How to Switch a Medicare Plan—and Why You Would

Medicare open enrollment begins soon, but 7 out of 10 Medicare beneficiaries say they don’t compare to Medicare plans during this period, according to a 2021 analysis by KFF, a health policy nonprofit.

That’s not great, because Medicare Advantage plans — which work like private insurance through your employer — change from year to year. Maybe one of your doctors has gone out of network or your prescription drug prices have gone up. And those with Original Medicare should compare their Part D prescription drug coverage.

Here’s how to switch Medicare plans.

Take advantage of enrollment period

If you have a Medicare plan, Medicare Open Enrollment from October 15 through December 7 is your opportunity to change coverage. You can switch from Original Medicare to Medicare Advantage, or vice versa, or enroll in or change a Medicare Part D prescription drug plan.

If you have Medicare Advantage, you can also use Medicare Advantage Open Enrollment from January 1 to March 31 each year to change plans or go back to Original Medicare and sign up for a Medicare Part D drug plan.

Consider Prescription Medications

If you’re on any prescription drugs, understand how your current plan will cover them in 2023 and whether another plan might be more affordable.

“It can be as simple as putting your medications in,” said Boston-based Medicare consultant Scott Maybor. “You should at least verify that ‘this is the plan I am on, this is the plan that is recommended, what are the savings?'”

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That’s because Part D prescription drug plans — whether you’re getting coverage with Original Medicare or through a Medicare Advantage plan — can change each year. You may find that one of your prescriptions will cost more in 2023, or that your plan will stop covering it. Or maybe you’ve started a new drug and found a plan that charges you less.

Don’t forget to browse your drug plan’s favorite pharmacies. “Sometimes it’s not just a matter of cost, it’s a matter of location,” said Karen Schechter, director and assistant professor of health care management and health administration programs at the University of Maryville. “If I’m the kind of person who has to refill prescriptions once a month, I don’t want to go to a place that’s too far away.”

Think carefully before leaving your Medigap plan

You are eligible for Medicare Supplement Insurance, or Medigap, for the first time when you turn 65 or older and have Medicare Part B. This six-month Medigap open enrollment period is only one-time, and you can buy any policy you want, regardless of your health. After that, you may not be able to get a Medigap plan — or it may cost more.

Medigap pays for many of the out-of-pocket costs of Original Medicare. If you have a serious or chronic health condition, this can lead to significant cost savings. Some people switch to Medicare Advantage plans during open enrollment, not realizing they may not be able to switch back to a Medigap plan later.

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Emily Gang, owner of The Medicare Coach, said, “Our clients are sitting at home, watching these commercials on television talking about free gym memberships, zero premiums, and they go ahead and make changes on their own. ” “They realize at the beginning of the year that they made a mistake and we can’t go back.”

complete the process

To sign up for a new plan, you’ll need your Medicare number and the date of your Part A and/or Part B coverage. (All of this information is on your Medicare card.)

You may be able to enroll online, but you may also have to make a call or two to:

— If you are switching from one Medicare Advantage plan to another Medicare Advantage plan, you will automatically be declined from your previous plan as soon as your new coverage begins.

— If you are switching from Medicare Advantage to Original Medicare, call 800-Medicare to make changes or call your plan provider to disenroll. Don’t forget to sign up for prescription drug coverage (Part D) to avoid paying a penalty.

— If you are switching from Original Medicare to Medicare Advantage, your new plan will transfer your benefits from Medicare. But you must cancel your enrollment from any Part D plan you have.

— If you are switching Part D drug plans, your old coverage will end when your new coverage begins.

— If you’re sticking with your current plan, do nothing. Your coverage will automatically renew.

This article was provided by personal finance site NerdWallet to the Associated Press. Kate Ashford is a writer at NerdWallet.

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