How To Switch Plans During Open Enrollment

Open enrollment exists to give beneficiaries the chance to make changes to their coverage and switch plans each year.

Your options during this period include switching from Original Medicare to Medicare Advantage or vice versa. You can also switch from one Medicare Advantage plan to another. In addition, you can look into adding a Part D plan or switching to a different Part D plan during this time.

Essentially, open enrollment gives you the chance to go over all your Medicare options and switch to the plan that makes the most sense for you.

When switching to a different Medicare plan, the most important thing to consider is what makes the most sense both financially and for your personal situation.

For example, you may have found in the last year that Original Medicare does not provide the level of coverage that you need. You could then use the open enrollment period to research Medicare Advantage plans available in your area and potentially switch to one that fits your needs.

Or you may find that Original Medicare is sufficient, but prescription drug coverage has become more important to you in the last year, and you’d like to join a Part D plan.

Even if you aren’t currently considering switching plans, it may be wise to take at least some time during open enrollment to review your other options since plan offerings can change year to year.

It’s important to note that this may be the only time of the year you can switch plans. However, if you have Medicare Advantage, then there is an additional enrollment window for beneficiaries on private plans from January through March.

You can opt to switch from Original Medicare to Medicare Advantage during open enrollment. While the federal government provides Original Medicare, private insurance companies offer Medicare Advantage plans.

These plans typically vary regionally, so you will need to research the plans that are available in your area and choose the option that best suits your personal situation and finances. You will have to enroll with the insurance company that is offering the plan you are interested in.

Some plans may offer you the ability to enroll directly on their website while others require a phone call.

You can use the Medicare Plan Finder tool to locate plans near you.

Even though Medicare Advantage plans are provided privately, they must cover, at minimum, everything that is covered through Original Medicare. They often include expanded coverage or benefits as well, but you may have to receive care within a network.

Medigap — which can help fill in some of the gaps and pay for some of the costs that Original Medicare doesn’t cover — may work a little differently when it comes to open enrollment.

You have a separate open enrollment period for Medigap that begins the month after the first month you have Part B and are 65 or older.

That period lasts for six months and allows you to enroll in any Medigap policy regardless of whether you have pre-existing health conditions.

If you look to purchase a Medigap policy after those six months, there may not be as many options available to you, and you can be denied by the plan.

According to the U.S. Centers for Medicare and Medicaid Services, you can get information on your Medigap options by calling your state insurance department or your State Health Insurance Assistance Program.

If you are happy with Original Medicare, there are standalone prescription drug plans that you can purchase from private insurance companies to pair with Medicare.

The first thing that you should do is research the plans that are available to you and compare your options. Remember that these options may change each year so it can be beneficial to review plans even if you aren’t on the market for a new plan.

You can also use the Medicare Plan Finder to compare options and contact plan providers directly to get additional information.

When going into open enrollment, know that a Medigap policy cannot be paired with Medicare Advantage. In fact, it is illegal for a company to sell you a supplement plan if you have Medicare Advantage.

It should also be noted that Medigap serves as supplement insurance, so it doesn’t actually replace Medicare Advantage.

If you have a Medicare Advantage plan but want Medigap, then you would need to switch back to Original Medicare and then apply for supplement insurance.

According to CMS, you will need to contact your Medicare Advantage plan to disenroll. If you had joined Medicare Advantage for the first time and are not happy with it, then you will have a trial right to get a Medigap policy after switching back to Original Medicare if you do so within 12 months of joining the Medicare Advantage plan.

If you do not have a trial right, you may struggle to get a Medigap policy since providers are able to deny you at that point.