Changing Your Medicare Options

Medicare Advantage Annual Enrollment Period (AEP)

This period runs from October 15th to December 7th.  Here's what you can do during this period :

• Change from one Medicare Advantage plan or carrier to another.     

• Change from Original Medicare to Medicare Advantage or visa versa

• Add or drop a Medicare Prescription Drug plan (available with Original Medicare).

Changes made during the Annual Enrollment Period take effect on January 1st.  

Medicare Advantage Open Enrollment 

This period runs from January 1st - March 31st.  Here's what you can do:

• Change from one Medicare Advantage plan or carrier to another, while adding or dropping drug coverage.    

• Drop Medicare Advantage and return to Original Medicare. 

• Add a Medicare Prescription Drug Plan (if you have Original Medicare).  

Changes made during this period go into effect the first day of the month after the change.  

Medigap (Supplement) Open Enrollment Period:

The best time to add a Medicare Supplement is within the first 6 months of the start of your Part B coverage (you must have both Parts A & B).  Usually, this is at age 65.  During this period, you can get a policy at the best available rate, regardless of your health status.  Acceptance is guaranteed.

If you miss your Medigap Open Enrollment Period, you may be eligible for a Special Enrollment Period (SEP) - see below.  

If you miss Medigap Open Enrollment and do not qualify for a Special Enrollment Period, you can apply for a Supplement, but there are medical questions, your acceptance is not guaranteed, and even if you are accepted, costs may be high.  

Medigap (Supplement) Birthday Rule Open Enrollment

In 5 states (California, Idaho, Illinois, Nevada, and Oregon), the month or so following your birthday is considered an Open Enrollment period if you are already enrolled in a Medicare Supplement.  The Birthday Rule allows you to change your Medigap coverage without going through medical underwriting or answering health questions.  Each state has slightly different rules for this period, so check the rules that apply where you live.  

For example, in Illinois, people between 65 and 75 may change from one Medigap plan to another plan offered by the same carrier within 45 days, starting on the day of their  birthday each year.  The new plan must be of equal or lesser benefit than the existing plan. 

Special Enrollment Period (SEP) 

Life happens and conditions change, sometimes leaving you without health insurance.  What do you do?  Call your agent and find out if you qualify for a Special Enrollment Period.  Here are some of the circumstances that would trigger a SEP:

• • • • You moved.  You moved to a new location that your old plan doesn't cover; you have new plan options in this new residence area; you moved back to the U.S. after living abroad; you were released from jail; or you moved out of an institution.    

      • You lost current coverage. You left group coverage through an employer; your Medigap, Medicare Advantage, or PACE+ plan carrier ended coverage; or you are no longer eligible for Medicaid.

      • You enrolled in other coverage.  You joined a private employer or union plan; enrolled in drug coverage through TRICARE or the VA; or enrolled in PACE.

      • You have a severe or disabling condition. Your diagnosis might qualify you for a Special Needs Plan.  Or, if you are already enrolled in such a plan and no longer have that condition, you need to drop it. 

      • You are in the Medicare Advantage "trial period." This is the one-year period during which you first try Medicare Advantage.  If you don't like it, you can drop it and go back to Original Medicare with your Supplement.  

There are other SEPs that may be issued following flooding and other natural disasters, and there are SEPs for other situations. Talk to your Medicare agent if you think you would qualify for a SEP.  

+PACE is a Medicare and Medicaid program for the elderly that helps meet members' needs within the community.