Medicare Advantage Open Enrollment Period

If you are in a Medicare Advantage plan, then January 1 is the dawn of a new day in more ways than one. Each year, January 1 kicks off a three-month window that allows you to make changes to your Medicare coverage.

Here’s everything you need to know about the Medicare Advantage Open Enrollment Period.

If you begin the new year with Medicare Advantage coverage, you have the option to switch to new coverage.

The Medicare Advantage Open Enrollment Period begins January 1 and ends March 31 each year.

During this period, if you are already enrolled in a Medicare Advantage plan, you can:

• Switch from your current Medicare Advantage plan to another Medicare Advantage plan. You can switch regardless of whether your current or your new plan includes Medicare Part D drug coverage.

• Switch from Medicare Advantage back to Original Medicare. If you decide to return to Original Medicare, you will have the option to also add a standalone Part D plan (unlike Medicare Advantage, Original Medicare doesn’t bundle Part D coverage).

The federal Medicare program stipulates that you can have either Original Medicare or Medicare Advantage, but you can’t have both. Original Medicare features Part A (hospital insurance) and Part B (medical insurance) for adults age 65 and older and for people with certain physical or financial circumstances regardless of age. Medicare Advantage (also known as Part C) offers an alternative provided by private insurance companies that features Part A and B coverage and often includes other benefits like dental and vision coverage.

The Medicare Advantage Open Enrollment Period is for people already enrolled in Medicare Advantage. You cannot take part if you are enrolled in Original Medicare.

Changes will take effect on the first day of the month after your new plan receives your request.

Why Would I Switch to Another Medicare Advantage Plan?

Whether you just started a new Medicare Advantage plan on January 1 or you’ve been in the same plan for years, your plan might not be fulfilling all of your needs. Perhaps you just signed up for the first time and now realize you didn’t take everything into consideration. Or maybe you’ve been on cruise control with your old plan and aren’t sure it covers some of your circumstances that have changed over time.

Whatever the reason, the Medicare Advantage Open Enrollment Period could save the day — and save you from both a coverage and cost standpoint.

If you like the added benefits offered by Medicare Advantage but think another plan may add even more value than your current one, a GoHealth licensed insurance agent can help you compare your current plan to other ones available in your area.

What Should I Keep in Mind if I Want to Switch Back to Original Medicare?

If you plan to use the Medicare Advantage Open Enrollment Period to switch back Original Medicare, make sure you are in position to do what you want to do when it comes to Medicare Part D and Medicare Supplement Insurance (Medigap).

If you had Part D drug coverage as a part of your Medicare Advantage coverage, you shouldn’t have any difficulty adding a standalone Part D plan to your Original Medicare coverage. If you for some reason didn’t have drug coverage with Medicare Advantage but want it when you switch back to Original Medicare, you may face the same kind of late-enrollment penalties that you would face in similar situations when you chose not to carry creditable drug coverage.

While issues are relatively rare when it comes to Part D and switching back to Original Medicare, things can be trickier when it comes to adding Medigap when switching back. Medigap policies can only be paired with Original Medicare and help fill in the gaps in your out-of-pocket costs.

If you switch back to Original Medicare within the first 12 months that you have ever had a Medicare Advantage plan, you have a trial right that allows you to switch back to a Medigap plan you previously were in — no questions asked. But if you hadn’t previously purchased a Medigap plan or if you’ve had Medicare Advantage for more than one year, you may face some obstacles. You may be asked medical questions that could impact how much you’ll pay; you may face issues related to pre-existing conditions; and in some cases, you may not even be given the option of purchasing a Medigap plan. A GoHealth licensed insurance agent can help you weigh your options.

The Medicare Advantage Open Enrollment Period isn’t the only chance on the calendar for someone in a Medicare Advantage plan to make changes, but your chances are limited.

Medicare’s Open Enrollment Period: Also known as the Annual Enrollment Period, the period from October 15 to December 7 each year allows more people to make changes than any other dates on the calendar.

People in Medicare Advantage plans can make the same kinds of changes they can make during the subsequent Medicare Advantage Open Enrollment Period, but people on Original Medicare also can make changes. For example, you could switch from Original Medicare to Medicare Advantage during this period, with coverage taking effect January 1.

Special Enrollment Period: This period is individual in nature and isn’t associated with any set dates on the calendar. An example of a Special Enrollment Period would be an opportunity granted for you to change Medicare Advantage plans because you’re moving out of the area where your current plan’s network is located.

Another example is the 5-star Special Enrollment Period that allows you to switch to a 5-star plan (the highest rating) if you’re in a lower-rated Medicare Advantage or Part D plan.

Even if you take advantage of one of those periods, the Medicare Advantage Open Enrollment Period provides you with another option.

If you used Medicare’s Open Enrollment Period to enroll in Medicare Advantage for the first time, the Medicare Advantage Open Enrollment Period that follows on the calendar gives you the chance to make changes if your new plan isn’t meeting your needs like you thought it would. And if you made a change using a Special Enrollment Period, you still have the option of making other changes if need be during the Medicare Advantage Open Enrollment Period.