To obtain a high-quality plan, people should first look at the plan’s Medicare Star Rating, as it will help them compare the quality of Medicare plans offered by private insurance companies. Medicare rates every plan from one to five stars, where five is the highest rating. The rating of the plan is based on the performance of the plan in several categories including member experience and quality of care. People who want to switch to a 5-star plan in their area are allowed to change but they can do it once between December 8 and November 30.
Every year between October 15 and December 7 people are allowed to change their Medicare plan during which they can even switch to a new plan. The coverage of the new plan will become effective from January 1 of the following year. This is also known as the annual enrollment period. Outside of this window, people are not allowed to make changes in their plan until they choose to enroll in a 5-star plan, or something special happens in their life or to their plan.
Change of Plan Rules for Medicare Part A and Part B
There is a separate general enrollment window for Medicare Part B and also for Part A for people who have to pay a premium for it that runs from January 1 to March 31, and the coverage becomes effective from July 1. Medicare beneficiaries who didn’t enroll in Medicare Part B during their initial enrollment window, which starts when they turn 65, are allowed to enroll during the general enrollment period, which is the first three months of each year, January 1 to March 31. However, people are required to pay a penalty if they enroll during the general enrollment period. The premium gets increased by ten percent for each year that enrollment was delayed if the individual was not covered by a creditable employer-sponsored plan during the period that enrollment was delayed.
Rules for Switching for Medicare Advantage and Part D Plan
The open enrollment period for Medicare Advantage and Medicare Part D also runs from October 15 to December 7, during which people can either enroll in a new plan or switch to another Medicare Plan that will become effective from January 1. Beneficiaries of Medicare Advantage plan can make use of the open enrollment window to switch to Original Medicare or a Medicare Part D prescription drug plan if they prefer and they also have the option to switch to a different Medicare Advantage plan. During this annual window, people can make only one plan change, in contrast to the fall open enrollment period, when beneficiaries can change their plan several times.
Ways to Switch from Medicare Advantage Plans
No doubt Medicare Advantage has become increasingly popular, as thirty-four percent of beneficiaries enrolled in Advantage plans in 2019. Thus, to protect Medicare beneficiaries, lawmakers provided hatches for Medicare Advantage enrollees who decide to switch back to Original Medicare. Enrollees can switch back to Original Medicare in the following ways:
- People can make changes during the general open enrollment period i.e. October 15 to December 7, with changes effective January 1.
- Enrollees of the Medicare Advantage plan can switch back to Original Medicare during the first year on the Medicare Advantage plan.
- People can switch to Original Medicare during the annual Medicare Advantage open enrollment period. Medicare Advantage enrollees have the option to switch to a different Medicare Advantage plan during this time.
- People can switch to Original Medicare or to a different Medicare Advantage plan depending upon their situation if a special enrollment period becomes available.
Eligibility for a Special Enrollment Period
People can change their Medicare plans if certain changes in their life take place. The period during which people can make a change is called a special enrollment period. Life events that make people eligible for a special enrollment period include:
- If people move to a new address that is not included in their current plan’s service area.
- People lose their current employer-based coverage.
- People qualifying for additional help paying for their plan.
People looking to change Plan
People who want to change their plan should do the following things:
- People need to get in touch with their health insurance company for help.
- They should visit medicare.gov to check their eligibility to switch plans.
- People should consult a licensed health insurance broker or an agent who can help them find a new plan.