change how other insurance you might have works with your Medicare. If you want to switch from Original Medicare with a Medigap to a Medicare Advantage Plan, learn about and carefully consider when and if you will have the right to re-join your Medigap or buy a new one if you want to switch back to Original Medicare at a later date. There are only a few specific protected times to purchase a Medigap under federal rules, but your state may offer additional rights. To determine whether you can make the switch, I would encourage you to reach out to your State Health Insurance Assistance Program (SHIP), as they will be familiar with the Medigap rules in your state.
Best of luck!