As a Medicare Advantage beneficiary, you can switch from one Medicare Advantage plan to another during the fall Open Enrollment Period, which runs from October 15 to December 7 each year.
You may also switch MA plans outside of the Open Enrollment period if you qualify for a Special Enrollment Period (SEP).
Below we examine some reasons why you may change Medicare Advantage plans and explain when you can make the switch.
Why would you change Medicare Advantage plans?
There are several reasons why you may switch from one Medicare Advantage Plan to another:
1. Your plan no longer works for your healthcare needs or budget
Each year, insurance companies can make changes to Medicare Advantage benefits, premiums, networks, cost-sharing and geographic service areas.
These changes may influence how much you pay for healthcare and could also impact which doctors and other providers are included in your plan.
You should review your Medicare Advantage plan each year to ensure it still works for your healthcare needs and budget. If you determine that your Medicare Advantage plan no longer works for you, we recommend doing a plan comparison of your current plan and other Medicare Advantage plans in your area.
When can I switch?
If you decide to switch MA plans because of any of the reasons listed above, you can switch during the Medicare Open Enrollment Period.
2. You move
If you move to a new address that isn’t in your MA plan’s service area, you can switch to a different Medicare Advantage plan (that is available in your new service area) or return to Original Medicare.
When can I switch?
Moving to an area that does not offer your current MA plan qualifies you for a Special Enrollment Period (SEP), so you do not have to wait until Open Enrollment to switch plans.
- If you tell your insurance company before you move, your chance to switch plans begins the month before the month you move and continues for 2 months after you move.
- If you tell your insurance company after you move, your chance to switch plans begins the month you tell your insurance company, plus two more full months.
3. Medicare terminates your MA plan’s contract
If Medicare terminates your plan’s contract, you can switch from your MA plan to another MA plan.
When can I switch?
Your chance to switch begins two months before and ends one full month after the contract is terminated.
4. Medicare does not renew your MA plan’s contract
If your MA plan’s contract is not renewed with Medicare, you can switch to another MA plan.
When can I switch?
December 8 through the last day in February.
These are just some examples of why you may switch Medicare Advantage plans. If you have specific questions about switching plans, a licensed insurance agent can help you better understand your situation and find a solution that works for you.
Comparing Medicare Advantage plans
Some things you should consider when comparing Medicare Advantage plans include:
- Monthly premiums
A premium is how much you pay each month for your Medicare plan. When you enroll in Medicare Advantage, you continue paying premiums for your Medicare Part B benefits. In 2019, the Part B premium is $135.50 per month. Some Medicare Advantage plans charge a monthly premium on top of your Part B premium1 and some do not. Medicare Advantage Premiums vary widely from insurance company to insurance company and from plan to plan, so it is important to shop around and compare premium costs before deciding on a policy.
A deductible is how much you must pay out of pocket for your health care before Medicare will begin paying its share. Insurance companies set their own Medicare Advantage deductibles, which can vary widely from plan to plan and from company to company.
- Copayments and coinsurance
Copayments and coinsurance are what you pay out-of-pocket for a service or procedure after your deductible is met. Copayments are usually a set amount ($20 for example), whereas coinsurance is usually a percentage.
- Plan networks
Some Medicare Advantage plans require you to stay within a specific network of doctors, hospitals and other health care providers. This means that the plan will not pay its share if you go outside of the network for care. Other MA plans allow you to go outside of the network, but you will likely pay more for your healthcare services if you do. If you’d like to keep your current doctor, be sure that he or she is part of your MA plan’s provider network and take time to familiarize yourself with the plan’s network restrictions.
- Out-of-pocket maximum
Unlike Original Medicare, Medicare Advantage plans have an out-of-pocket limit, which means that once you reach the limit amount, your Medicare Advantage plan covers 100 percent of covered medical costs for the rest of the year. Different MA plans have different out-of-pocket limits, however, so it’s important to keep that in mind when comparing plans.
- Prescription drug coverage
Many but not all Medicare Advantage plans provide coverage for prescription drugs. If a MA plan does not cover prescription drugs, you may be able to enroll in a Medicare Prescription Drug Plan (Medicare Part D). If your current MA plan includes prescription drug coverage and another MA plan does not, you may want to get a quote for a Part D plan and factor that into your budget.
Get a plan comparison from a licensed insurance agent
A licensed insurance agent can give you an in depth comparison of Medicare Advantage plans over the phone and get you enrolled in a Medicare Advantage plan that works for you. Speak with a licensed insurance agent at TTY Users: 711 24 hours a day, 7 days a week.
1 You must continue to pay your Part B premium. $0 premium plans may not be available in all areas.