- The window for making changes opened on January 1 and closes on March 31.
- You can change your Advantage Plan or cancel it entirely.
- In any case, you should be aware of some limitations that come with the move.
Medicare beneficiaries may enroll in an Advantage Plan that does not meet their needs.
If you're in that situation this year, you only have a few weeks to make a change.
During a window that runs from January 1 to March 31, you can switch to a different Advantage Plan or drop your current one entirely in favor of basic Medicare (Part A hospital coverage and Part B outpatient care coverage).
"The most common reason people change is because something on their plan has changed that they don't like," said Danielle Roberts, co-founder of insurance firm Boomer Benefits.
For example, they may have discovered that a doctor they prefer is no longer in network, or that a medication they take is no longer covered.
About 26.9 million of Medicare's approximately 63.6 million beneficiaries are enrolled in Advantage Plans, which provide Parts A and B and, in most cases, Part D prescription drug coverage, as well as extras such as dental and vision. They do, however, have their own cost-sharing structures (deductibles and copays) and lists of drugs covered (and their costs), which vary from plan to plan.
The most common reason people change is because they discover... that something on their plan has changed that they don't like.
CO-FOUNDER OF BOOMER BENEFITS, Danielle Roberts
The current opportunity to change or drop your Advantage Plan began just weeks after the end of Medicare's annual fall enrollment period, when a variety of options were available for those who wanted to modify their coverage.
This Advantage Plan-related window, on the other hand, is restricted.
To begin, you can only make one switch. This means that if you switch to a different Advantage Plan or drop it in favor of basic Medicare, the change is generally permanent.
"Once you make your election, you're in this plan for the rest of the year," explained Elizabeth Gavino, founder of Lewin & Gavino and an independent broker and general agent for Medicare plans.
Furthermore, you are not permitted to switch from one standalone Part D prescription drug plan to another during this three-month period.
If you chose a Part D plan during the fall open enrollment period based on incorrect or misleading information, you can call 1-800-Medicare to see if your circumstances allow you to switch.
Meanwhile, dropping an Advantage Plan in favor of basic Medicare frequently results in the loss of drug coverage, necessitating enrollment in a separate Part D plan.
For each full month you go without drug coverage, you will be charged 1% of the national base premium ($33.37 in 2022).
Also, if you return to original Medicare and want to get a supplemental policy (also known as "Medigap"), keep in mind that you may not be eligible for guaranteed coverage. These policies either fully or partially cover the cost-sharing associated with some aspects of parts A and B, such as deductibles, copays, and coinsurance. They do, however, have their own set of rules for enrolling.
"In most states, you'll have to go through underwriting to get approved for a Medigap plan," Roberts explained. "So it's a good idea to apply for that first to ensure you'll be approved before canceling the Advantage Plan."
Also, if you missed your initial Medicare enrollment period and do not qualify for an exception, you can sign up during this window, which runs from January 1 to March 31. If you fall into this category, coverage will not begin until July 1.
