Thursday, 18 April 2024

Understanding Medicare: Still time to change your Medicare health plan

Cate Kortzeborn is Medicare’s new regional administrator for Arizona, California, Hawaii, Nevada and the Pacific Territories. Courtesy photo.

Did you sign up for a Medicare Advantage health plan last year only to find that it doesn’t meet your needs? Not to worry.

You still have time to switch to another Medicare Advantage plan or return to Original Medicare.

Between Jan. 1 and March 31 each year, you can make the following changes during the Medicare Advantage Open Enrollment Period:

• If you’re in a Medicare Advantage plan (with or without drug coverage), you can switch to another Medicare Advantage plan (with or without drug coverage).

• You can drop your Medicare Advantage plan and return to Original Medicare. You’ll also be able to join a Medicare prescription drug plan (also known as a Part D plan).

During this period, you can’t:

• Switch from Original Medicare to a Medicare Advantage plan.

• Join a Medicare prescription drug plan if you’re in Original Medicare.

• Switch from one Medicare prescription drug plan to another if you’re in Original Medicare.

You can only make one change during this period, and any changes you make will be effective the first of the month after the plan gets your request.

If you’re returning to Original Medicare and joining a drug plan, you don’t need to contact your Medicare Advantage plan to disenroll. The disenrollment will happen automatically when you join the drug plan.

In most cases, you must stay enrolled for the calendar year, starting on the date your coverage begins.

However, you can make changes to your Medicare Advantage and Medicare prescription drug coverage when certain events happen in your life, like if you move or you lose other insurance coverage. These opportunities to make changes are called Special Enrollment Periods, or SEPs.

Rules about when you can make changes and the type of changes you can make are different for each SEP. You can learn more about SEPs here: https://www.medicare.gov/sign-up-change-plans/when-can-i-join-a-health-or-drug-plan/special-circumstances-special-enrollment-periods .

How do you switch? Follow these steps if you’re already in a Medicare Advantage plan and want to switch:

• To switch to a new Medicare Advantage plan, simply join the plan you want. You’ll be disenrolled automatically from your old plan when your new plan’s coverage begins.

• To switch to Original Medicare, contact your current plan, or call 1-800-MEDICARE (1-800-633-4227). TTY users can call 1-877-486-2048.

If you don’t have drug coverage, you should consider joining a Medicare prescription drug plan to avoid paying a penalty if you decide to join later. You may also want to consider buying a Medicare Supplement Insurance (Medigap) policy if you’re eligible.

You can find out more about Medigap here: https://www.medicare.gov/supplements-other-insurance/when-can-i-buy-medigap/4-steps-to-buy-a-medigap-policy .

For more details about Medicare Advantage plans, visit www.Medicare.gov/publications to view the booklet “Understanding Medicare Advantage Plans.”

If you believe you made the wrong plan choice because of inaccurate or misleading information, including information from Medicare’s online Plan Finder, call 1-800-MEDICARE and explain your situation. Call center representatives can help you throughout the year with options for making changes.

A final note: If you enrolled in a Medicare Advantage plan during your Initial Enrollment Period (when you first became eligible for Medicare), you can change to another Medicare Advantage plan (with or without drug coverage) or go back to Original Medicare (with or without a drug plan) within the first three months you have Medicare.

Cate Kortzeborn is Medicare’s regional administrator for Arizona, California, Nevada, Hawaii, and the Pacific Territories. You can always get answers to your Medicare questions by calling 1-800-MEDICARE (1-800-633-4227).

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