Changing coverage

Understanding Medicare enrollment periods and the rules for changing your plan after your initial enrollment period is crucial for making sure you have the right coverage for your needs. Medicare provides specific windows of time when you can enroll, switch plans, or make other coverage changes. Here's a breakdown of the key enrollment periods and rules to keep in mind.​

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The Annual Enrollment Period (AEP)

 

 

This is the most common time for anyone with Medicare to make changes to their coverage.

• When it is: October 15 to December 7 each year.

• What you can do:

  • Switch from Original Medicare to a Medicare Advantage Plan.

  • Switch from a Medicare Advantage Plan back to Original Medicare.

  • Switch from one Medicare Advantage Plan to another.

  • Join a Medicare Prescription Drug Plan (Part D).

  • Switch from one Part D plan to another.

  • Drop your Part D coverage completely.

• When coverage starts: Any changes you make during the AEP will become effective on January 1 of the following year.

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The Medicare Advantage Open Enrollment Period (MA OEP)

 

 

This period is specifically for people who are already enrolled in a Medicare Advantage plan.

• When it is: January 1 to March 31 each year.

• What you can do:

  • Switch to a different Medicare Advantage plan (with or without prescription drug coverage).

  • Disenroll from your Medicare Advantage plan and return to Original Medicare.

  • If you return to Original Medicare, you can also join a stand-alone Medicare Prescription Drug Plan (Part D).

• Important note: You can only make one change during this period.

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Special Enrollment Periods (SEPs)

 

 

In some cases, you may qualify for a Special Enrollment Period (SEP) that allows you to change your Medicare plan outside of the standard enrollment periods. These periods are triggered by specific life events. The length of a SEP can vary, but they often last for a couple of months after the qualifying event.

• Common reasons for an SEP include:

  • Moving: You move out of your plan's service area or move to a new location where you have new plan options.

  • Losing other coverage: You lose your employer-sponsored health coverage or your eligibility for Medicaid.

  • Changes to your plan's contract with Medicare: Your Medicare Advantage or Part D plan leaves your area or stops its contract with Medicare.

  • Qualifying for "Extra Help" or Medicaid benefits

  • Disaster or emergency situations: The government may declare an SEP for those affected by a disaster or emergency.

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