How to Switch Medicare Advantage Plans
Most people have to wait until open enrollment season to change Medicare Advantage plans. But you still have time to switch to traditional Medicare.
I signed up for a new Medicare Advantage plan this year but discovered that some of the doctors I want to use aren't included. Is it too late to switch to another plan?
You generally can't switch from one Medicare Advantage plan to another until open enrollment for 2016, which is October 15 to December 7. There are a few exceptions, such as if you move to an address that isn't in your plan's service area. See the Special Enrollment Periods fact sheet at Medicare.gov for a full list of special circumstances that let you switch plans outside of open enrollment.
You can also switch into a Medicare Advantage plan with a five-star quality rating anytime during the year, if one is available in your area. Use the Medicare Plan Finder to see if there are any five-star plans based on your zip code. Such plans aren't common. Only 11 Medicare Advantage plans with prescription-drug coverage earned five-star ratings for 2015; they are available in certain counties in California, Colorado, Florida, Hawaii, Iowa, Maine, Maryland, New Hampshire, Ohio, Oregon, Virginia, Washington and Wisconsin, as well as in Washington, D.C. Five-star Medicare Advantage plans without prescription-drug coverage are available in certain counties in Illinois, Iowa and Wisconsin.
If you don't qualify for a special enrollment period and don't have a five-star plan in your area, you can't switch Medicare Advantage plans now. But you do still have time to leave your Medicare Advantage plan and switch to traditional Medicare plus a Part D prescription-drug plan. The Medicare Advantage disenrollment period lasts from January 1 to February 14, and changes take effect at the start of the following month. For more information, see When Can I Join a Health or Drug Plan? You can also get a lot of information about your options from the Medicare Rights Center's Medicare Interactive resource.
If you take advantage of the disenrollment period, you could be rejected for a Medicare supplement (medigap) plan. Medigap plans fill in the gaps, such as deductibles and co-payments, in traditional Medicare's coverage. But if you sign up for medigap more than six months after first enrolling in Medicare Part B, insurers in many states may charge you more or reject you because of pre-existing conditions. (You must sign up for Part B whether you have coverage provided through Medicare or through Medicare Advantage.)
Most state insurance departments have information about their state's medigap rules, and many include prices for each insurer's medigap plans available in the area. See the National Association of Insurance Commissioners' contact map for links to your state's department. For more information about medigap coverage, see The ABCs of Picking a Medigap Policy.