People who are members of Medicare Advantage (MA) plans have three additional months (January 1 -March 31st each year) to change their plan.
Why would you want to change your MA plans now?
Some reasons could include:
- You missed the Annual Fall Open Enrollment period (October 15-December 7)
- You didn’t realize your MA plan doesn’t include your medications, preferred doctors, hospitals, pharmacies, etc.
- Your health condition has changed and you want better/different coverage.
- Your financial situation has changed and you can’t afford the new Medicare Part B monthly cost ($170 for most people) for outpatient services plus your MA monthly premiums, deductibles, copayments, restrictions and exclusions of your current MA plan.
- You or your relative didn’t understand the limitations, cost, or consequences of their current plan.
- You got bad advice from a former friend or salesman.
Normally, you wouldn’t be able to change plans for these reasons during the calendar year, except in special circumstances (eg. moved out of service area, plan termination, end of employer coverage etc.). However, now you have 3 additional months to make a change each year.
To be eligible to make a change, you must currently be a subscriber of a Medicare Advantage plan (as opposed to being a subscriber to Original Medicare).
What are Some Permitted Changes?
- You can change from one MA plan to another (either with the same or a different insurance company)
- You can select a new MA plan that either increases or decreases your coverage and/or cost.
- You can terminate your MA plan and switch to Original Medicare and buy (or not buy), a stand-alone Prescription Drug Plan (PDP).
- In some states, like New York, you can also choose to purchase a Medicare Supplemental (Medigap) plan for added coverage to Original Medicare, with or without purchasing a PDP.
How to Change Your Medicare Advantage Plan?
- If you want to explore other MA plan options with your existing MA insurance company, call their member services dept. (a phone number is listed on the back of your insurance card).
- If you purchased your plan through an insurance broker that you feel provides great service, call them.
- If you know one or more specific insurance companies and of their MA plans that you are considering, you can call and enroll in a specific plan by phone, on their website or on Medicare.gov. However, keep in mind, a company salesperson is only representing and getting paid by their company, so don’t expect them to recommend their competitors.
- If you want to compare options among different MA insurers in your service area, go to Medicare.gov and select “plan finder” and enter your information and select different insurance companies and their plans to compare.
Are there independent people who can help you review your options, their coverage & limitations and costs?
Yes, there are a number of free, independent people that don’t work for insurance companies or receive any sales commissions that can help you understand these complex issues. They include:
SHIP connects you with local individual and group information/assistance in your community regarding Medicare issues and questions.
Medicare Rights Center: 800-333-4114
MRC is a national non-profit agency that helps people with Medicare understand their rights, benefits and helps them navigate the complex Medicare system.
Please be cautious of responding to the endless TV ads with 60’s Jets quarterback Joe Namath and other TV personalities (The Medicare Helpline), door-to-door salespeople, group insurance presentations, emails, unsolicited phone calls and junk mail advertising to help “get you the free benefits that you are entitled to”. These are deceptive ads often using paid actors. They don’t represent Medicare or your health care providers. Their aim is to get you to call them and they will collect your personal information, sell it to a large national for-profit insurance company, who will follow-up and personally try to sell you their plans.
And, remember Medicare Advantage plans are big business for private insurance companies that receive taxpayer subsidies of approximately $12,000 a year per person. Most insurance companies don’t provide any health care services at all but rather provide obstacles to you and the healthcare providers that are trying to serve you.